Impacts of Mechanistic Target of Rapamycin (mTOR) Inhibition on Aged Human Muscle (Rapamune)

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexMale
Age50-90
SponsorUniversity of Nottingham

About this trial

As people age, muscle mass and function is lost and exercise training is an important way to reduce the effects of this and remain independent. However, not everyone can perform this exercise and the muscle responses to exercise are often reduced in older people. So far there has been no drug found to specifically treat or reduce this problem.

Muscle size depends on the balance of muscle protein breakdown and synthesis (building). This balance is regulated by multiple signals within the body, but a particular molecule - the mechanistic target of rapamycin (mTOR), is known to play an important role. For protein synthesis to build up the muscles, this pathway is needed to start the process when triggered by eating protein or exercise. Although this would suggest that mTOR activity is good, excessive levels of this signalling seem to have negative impacts on muscle maintenance with age.

In animal studies, blocking mTOR signalling has stopped the development of a number of age-related diseases and increased health-span. Drugs that block this pathway (e.g. Rapamune) reduce the stimulation of muscle protein synthesis, possibly through changing the immune system, but conversely have also been shown to increase muscle size and reduce markers of nerve supply loss. This means that drugs which block the mTOR pathway could, in older people, help to reduce the negative impacts of excessive mTOR signalling on muscle size and function.

The investigators aim to recruit 16 healthy male volunteers over 50 years old to investigate how the drug Rapamune (which blocks the mTOR pathway) affects aged human muscle both on its own and when combined with resistance exercise training.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Participant is willing and able to give informed consent for participation in the study

Participant is physically able to complete the resistance exercise training programme

Disqualifiers

• A BMI <18 or >35 kg/m2

Active cardiovascular, cerebrovascular or respiratory disease: e.g. uncontrolled hypertension (BP > 160/100), angina, heart failure (class III/IV), arrhythmia, right to left cardiac shunt, recent cardiac event, COPD, pulmonary hypertension or recent stroke

Any metabolic disease

Clotting dysfunction

Trial design

Design model

Parallel

Treatments tested in this trial

  • Rapamune (sirolimus) 1Mg Tablet

    Drug

    Take Rapamune to see the effect on muscle structure and function during a 14 week unilateral resistance exercise training programme.

  • Unilateral resistance exercise training

    Behavioral

    Participants will complete unilateral leg extension resistance training 3 times per week for 14 weeks at 75% of their 1 repetition maximum

Treatment groups

16 Participants
are divided into 2 treatment groups
Group A: Drug groupExperimental treatment 2 interventions
Group B: Placebo groupPlacebo comparator 1 intervention

Trial outcomes

Primary outcomes

1

Change in muscle mass from baseline

To determine the impacts of rapamycin, an mTOR inhibitor, on human muscle mass through whole body muscle mass measures by MRI and D3 creatine tracer, and ultrasound of the thigh muscles.

Time frame
0 and 16 weeks
2

Change in muscle mass from baseline

To determine the impacts of rapamycin, an mTOR inhibitor, on human muscle mass through whole body muscle mass measures by MRI and D3 creatine tracer, and ultrasound of the thigh muscles.

Time frame
0 and 8 weeks
3

Change in muscle mass from baseline

To determine the impacts of rapamycin, an mTOR inhibitor, on human muscle mass through whole body muscle mass measures by MRI and D3 creatine tracer, and ultrasound of the thigh muscles.

Time frame
0 and 5 weeks

Secondary outcomes

1

Change in muscle strength

To determine the impacts of rapamycin on muscle function through muscle strength measures of 1 Repetition Maximum

Time frame
0, 5, 8 and 16 weeks
2

Change in muscle power

To determine the impacts of rapamycin on muscle function through muscle power measured from countermovement jump analysis.

Time frame
0, 5, 8 and 16 weeks
3

Change in muscle function

To determine the impacts of rapamycin on muscle function through muscle performance measures included in the short performance physical battery test (SPPBT).

Time frame
0, 5, 8 and 16 weeks
4

Change in neuromuscular function

• To determine the impacts of rapamycin on muscle function through muscle-nerve electrical signals studied with electromyography (EMG).

Time frame
0, 5, 8 and 16 weeks

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

University of Nottingham

Lead sponsor

University of Oxford

Collaborator