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A New Model of Acute Febrile Disease

Primary Purpose

Immobilization, Tonic, Fasting, Endotoxemia

Status
Completed
Phase
Not Applicable
Locations
Denmark
Study Type
Interventional
Intervention
LPS, 36 hour immobilization and fast
Sponsored by
University of Aarhus
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Immobilization, Tonic focused on measuring immobilization, fasting, endotoxemia, LPS, metabolism, model of disease

Eligibility Criteria

20 Years - 40 Years (Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Male sex
  • 20 < BMI < 30
  • 20 < Age < 40 years
  • Written consent prior to trial

Exclusion Criteria:

  • Participation in trials using ionized radiation a year prior to this trial.
  • Comprehensive x-ray examinations in the study period.
  • In case of immobilization of an extremity, the extremity should be fully re- habilitated and this should be stated by a physician or physiotherapist. The test subject's word for this will be sufficient.
  • Allergies to eggs or soy oil.
  • Diseases: Diabetes, epilepsy, ongoing infectious disease, immunodeficiency, heart disease, dysregulated hypertension.

Sites / Locations

  • Institute for Clinical MEdicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

"LPS, 36 hour immobilization and fast"

"Control"

Arm Description

Interventions: Test subjects undergo 48 hour exercise restriction and overnight fast. Study day 1: - LPS (1 ng/kg) will be administered. Test subjects will fast and bedrest for the rest of the study period. Study day 2: 3 hour Basal period: Continued fast and bedrest. Phenylalanine, tyrosine, carbamide, glucose and palmitate tracers are infused. Muscle and fat biopsies are taken from m. vastus lateralis and stomach. 3 hour hyperinsulinemic euglycemic clamp period with muscle and fat biopsies. Study day 3: - Blood sample.

Test subjects undergo overnight fast. No exercise restrictions. 3 hour Basal period: Continued fast and bedrest. Phenylalanine, tyrosine, carbamide, glucose and palmitate tracers are infused. Muscle and fat biopsies are taken from m. vastus lateralis and stomach. 3 hour hyperinsulinemic euglycemic clamp period with muscle and fat biopsies.

Outcomes

Primary Outcome Measures

insulin sensitivity
Measured by hyperinsulinemic euglycemic clamp technique

Secondary Outcome Measures

Protein metabolism
Quantified by phenylalanine and tyrosine tracer methodology (whole body and the forearm model)
ketone body metabolic changes
measurement of ketone bodies
inflammation
Quantified by C-reactive peptide (CRP), white blood cell count, cytokines
Intracellular signalling pathway activation
Intracellular signalling pathway activation in muscle and fat
Energy expenditure
measured by indirect calorimetry
Glucose metabolism
measured by glucose tracer, calculations of rate of appearance, disappearance and endogenous glucose production
Hormonal changes
measures of insulin, glucagon, c-peptide and growth hormone
CD163
measures of CD163 and soluble CD163 (sCD163) after LPS exposure
Fat metabolism
measured by palmitate tracer, calculating whole body palmitate flux. Measures of free fatty acids.
Urea balance
measured by urea tracer and urine nitrogen excretion.
Glucose uptake by the forearm
Arterio-venous balance x blodflow

Full Information

First Posted
May 16, 2017
Last Updated
February 20, 2019
Sponsor
University of Aarhus
Collaborators
Arla
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1. Study Identification

Unique Protocol Identification Number
NCT03158363
Brief Title
A New Model of Acute Febrile Disease
Official Title
A New Model of Acute Febrile Disease - Combining Endotoxemia, Immobilisation and Fasting in Healthy Young Males.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
June 1, 2017 (Actual)
Primary Completion Date
August 31, 2017 (Actual)
Study Completion Date
August 31, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Aarhus
Collaborators
Arla

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The investigators want to establish a new model of acute febrile disease by mimicking the conditions seen in hospitalized patients in regards to inflammation, immobilisation and fasting. In this new model of disease, healthy young adults will be given lipopolysaccharide (LPS) to induce endotoxemia and inflammation/fever and then fast and bedrest for 36 hours. Glucose, fat and protein metabolism will be investigated using clamp technique and tracer methodology together with intracellular signalling pathway activation in muscle and fat biopsies. This new model of disease will later be used in another study to investigate different protein supplement´s effect on muscle waste during acute febrile disease.
Detailed Description
The investigators want to establish a new model of acute febrile disease by mimicking the conditions seen in hospitalized patients in regards to inflammation, immobilisation and fasting. In this new model of disease, healthy young adults will be given lipopolysaccharide (LPS) to induce endotoxemia and inflammation on study day 1 and then fast and bedrest for 36 hours (Study day 2). Glucose, fat and protein metabolism will be investigated using clamp technique and tracer methodology together with intracellular signalling pathway activation in muscle and fat biopsies. This new model of disease will later be used in another study to investigate different protein supplement´s effect on muscle waste during acute febrile disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immobilization, Tonic, Fasting, Endotoxemia, Metabolism
Keywords
immobilization, fasting, endotoxemia, LPS, metabolism, model of disease

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Healthy young adults will be randomized to either intervention "Endotoxemia, 36 hour immobilization and fasting" or "overnight fast" being the control day.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
"LPS, 36 hour immobilization and fast"
Arm Type
Experimental
Arm Description
Interventions: Test subjects undergo 48 hour exercise restriction and overnight fast. Study day 1: - LPS (1 ng/kg) will be administered. Test subjects will fast and bedrest for the rest of the study period. Study day 2: 3 hour Basal period: Continued fast and bedrest. Phenylalanine, tyrosine, carbamide, glucose and palmitate tracers are infused. Muscle and fat biopsies are taken from m. vastus lateralis and stomach. 3 hour hyperinsulinemic euglycemic clamp period with muscle and fat biopsies. Study day 3: - Blood sample.
Arm Title
"Control"
Arm Type
No Intervention
Arm Description
Test subjects undergo overnight fast. No exercise restrictions. 3 hour Basal period: Continued fast and bedrest. Phenylalanine, tyrosine, carbamide, glucose and palmitate tracers are infused. Muscle and fat biopsies are taken from m. vastus lateralis and stomach. 3 hour hyperinsulinemic euglycemic clamp period with muscle and fat biopsies.
Intervention Type
Other
Intervention Name(s)
LPS, 36 hour immobilization and fast
Intervention Description
LPS endotoxin is administered on study day 1 and immobilization and fast continue throughout study day 1 and 2.
Primary Outcome Measure Information:
Title
insulin sensitivity
Description
Measured by hyperinsulinemic euglycemic clamp technique
Time Frame
After a 3 hour clamp
Secondary Outcome Measure Information:
Title
Protein metabolism
Description
Quantified by phenylalanine and tyrosine tracer methodology (whole body and the forearm model)
Time Frame
measured at baseline and after 3 hours of clamp
Title
ketone body metabolic changes
Description
measurement of ketone bodies
Time Frame
measured at baseline and after 3 hours of clamp
Title
inflammation
Description
Quantified by C-reactive peptide (CRP), white blood cell count, cytokines
Time Frame
measurements over 36 hours
Title
Intracellular signalling pathway activation
Description
Intracellular signalling pathway activation in muscle and fat
Time Frame
measured at baseline and after 3 hours of clamp
Title
Energy expenditure
Description
measured by indirect calorimetry
Time Frame
measured at baseline and after 3 hours of clamp for 15 minutes
Title
Glucose metabolism
Description
measured by glucose tracer, calculations of rate of appearance, disappearance and endogenous glucose production
Time Frame
measured at baseline and after 3 hours of clamp
Title
Hormonal changes
Description
measures of insulin, glucagon, c-peptide and growth hormone
Time Frame
measured at baseline and after 3 hours of clamp
Title
CD163
Description
measures of CD163 and soluble CD163 (sCD163) after LPS exposure
Time Frame
0, 24 and 48 hours after LPS exposure
Title
Fat metabolism
Description
measured by palmitate tracer, calculating whole body palmitate flux. Measures of free fatty acids.
Time Frame
measured at baseline and after 3 hours of clamp
Title
Urea balance
Description
measured by urea tracer and urine nitrogen excretion.
Time Frame
measured at baseline and after 3 hours of clamp
Title
Glucose uptake by the forearm
Description
Arterio-venous balance x blodflow
Time Frame
measured at baseline and after 3 hours of clamp

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male sex 20 < BMI < 30 20 < Age < 40 years Written consent prior to trial Exclusion Criteria: Participation in trials using ionized radiation a year prior to this trial. Comprehensive x-ray examinations in the study period. In case of immobilization of an extremity, the extremity should be fully re- habilitated and this should be stated by a physician or physiotherapist. The test subject's word for this will be sufficient. Allergies to eggs or soy oil. Diseases: Diabetes, epilepsy, ongoing infectious disease, immunodeficiency, heart disease, dysregulated hypertension.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Niels Moeller, Professor
Organizational Affiliation
Institute for Clinical Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institute for Clinical MEdicine
City
Aarhus
ZIP/Postal Code
8000
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
No

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A New Model of Acute Febrile Disease

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