Evidence map›Paper›PMID 42035707›Full record

Observational studyJournal of cachexia, sarcopenia and muscle2026

Systemic Drivers and Molecular Mechanisms of Sarcopenia in Aetiology-Specific End-Stage Liver Disease.

Thomas Nicholson, Sophie L Allen, Jonathan I Quinlan, Amritpal Dhaliwal, Michael Macleod, Joshua Price, Jon Hazeldine, Michael S Sagmeister, Caitlin Ditchfield, Kirsty C McGee and 7 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Journal of cachexia, sarcopenia and muscle, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04734496 (Evaluation of Mechanisms of Sarcopenia in Chronic Inflammatory Disease), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04734496 unknown statusnot on this map

Evaluation of Mechanisms of Sarcopenia in Chronic Inflammatory Disease (Chronic Liver Disease, Inflammatory Bowel Disease and Inflammatory Arthritis) Pre and Post Standard of Care Intervention; an Observational Study

TypeobservationalSponsorUniversity of BirminghamRan2019 to 2021Enrolled170ConditionsChronic Liver Disease, Rheumatoid Arthritis, Inflammatory Bowel DiseasesArmsNational Healthcare System Standard of care for each disease type (National Institute for Health and Care Excellence guidelines)
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Thomas NicholsonNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Sophie L AllenNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Jonathan I QuinlanNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Amritpal DhaliwalNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Michael MacleodNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Joshua PriceNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Jon HazeldineDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Michael S SagmeisterNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Caitlin DitchfieldDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Kirsty C McGeeDepartment of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medicine and Health, University of Birmingham, Birmingham, UK.
Felicity R WilliamsNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Ahmed M ElsharkawyNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Matthew J ArmstrongNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Carolyn A GreigNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Janet M LordNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Leigh BreenNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.
Simon W JonesNational Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, UK.ORCID 0000-0001-6785-2310

Funding

NIHR Birmingham Biomedical Research Centre, Birmingham, UK
6 · The paper itself

Abstract

backgroundPatients with end-stage liver disease (ESLD) often present with sarcopenia, defined as loss of skeletal muscle mass and quality, which is associated with reduced quality of life and increased mortality. However, the molecular mechanisms driving sarcopenia in ESLD are not fully understood and there are currently no therapeutic interventions. This study aimed to identify potential circulating factors contributing to sarcopenia progression in ESLD by assessing their role in driving transcriptomic alterations in skeletal muscle.

methodsQuadriceps muscle tissue, plasma and serum were obtained from ESLD patients (n = 24) and age/sex-matched healthy controls (HC; n = 18) (Clinical Trial ID: NCT04734496, Ethical Approval 18/WM/0167). Total RNA from snap-frozen vastus lateralis muscle biopsies underwent RNA sequencing (Illumina). Serum concentrations of 60 cytokines were profiled by Luminex and ELISA, with comparisons made both between ESLD and HC, and across ESLD aetiologies (alcohol-related, NAFLD, viral hepatitis, other). In vitro, primary human myotubes (from non-ESLD aged donors, NRES #16/SS/0172) were treated with 10% ESLD or HC plasma (24 h, n = 6 per group) followed by RNA sequencing (BGI Genomics). Differentially expressed genes (p < 0.05, fold-change > 1.5) were identified via Qlucore and DESeq2, and pathway analysis performed using Ingenuity (Qiagen). The impact of physiological concentrations of candidate cytokines (IL-1α, GDF-15 and HGF) on myotube thickness, differentiation and mitochondrial function was assessed by immunofluorescence microscopy, RT-qPCR and metabolic flux assays.

resultsIn ESLD muscle, 387 and 225 genes were significantly up- and downregulated compared to HC, respectively, with cellular senescence identified as a top dysregulated function. Upstream regulator analysis predicted activation of hepatocyte growth factor (HGF) and interleukin-1 signalling. Subgroup analysis revealed distinct transcriptomic profiles based on disease aetiology. Serum profiling identified 15 cytokines significantly elevated (p < 0.05) and five reduced (p < 0.05) in ESLD, including increased HGF and reduced interleukin-1 receptor antagonist. Stratified analysis also revealed aetiology specific cytokine profiles, with only GDF-15 significantly (p < 0.0001) elevated in all groupsTwenty-four-hour ESLD plasma treatment induced 423 differentially expressed genes in human myotubes, which were again associated with significant activation of senescence pathways, with IL-1 identified as a key upstream driver. In vitro, IL-1α, GDF-15, and HGF significantly reduced myotube thickness, nuclear fusion index and perturbed metabolism (increased glycolysis, impaired oxidative phosphorylation).

conclusionsCollectively, these findings suggest that sarcopenia in ESLD is driven by aetiology-specific mechanisms, highlighting the potential for targeted therapies to improve muscle mass and function.

Indexed as

End Stage Liver DiseaseSarcopeniaAgedBiomarkersCytokinesFemaleHumansMaleMiddle AgedMuscle, SkeletalBiomarkersCytokinescytokinesend‐stage liver diseasehuman myotubessarcopeniaskeletal muscle

Identifiers

PMID42035707
PMCPMC13110875

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.