# Interrogating adrenal dysfunction to prevent muscle wasting after acute spinal cord injury

> **NIH NIH F31** · OHIO STATE UNIVERSITY · 2021 · $32,185

## Abstract

SUMMARY
Traumatic spinal cord injury (SCI) is a devastating condition that affects ~18,000 Americans annually, resulting
in death or a lifetime of severe disability. Early muscle wasting is an endemic consequence of SCI that contributes
to mortality, impaired functional recovery and the development of secondary complications. Current interventions
are not started until after considerable muscle wasting has already occurred during acute care and are minimally
effective. To reduce mortality and maximize quality of life, mechanism-based interventions are needed to protect
muscle and prevent wasting during the critical acute period ‘bridging’ between SCI and rehabilitation. Though
denervation and inactivity of paralyzed muscles are common explanations for muscle wasting, they cannot
explain the wasting of non-paralyzed muscles that occurs early after SCI. Interestingly, high thoracic level SCI
concurrently exacerbates acute hypercortisolism and systemic muscle wasting, compared to low thoracic level
SCI; Transient hypercortisolism during acute low thoracic SCI corresponds with transient non-paralyzed muscle
wasting, whereas progressive hypercortisolism corresponds with enduring non-paralyzed muscle wasting during
acute high thoracic SCI. SCI level-dependent hypercortisolism represents a systemic candidate signal
exacerbating systemic muscle wasting since glucocorticoids potently induce muscle wasting. This research will
investigate the cause of acute SCI level-dependent hypercortisolism and determine whether protecting muscle
from glucocorticoids attenuates systemic muscle wasting during acute high thoracic level SCI. Based on pilot
data, the investigators aim to determine whether SCI level-dependent acute hypercortisolism results from
skewed sympathetic control over adrenal function. Hypothalamic-pituitary-adrenal (HPA)-axis hormones, HPA-
axis function, and adrenal glucocorticoid synthesis during the acute phase of high and low thoracic SCI will be
profiled. Then, it will be investigated whether shielding the adrenal glands from spinal sympathetic reflex activity
by sympathetic denervation attenuates SCI level-dependent hypercortisolism. Subsequently, the investigators
will determine whether preventing muscle exposure to glucocorticoids through pharmacological glucocorticoid
receptor (GR) antagonism or knockout of muscle GR attenuates SCI level-dependent muscle wasting severity,
as determined by measures of muscle mass, muscle function, muscle composition and gene/protein expression
quantification of muscle wasting mediators. This research will be conducted by an MD/PhD candidate under the
supervision of 2 leaders in the field of SCI research and in collaboration with 3 neuromuscular experts. The
MD/PhD program is well established, and the institutional environment is exceptionally strong in SCI, myology
and endocrine research. The training plan consists of opportunities to develop the foundational scientific
knowledge, independence, technical expe...

## Key facts

- **NIH application ID:** 10269923
- **Project number:** 5F31NS117124-02
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Markus E. Harrigan
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $32,185
- **Award type:** 5
- **Project period:** 2020-09-30 → 2022-05-09

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10269923

## Citation

> US National Institutes of Health, RePORTER application 10269923, Interrogating adrenal dysfunction to prevent muscle wasting after acute spinal cord injury (5F31NS117124-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10269923. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
