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SarcopeniaPA-AGENCT03446924

Determining the Muscle Anabolic Properties of Phosphatidic Acid.

A study testing Phosphatidic Acid and Rice flour in people with Sarcopenia, run by University of Birmingham at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Ageing is characterized by a loss of muscle mass that is detrimental for physical function and metabolic health and increases the risk of mortality. The loss of muscle protein mass with ageing is characterized by a blunted muscle anabolic response to nutrition and exercise. Read more about this study

Who is it for?
Ages 65 to 80 years, men onlyHealthy volunteers can take part
Conditions the study is for
Sarcopenia
What is being tested?
Phosphatidic Acid and Rice flour
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
16 participants
Where
1 siteUnited Kingdom
Study dates
Aug 2015to Sep 2017
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 to 80 years
  • Men only
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • Be a non-smoking male between 65 and 80 years.
  • Have a BMI between 18 and 25 kg/m2.
  • Be in good general health: no cardiovascular or metabolic diseases.

Who cannot join

  • Health problems such as: heart disease, rheumatoid arthritis, uncontrolled hypertension, poor lung function, or any health condition that might put you at risk when participating in this study.
  • Generalised neuromuscular disease (such as Parkinson's disease or motorneurone disease).
  • Failure to obtain clearance for exercise participation from your GP or negative advice given by your GP concerning exercise participation.
  • Involvement in regular structured resistance exercise training at the time of the study.
  • Consumption of any analgesic drugs, anti-inflammatory drugs, or medication that is known to affect protein metabolism (beta-blockers, corticosteroids, NSAIDs).
  • Participants who have undergone muscle biopsy testing or isotope infusion procedures within the last 5 years.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • University of Birmingham, School of Sport, Exercise and Rehabilitation Sciences

    Edgbaston, West Midlands, B15 2TT

Other trials in United Kingdom

About this study

Official title: Determining the Muscle Anabolic Properties of Phosphatidic Acid in Ageing.

Ageing is characterized by a loss of muscle mass that is detrimental for physical function and metabolic health and increases the risk of mortality. The loss of muscle protein mass with ageing is characterized by a blunted muscle anabolic response to nutrition and exercise. Thus, interventions to counteract muscle anabolic blunting in old age might assist in the long-term maintenance of muscle mass.

Phosphatidic acid (hereafter defined as 'PA') is a novel nutrient compound that has been suggested to play an important role in muscle growth. Oral consumption of PA may amplify the signalling response to nutrition and exercise and restore muscle anabolic sensitivity in older adults. In order for PA to be 'clinically' applied as a means to mitigate muscle loss in aged populations, we must first understand the efficacy and mechanisms underlying the anabolic properties of this compound, which have yet to be defined in man. The proposed pilot study is needed to investigate the acute muscle metabolic properties of oral PA supplementation in older individuals.

Sixteen healthy (non-obese, non-diabetic, non-smokers) older males aged 65-75 yrs will initially complete a lower-limb strength assessment and undergo a body composition scan. Between 4-14 days after these initial assessments, participants will be assigned to co-ingest 1.5g of either phosphatidic acid (N= 8; PA) or a non-caloric placebo (N=8; PL) after following a bout of moderate intensity, single leg resistance exercise. A stable isotope infusion will be combined with serial muscle biopsies from the thigh of each leg to determine the measure rates of muscle protein synthesis in the fasted state and in the 'early' and 'late' phase of feeding-only and exercise-plus-feeding.

Read the detailed description

The investigators will recruit 16 healthy (non-obese, non-diabetic, non-smokers) elderly men aged 65-80 yrs to complete a double-blinded, parallel designed study, in which they will be randomly assigned to a phosphatidic acid (N= 8; PA) or placebo (N=8; PL) treatment group, matched closely for anthropometric characteristics. Participants will be recreationally active, but not involved in structured exercise training. All study procedures will be clearly explained and written consent obtained prior to study participation.

Preliminary assessments Following explanation of the study and the acquisition of informed consent, participants will report to our laboratory at 0800 in an overnight fasted-state and having refrained from strenuous physical activity for >24 hrs. Participants will be weighed on a digital scale to the nearest 0.1 kg in light clothing. A dual x-ray absorptiometry (DXA) scan will be conducted to determine body composition (fat and fat-free mass). Following DXA scanning, single-leg one repetition maximum strength (1RM) will be determined for knee extension and leg press exercise machines. Selection of the limb to be exercised (dominant or non-dominant) will be randomized.

Experimental trials Between 4 and 14 days after the preliminary assessments, participants will report to the laboratory at ∼0700 following an overnight fast, having refrained from strenuous physical activity for 72 hrs previously. A catheter will be inserted into a forearm vein of both arms for frequent blood sampling (∼80mL in total) and a continuous infusion of a stable isotope amino acid tracer (L- [ring] 13C6 phenylalanine). Participants will remain in a supine position throughout the trial with the exception of the exercise bout. After 150 min of steady-state tracer infusion a muscle biopsy will be obtained from the vastus lateralis quadriceps muscle of a randomly selected leg under local anesthesia (1% lidocaine) using the Bergström biopsy needle technique. Thereafter, participants will perform a bout of single-leg resistance exercise on the opposite leg. Exercise will consist of 6 sets of knee extension resistance exercise at 75% of the pre-determined 1RM; a protocol designed to elicit 8-12 repetitions per set prior to the onset of volitional fatigue. Immediately after exercise, participants will ingest 750mg of PA or a placebo (both in non-identifiable capsule form) with water and a further 750mg of PA or placebo at 60 mins post-exercise. Thereafter, participants will lie in a supine position for the remainder of the trial. An individual with no direct study involvement will administer treatments in a double-blind manner. Investigators will be un-blinded to treatment arms upon completion of data analysis. At 150 and 300 min following treatment consumption muscle biopsies will be obtained from both legs. Thus, a total of 5 invasive muscle biopsies will be obtained during the trial, which precludes the use of a crossover design in older individuals. Each biopsy will be obtained from a separate incision spaced ∼3cm apart. This model of study design will permit us determine rates of muscle protein synthesis in the postabsorptive state and over the early (0-2.5 h), late (2.5-5 h) and aggregate (0-5 h) time-course.

Data Analyses To calculate muscle protein synthesis, the investigators will adopt sophisticated mass spectrometry techniques to determine isotopic tracer enrichment in biopsy-isolated muscle proteins and plasma. Intramuscular "anabolic signals" (in the mechanistic target of rapamycin pathway, a key regulator of cell size) will be determined via Western Blot (a technique to detect the content of specific phospho-proteins). Plasma insulin concentrations will be measured by immunoassay and plasma lipid profiles by Gas Chromatography Mass Spectrometry.

Conditions
Sarcopenia
Being tested
Phosphatidic Acid, Rice flour
Keywords
Nutraceuticals, Muscle anabolism, Ageing
Medical subject headings
Sarcopenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Phosphatidic AcidDietary supplement

    To be administered a single dose of 1.5 g phosphatidic acid in capsule form (250 mg / capsule).

  • Rice flourDietary supplement

    Rice flour placebo to be administered a single dose of 1.5 g in capsule form (250 mg / capsule).

Study groups in NCT03446924
Study groupRoleWhat they receive
ControlPlacebo comparatorThe control group will be given a single dose of 1.5 g rice flour in capsule form (250 mg / capsule). The gelatine capsules (MyProtein, Northwich, UK) used are identical to those used in the treatment group. Capsules are prepared by the investigatory team using good hygiene practice in the research kitchen of the School of Sport, Exercise and Rehabilitation (University of Birmingham).
Receives: Dietary Supplement: Rice flour
TreatmentActive comparatorThe treatment group will be given a single dose of 1.5g phosphatidic acid in capsule form (250 mg / capsule). Capsules are prepared by the investigatory team using good hygiene practice in the research kitchen of the School of Sport, Exercise and Rehabilitation (University of Birmingham). PA is considered a dietary supplement ingredient according to the US FDA. The source of PA will be a commercial available soy-derived PA (Mediator®, Chemi Nutra, White Bear Lake, MN). The safety of Mediator® Soy-PA has been thoroughly demonstrated in humans. Mediator® Soy-PA does not contain any compounds with narcotic, psychotropic or pharmaceutical effects and is in compliance with banned substances requirements as espoused by the World Anti-Doping Agency. Mediator® Soy-PA is not a medicinal product.
Receives: Dietary Supplement: Phosphatidic Acid

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Myofibrillar protein synthesis in response to oral phosphatidic acid or placebo ingestion alone or in combination with resistance exercise

    Myofibrillar protein synthesis will be determined via mass spectrometry to assess stable isotope enrichment of 13C6 phenylalanine isotope in the myofibrillar protein fraction of biopsy tissue. The standard precursor-product calculations will be applied, using plasma isotope enrichment as the precursor.

    Measured: The change in myofibrillar protein synthesis after treatment ingestion will be determined over 0-to-2.5 hours and 2.5-to-5 hours post-ingestion in rested and exercised legs

Secondary outcomes (1)
  1. Anabolic and proteolytic signalling phosphorylation

    Phosphorylation of key anabolic and proteolytic signalling intermediates that modulate myofibrillar protein synthesis will be determined via western blot technique

    Measured: The change in signaling protein phosphorylation from rest will be measured at 2.5 and 5 h after treatment ingestion in rested and exercised legs

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Feb 2018
  2. Study startAug 2015
  3. Primary completionMar 2017
  4. Study completionSep 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Model description
Parallel-designed study in which participants will be randomized to receive phosphatidic acid or placebo treatment. A parallel design was chosen due to the number of invasive muscle biopsies performed during each experimental trial.
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03446924
Sponsor's protocol ID
RG_14-192
Acronym
PA-AGE
Status last verified
Feb 2018
First submitted
15 Feb 2018
Last updated
27 Feb 2018
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Smeuninx B, Nishimura Y, McKendry J, Limb M, Smith K, Atherton PJ, Breen L. The effect of acute oral phosphatidic acid ingestion on myofibrillar protein synthesis and intracellular signaling in older males. Clin Nutr. 2019 Jun;38(3):1423-1432. doi: 10.1016/j.clnu.2018.06.963. Epub 2018 Jun 21.

    PubMed 29970319

Questions about this trial

What is this clinical trial studying?

A study testing Phosphatidic Acid and Rice flour in people with Sarcopenia, run by University of Birmingham at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Feb 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Myofibrillar protein synthesis in response to oral phosphatidic acid or placebo ingestion alone or in combination with resistance exercise (time frame: The change in myofibrillar protein synthesis after treatment ingestion will be determined over 0-to-2.5 hours and 2.5-to-5 hours post-ingestion in rested and exercised legs). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03446924, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Feb 2018.

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