EAA Intake to Optimize Protein Anabolism in COPD
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Chronic Obstructive Pulmonary Disease, Pulmonary |
| Therapuetic Areas: | Pulmonary / Respiratory Diseases |
| Healthy: | No |
| Age Range: | 45 - Any |
| Updated: | 9/9/2017 |
| Start Date: | January 2009 |
| End Date: | June 2018 |
Essential Amino Acid Intake to Optimize Protein Anabolism in Elderly COPD Patients
Weight loss commonly occurs in patients with chronic obstructive pulmonary disease (COPD),
negatively influencing their quality of life, treatment response and survival. Loss of muscle
protein is generally a central component of weight loss in COPD patients. Attempts to reverse
muscle loss in COPD by supplying large amounts of protein or calories to these patients have
been unsuccessful. Gains in muscle mass are difficult to achieve in COPD unless specific
metabolic abnormalities are targeted. The investigators recently observed that alterations in
protein metabolism are present in normal weight COPD patients. Elevated levels of protein
synthesis and breakdown rates were found in this COPD group indicating that alterations are
already present before muscle wasting occurs. Furthermore, reduced plasma essential amino
acid (EAA) levels were observed in COPD patients. These reduced EAA plasma levels were
significantly related with the presence of muscle wasting in COPD. Until now, limited
research has been done examining protein metabolism and the response to feeding in patients
with COPD. Previous studies support the concept of essential amino acids (EAA) as an anabolic
stimulus in the young and elderly and in insulin resistant states. Until yet no information
is present on the anabolic effects of EAA in elderly COPD patients.
It is therefore our hypothesis that a high-leucine essential amino acids mixture specifically
designed to stimulate protein anabolism will target the metabolic alterations of COPD
patients. In the present study, the acute effects of an EAA nutritional supplement on whole
body, muscle and liver protein metabolism will be examined in COPD patients and compared to a
supplement consisting of a balanced mixture of total amino acids. The principal endpoints
will be the extent of stimulation of whole body protein synthesis as this is the principal
mechanism by which either amino acid or protein intake causes muscle anabolism, and the
reduction in endogenous protein breakdown. Both endpoints will be assessed by isotope
methodology which is thought to be the reference method.
negatively influencing their quality of life, treatment response and survival. Loss of muscle
protein is generally a central component of weight loss in COPD patients. Attempts to reverse
muscle loss in COPD by supplying large amounts of protein or calories to these patients have
been unsuccessful. Gains in muscle mass are difficult to achieve in COPD unless specific
metabolic abnormalities are targeted. The investigators recently observed that alterations in
protein metabolism are present in normal weight COPD patients. Elevated levels of protein
synthesis and breakdown rates were found in this COPD group indicating that alterations are
already present before muscle wasting occurs. Furthermore, reduced plasma essential amino
acid (EAA) levels were observed in COPD patients. These reduced EAA plasma levels were
significantly related with the presence of muscle wasting in COPD. Until now, limited
research has been done examining protein metabolism and the response to feeding in patients
with COPD. Previous studies support the concept of essential amino acids (EAA) as an anabolic
stimulus in the young and elderly and in insulin resistant states. Until yet no information
is present on the anabolic effects of EAA in elderly COPD patients.
It is therefore our hypothesis that a high-leucine essential amino acids mixture specifically
designed to stimulate protein anabolism will target the metabolic alterations of COPD
patients. In the present study, the acute effects of an EAA nutritional supplement on whole
body, muscle and liver protein metabolism will be examined in COPD patients and compared to a
supplement consisting of a balanced mixture of total amino acids. The principal endpoints
will be the extent of stimulation of whole body protein synthesis as this is the principal
mechanism by which either amino acid or protein intake causes muscle anabolism, and the
reduction in endogenous protein breakdown. Both endpoints will be assessed by isotope
methodology which is thought to be the reference method.
In this study the investigators will test the following hypothesis: A high-leucine essential
amino acid mixture (dose of 7.0 g EAA + 15 g carbohydrates) will stimulate protein anabolism
to a greater extent than a standard balanced mixture of total (essential and non-essential)
amino acids (dose of 6.7 g total AA + 15 g carbohydrates) in COPD patients. The principal
endpoints will be the extent of stimulation of protein synthesis rate and the reduction in
endogenous protein breakdown. The current project will provide information that will enable
us to better understand the underlying metabolic mechanisms that regulate protein metabolism
in patients with COPD.
amino acid mixture (dose of 7.0 g EAA + 15 g carbohydrates) will stimulate protein anabolism
to a greater extent than a standard balanced mixture of total (essential and non-essential)
amino acids (dose of 6.7 g total AA + 15 g carbohydrates) in COPD patients. The principal
endpoints will be the extent of stimulation of protein synthesis rate and the reduction in
endogenous protein breakdown. The current project will provide information that will enable
us to better understand the underlying metabolic mechanisms that regulate protein metabolism
in patients with COPD.
Inclusion Criteria:
- Diagnosis of chronic airflow limitation, defined as measured forced expiratory volume
in one second (FEV1) less than 70% of reference FEV1
- Shortness of breath on exertion
- Age 45 years and older
- Clinically stable condition and not suffering from respiratory tract infection or
exacerbation of their disease (defined as a combination of increased cough, sputum
purulence, shortness of breath, systemic symptoms such as fever, and a decrease in
FEV1 > 10% compared with values when clinically stable in the preceding year) at least
4 weeks prior to the study
- Ability to lie in supine position for 6 hours
Exclusion Criteria:
- Established diagnosis of malignancy
- Presence of fever within the last 3 days
- Established diagnosis of Diabetes Mellitus
- Untreated metabolic diseases including hepatic or renal disorder
- Presence of acute illness or metabolically unstable chronic illness
- Recent myocardial infarction (less than 1 year)
- Use of long-term oral corticosteroids or short course of oral corticosteroids in the
preceding month before enrollment
- Any other condition according to the PI or study physicians would interfere with
proper conduct of the study / safety of the patient
- Failure to give informed consent
We found this trial at
1
site
529 West Markham Street
Little Rock, Arkansas 72205
Little Rock, Arkansas 72205
(501) 686-7000
University of Arkansas for Medical Sciences The University of Arkansas for Medical Sciences (UAMS) in...
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