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In this project, we propose to investigate the metabolic consequences of glucocorticoid therapy, given orally as a 6 day Medrol Dose pack, on human skeletal muscle as measured by western blotting and PCR and skeletal muscle mitochondrial capacity as measured by High-Resolution Respirometry in healthy individuals. Medrol is an FDA approved drug with many clinical indications.
Healthy male and female individuals ages 60 - 80 (n=10) will be studied before and after 6 days of treatment with self-administered daily oral methylprednisolone.
Subjects will report to the Texas A&M Human Clinical Research Facility (HCRF) for testing before (day 0) and after (day 6) methylprednisolone intervention. Each visit will consist of determination of lean and fat mass using DEXA and a single muscle biopsy. Blood will be collected (up to 15ml) at screening, baseline and the conclusion of the study to measure metabolites and hormones. Phone calls will be made to subjects mid-week (day 3) during the study period to ensure compliance and continued consent.
This will be an unblinded study. All participants will receive methylprednisolone treatment.
Therapeutic Interventions. Methylprednisolone (Medrol®) dose pack. Methylprednisolone is a glucocorticoid. Glucocorticoids are adrenocortical steroids, both naturally occurring and synthetic, which are readily absorbed from the gastrointestinal tract. Therapeutic methylprednisolone is approved for clinical use for a variety of disorders. Medrol®, the agent to be used in this study, is manufactured by Pfizer.
Medrol® is supplied as white tablets, of 4mg each. The tablets come in a commercially produced blister pack with instructions for each day of the 6 day dosing on the packaging. Subjects will receive a standard 6-day, graded dosing regimen of methylprednisolone (24mg, 20mg, 16mg, 12mg, 8mg, and 4 mg on days 1 through 6 respectively, Table 1 above). This methylprednisolone dosing regimen is commonly prescribed for the treatment of inflammation associated with a number of pathologies, including arthritic, respiratory, and neoplastic diseases. The Medrol® pack has clear instructions on how to administer the tablets and participants will be given additional instruction to ensure understanding for proper self-administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Methylprednisolone | Experimental | Methylprednisolone glucocorticoid Medrol Dose Pack Medrol is supplied as white tablets, of 4mg each. The tablets come in a commercially produced blister pack with instructions for each day of the 6 day dosing on the packaging. Subjects will receive a standard 6-day, graded dosing regimen of methylprednisolone (24mg, 20mg, 16mg, 12mg, 8mg, and 4 mg on days 1 through 6 respectively). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Methylprednisolone | Drug | 6 day dosing as dictated by Medrol 6 Day Dose Pack |
|
| Measure | Description | Time Frame |
|---|---|---|
| Oxidative Phosphorylation Capacity measured by high resolution tissue respirometry on day 0 | Oxidative Phosphorylation will be measured in muscle tissue using high resolution respirometry (Oroboros O2K) on day 0. | day 0 |
| Oxidative Phosphorylation Capacity measured by high resolution tissue respirometry on day 6 | Oxidative Phosphorylation will be measured in muscle tissue using high resolution respirometry (Oroboros O2K) on day 6, after the 6 day methylpredinsolone treatment. | day 6 |
| Expression level of NFKB Inducing Kinase (NIK) in tissue measured by real time PCR on day 0 | NIK expression will be measured in muscle tissue using real time PCR on day 0. | day 0 |
| Expression level of NFKB Inducing Kinase (NIK) in tissue measured by real time PCR on day 6 | NIK expression will be measured in muscle tissue using real time PCR on day 6, after the 6 day methylprednisolone treatment. | day 6 |
| Measure | Description | Time Frame |
|---|---|---|
| Lean Body Mass as measured by Dual Energy X-Ray Absorptiometry on day 0 | Lean body mass will be measured using a Hologic DEXA on day 0. | day 0 |
| Lean Body Mass as measured by Dual Energy X-Ray Absorptiometry on day 6 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Melinda Sheffield-Moore, PhD | Texas A&M University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Texas A&M University | College Station | Texas | 77843 | United States |
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| ID | Term |
|---|---|
| D008775 | Methylprednisolone |
| ID | Term |
|---|---|
| D011239 | Prednisolone |
| D011246 | Pregnadienetriols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
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Lean body mass will be measured using a Hologic DEXA on day 6, after the 6 day methylprednisolone treatment.
| day 6 |
| Fat Mass as measured by Dual Energy X-Ray Absorptiometry on day 0 | Fat mass will be measured using a Hologic DEXA on day 0. | day 0 |
| Fat Mass as measured by Dual Energy X-Ray Absorptiometry on day 6 | Fat mass will be measured using a Hologic DEXA on day 6, after the 6 day methylprednisolone treatment. | day 6 |
| D013256 |
| Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |