Advancement of biomedical knowledge is more rapid when translation of research findings can easily andefficiently span across different biological levels of organization. This process entails conversion of fundamentalmolecular insights (basic research) into novel and applied clinical therapies ('forward translation'), as well asdiscovery of molecular mechanisms for specific clinical observations at the population level ('reversetranslation'). As outlined in the Leadership and Administrative Core, one of the primary goals of the WFU OAICis to develop new tools and implement research strategies and infrastructure for fostering translationalresearch. The main goal of this Research Development Project is to expand the ability of the MolecularSciences Resource Core (MSRC) to facilitate reverse translational research by developing the infrastructure togenerate, analyze, and integrate encompassing data on changes in expression levels of genes in humantissues in response to clinical interventions. These data will lead to the generation of novel hypothesesregarding the molecular adaptations and mechanisms underlying improvements in physicalperformance/disability in response to such interventions, and will provide a tool by which OAIC investigatorscan incorporate investigation of biological mechanisms into their existing protocols.The proposed developmental project will accomplish this overall goal by expanding upon a unique clinicalfinding from our recently completed OAlC-supported randomized, controlled pilot study ('Optimizing bodycomposition for function in older adults; OPTIMA'). The OPTIMA study was designed to assess the effects ofcombining caloric restriction with the peroxisome proliferator-activated receptor (PPARy) agonist pioglitizoneand/or resistance training on physical function and body composition in 88 community-dwelling older (65-79 yrs)overweight/obese (BMI>27 kg/m2) adults randomized to a 4-month intervention of: 1) hypocaloric diet alone(DIET); 2) DIET plus 30 mg daily pioglitizone/Actos (PIO); 3) DIET plus resistance training (RT); or 4) DIETplus PIO and RT. We discovered a remarkable interaction of pioglitizone with resistance training that resultedin significant improvements in muscle power, but not muscle strength, (see section f) such that the participantsrandomized to DIET+PIO+RT experienced a two-fold greater improvement in knee extensor maximal torque(muscle power) than those randomized to DIET+RT only.The mechanism for this novel observation is unknown, but could be related to altered gene expression inmuscle in response to stimulation of PPARy by pioglitizone. PPARs are members of a nuclear hormonereceptor superfamily that act to regulate gene transcription, which in turn regulates a number of diverseprocesses including lipid and carbohydrate metabolism, as well as certain inflammatory pathways.1 The effectsof PPARy ligands such as pioglitizone can be tissue specific, are not completely understood, and can potentiallyinclude effects independent of PPARy stimulation. Therefore, we propose to utilize stored biopsy samples of thevastus lateralis muscle (taken before and after the interventions) to conduct gene expression microarrays,followed by pathway analysis to begin to develop an understanding of the underlying mechanism for thisinteraction. Dr. Loeser's previous experience in the use of microarray technology, which provides a geneexpression profile of a given tissue, coupled with a systems biology analytical approach (contributed by Dr.Fetrow), are ideal tools for the task of identifying previously unknown genes (and ultimately proteins) that maybe causally linked to a specific clinical observation. The array data and pathway analysis will be combined withclinical measures of physical function, fat distribution (by DXA and CT), histologic measures of muscle (alreadyin progress), and with examination of the expression of selected candidate genes, in order to gain a completepicture of the effect of the intervention. Integration of physical function outcomes with this systems approach toexamining mechanisms represents the current gold standard approach to providing comprehensive informationand additional insight into the mechanisms underlying aging-related loss of physical function.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Center Core Grants (P30)
Project #
2P30AG021332-06
Application #
7646025
Study Section
Special Emphasis Panel (ZAG1-ZIJ-8 (J1))
Project Start
2008-08-01
Project End
2010-05-31
Budget Start
2008-08-01
Budget End
2009-05-31
Support Year
6
Fiscal Year
2008
Total Cost
$39,313
Indirect Cost
Name
Wake Forest University Health Sciences
Department
Type
DUNS #
937727907
City
Winston-Salem
State
NC
Country
United States
Zip Code
27157
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Haykowsky, Mark J; Nicklas, Barbara J; Brubaker, Peter H et al. (2018) Regional Adipose Distribution and its Relationship to Exercise Intolerance in Older Obese Patients Who Have Heart Failure With Preserved Ejection Fraction. JACC Heart Fail 6:640-649
Messier, Stephen P; Resnik, Allison E; Beavers, Daniel P et al. (2018) Intentional Weight Loss in Overweight and Obese Patients With Knee Osteoarthritis: Is More Better? Arthritis Care Res (Hoboken) 70:1569-1575

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