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CompletedNCT03158363Updated Feb 22, 2019

A New Model of Acute Febrile Disease

An interventional study of LPS, 36 hour immobilization and fast in Immobilization, Tonic, Fasting and Endotoxemia, sponsored by University of Aarhus. Completed at 1 site in Denmark. Open to male participants aged 20 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-02-22.

Sponsored by University of Aarhus · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
6
Allocation
Randomized
Ages
20 Years to 40 Years
Sex
Male
01

Study 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.

Read the 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.

02

Conditions studied

  • Immobilization, Tonic
  • Fasting
  • Endotoxemia
  • Metabolism

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Keywords

  • immobilization
  • fasting
  • endotoxemia
  • LPS
  • metabolism
  • model of disease
03

Who can participate

Ages eligible
20 Years to 40 Years
Sexes eligible
Male
Accepts healthy volunteers
Yes

Inclusion criteria

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

Exclusion criteria

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.
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
6 participants (actual)

Study arms

  • Experimental
    "LPS, 36 hour immobilization and fast"

    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.

    Other: LPS, 36 hour immobilization and fast

  • No intervention
    "Control"

    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.

Interventions

  • OtherLPS, 36 hour immobilization and fast

    LPS endotoxin is administered on study day 1 and immobilization and fast continue throughout study day 1 and 2.

05

What researchers measure

Primary outcomes

  1. insulin sensitivity

    Measured by hyperinsulinemic euglycemic clamp technique

    Time frame: After a 3 hour clamp

Secondary outcomes

  1. Protein metabolism

    Quantified by phenylalanine and tyrosine tracer methodology (whole body and the forearm model)

    Time frame: measured at baseline and after 3 hours of clamp

  2. ketone body metabolic changes

    measurement of ketone bodies

    Time frame: measured at baseline and after 3 hours of clamp

  3. inflammation

    Quantified by C-reactive peptide (CRP), white blood cell count, cytokines

    Time frame: measurements over 36 hours

  4. Intracellular signalling pathway activation

    Intracellular signalling pathway activation in muscle and fat

    Time frame: measured at baseline and after 3 hours of clamp

  5. Energy expenditure

    measured by indirect calorimetry

    Time frame: measured at baseline and after 3 hours of clamp for 15 minutes

  6. Glucose metabolism

    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

  7. Hormonal changes

    measures of insulin, glucagon, c-peptide and growth hormone

    Time frame: measured at baseline and after 3 hours of clamp

  8. CD163

    measures of CD163 and soluble CD163 (sCD163) after LPS exposure

    Time frame: 0, 24 and 48 hours after LPS exposure

  9. Fat metabolism

    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

  10. Urea balance

    measured by urea tracer and urine nitrogen excretion.

    Time frame: measured at baseline and after 3 hours of clamp

  11. Glucose uptake by the forearm

    Arterio-venous balance x blodflow

    Time frame: measured at baseline and after 3 hours of clamp

06

Study locations

1 site
  • Institute for Clinical MEdicine
    Aarhus, 8000, Denmark
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03158363
Lead sponsor
University of Aarhus
Collaborators
Arla
Responsible party
Sponsor
First posted
May 18, 2017
Start date
Jun 1, 2017
Primary completion
Aug 31, 2017
Completion
Aug 31, 2017
Last update
Feb 22, 2019

Study contacts

Niels Moeller, Professor
principal investigator · Institute for Clinical Medicine

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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