# Cellular and Physical Function Outcomes Leading to Failed Muscle Recovery After Critical Illness

> **NIH NIH K23** · UNIVERSITY OF KENTUCKY · 2024 · $149,574

## Abstract

Project Summary
 Survival of critical illness such as sepsis and acute respiratory failure is accompanied by serious
physical complications with many patients acquiring long-term impairments. Mechanisms and factors that
impede the recovery of muscle size and function after hospitalization are not understood. It is unclear if
recovery after critical illness leads to a subsequent deficiency in the ability to make new proteins (protein
synthesis) or if a catabolic/inflammatory environment persists preventing muscle regrowth which involves
muscle stem cell (satellite cell) fusion to myofibers. We will address gaps in knowledge by studying skeletal
muscle proteostasis, cellular environment, and RNA and mitochondrial biogenesis after critical illness with
closely aligned physical function outcomes. Understanding the cellular environment in the period after hospital
release, and how it impacts muscle protein turnover will direct efforts to effective therapies to accelerate
muscle regrowth. The overall goal of this application is to identify cellular properties of muscle that may
contribute to long-term physical disability in survivors of critical illness. Overall, I hypothesize that aberrant
cellular processes in muscle are underlying prolonged functional impairments in patients after critical illness. In
Aim 1, we will determine the longitudinal trajectory of muscle and physical function recovery and establish
muscle morphological and cellular characteristics in patients after critical illness. We hypothesize that patients
with higher severity of illness in the ICU and with longer duration of mechanical ventilation will have the most
persistent muscle weakness and deficits in muscle power in recovery. In Aim 2, we will identify cellular
mechanisms that contribute to muscle dysfunction after critical illness. We hypothesize that patients with
persistent muscle weakness and fatigue have impaired mitochondrial function compared to controls. Moreover,
we hypothesize that survivors of critical illness have elevated myofibrillar protein synthesis and ribosome
biogenesis in early recovery, but muscle regrowth does not occur due to elevated proteolysis. The overarching
goal of this proposal focuses on elucidating the factors that lead to muscle mass dysregulation in recovery and
inform why some patients develop persistent disability and others gradually improve. The proposed mentoring
team provides the knowledge and training to develop into an independent clinical investigator integrating basic
and applied science. The proposed training plan in Aim 1 emphasizes clinical trial methodologies and complex
longitudinal analyses. For aim 2, the training focuses on skeletal muscle experiments; specifically, knowledge
to assess muscle proteostasis, mitochondrial content and function, and muscle morphology. I will learn the
technical skills to examine skeletal muscle including stable isotope labeling, immunohistochemistry, western
blot analysis, and microscopy will be ...

## Key facts

- **NIH application ID:** 10887478
- **Project number:** 5K23AR079583-03
- **Recipient organization:** UNIVERSITY OF KENTUCKY
- **Principal Investigator:** Kirby P Mayer
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $149,574
- **Award type:** 5
- **Project period:** 2022-08-08 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10887478

## Citation

> US National Institutes of Health, RePORTER application 10887478, Cellular and Physical Function Outcomes Leading to Failed Muscle Recovery After Critical Illness (5K23AR079583-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10887478. Licensed CC0.

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