Vamorolone treatment improves skeletal muscle outcome in a critical illness myopathy rat model

Hazem Akkad, Nicola Cacciani, Monica Llano-Diez, Rebeca Corpeno Kalamgi, Tamara Tchkonia, James L Kirkland, Lars Larsson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim: Critical illness myopathy (CIM) is a consequence of modern critical care, leading to skeletal muscle atrophy/paralysis with negative consequences for mortality/morbidity and health care costs. Glucocorticoids (GCs) have been proposed to trigger CIM. Here, we compare outcomes of two GCs, the commonly used prednisolone and the newly developed dissociative vamorolone in response to the intensive care unit (ICU) condition for 5 days, ie, sedation, immobilization, and mechanical ventilation. Methods: Rats were divided into a 0-day sham-operated control group, and three groups exposed to 5 days ICU condition during treatment with prednisolone (PRED) or vamorolone (VAM) or none of these GCs (ICU-group). Survival, body and muscle weights, cytokine concentrations, regulation of muscle contraction in single fast- and slow-twitch muscle fibres, myofibrillar protein expression and protein degradation pathways were studied. Results: Critical illness myopathy geno- and pheno-types were confirmed in the ICU group. However, VAM and PRED groups showed reduced atrophy/weakness than the ICU group, and muscle specific differences with more severe negative effects on fast-twitch muscle fibres in the PRED than the other groups. Conclusion: These results show that vamorolone provides a GC intervention superior to typical GCs in improving CIM outcomes. Further, the findings do not support the notion that moderate-dose GC treatment represents a factor triggering CIM.

Original languageEnglish (US)
JournalActa Physiologica
DOIs
StateAccepted/In press - Jan 1 2018

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Muscular Diseases
Critical Illness
Glucocorticoids
Skeletal Muscle
Intensive Care Units
Prednisolone
Fast-Twitch Muscle Fibers
Therapeutics
Slow-Twitch Muscle Fibers
Muscles
Muscular Atrophy
Critical Care
Muscle Contraction
Artificial Respiration
Paralysis
Immobilization
Health Care Costs
Proteolysis
Atrophy
Body Weight

Keywords

  • Glucocorticoids
  • ICU
  • muscle wasting
  • prednisolone
  • vamorolone

ASJC Scopus subject areas

  • Physiology

Cite this

Akkad, H., Cacciani, N., Llano-Diez, M., Corpeno Kalamgi, R., Tchkonia, T., Kirkland, J. L., & Larsson, L. (Accepted/In press). Vamorolone treatment improves skeletal muscle outcome in a critical illness myopathy rat model. Acta Physiologica. https://doi.org/10.1111/apha.13172

Vamorolone treatment improves skeletal muscle outcome in a critical illness myopathy rat model. / Akkad, Hazem; Cacciani, Nicola; Llano-Diez, Monica; Corpeno Kalamgi, Rebeca; Tchkonia, Tamara; Kirkland, James L; Larsson, Lars.

In: Acta Physiologica, 01.01.2018.

Research output: Contribution to journalArticle

Akkad, Hazem ; Cacciani, Nicola ; Llano-Diez, Monica ; Corpeno Kalamgi, Rebeca ; Tchkonia, Tamara ; Kirkland, James L ; Larsson, Lars. / Vamorolone treatment improves skeletal muscle outcome in a critical illness myopathy rat model. In: Acta Physiologica. 2018.
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