Effect of oral beta-alanine supplementation on muscle carnosine in patients with COPD: A double blind, placebo-controlled, randomized trial

Background: Patients with COPD suffer from elevated levels of exercise-induced muscle oxidative stress and lactate. A strategy to improve this dysfunction may be oral beta-alanine (BA) supplementation, which increases muscle carnosine (mCAR), an antioxidant and pH-buffer. This study aimed to investigate safety and efficacy of oral BA supplementation to increase mCAR in patients with COPD. Methods: A double blind, placebo-controlled, randomized trial (NCT02770417) was performed. Forty patients with COPD (65±6 y; 75% male; 55±14 FEV1%pred) were randomly assigned to either 12 weeks oral BA or placebo (PL). Biopsy of m. vastus lateralis was obtained before and after the intervention and mCAR was measured with high-performance liquid chromatography. Linear mixed model analysis was performed. Compliance based on pill count and personal diary, and safety of supplement intake were also assessed. Results: Compliance was similar in BA (median (Q1–Q3), 100 (98–100)%) and PL (98 (96–100)%). Except for minor gastrointestinal problems, which were similar in BA and PL (38% and 47% respectively), patients did not report severe complaints possibly related to supplement intake. Oral BA supplementation increased mCAR (pre: mean [95% CI], 4.25 [3.41–5.09]; post: 6.56 [5.52–7.60] mmol/kg wet weight) versus PL (pre: 4.06 [3.18–4.94]; post: 3.57 [2.51–4.63] mmol/kg wet weight) (P Conclusion: Generally, oral BA supplementation is safe and increases mCAR with 54% of baseline values in patients with COPD. Whether this increase in mCAR leads to scavenging of muscle oxidative stress and later onset of lactate formation will be elucidated in the future.