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Carnosine loading promotes exercise capacity in healthy older adults. As patients with chronic obstructive pulmonary disease (COPD) suffer from elevated exercise\u2010induced muscle oxidative\/carbonyl stress and acidosis, and from reduced muscle carnosine stores, it was investigated whether BA supplementation augments muscle carnosine and induces beneficial changes in exercise capacity, quadriceps function, and muscle oxidative\/carbonyl stress in patients with COPD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this double\u2010blind, randomized, placebo (PL)\u2010controlled trial (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link> identifier: NCT02770417), 40 patients (75% male) with COPD (mean\u00a0\u00b1\u00a0standard deviation: age 65\u00a0\u00b1\u00a06\u00a0years; FEV<jats:sub>1<\/jats:sub>% predicted 55\u00a0\u00b1\u00a014%) were assigned to 12\u00a0weeks oral BA or PL supplementation (3.2\u00a0g\/day). The primary outcome, i.e. muscle carnosine, was quantified from m. vastus lateralis biopsies obtained before and after intervention. Co\u2010primary outcomes, i.e. incremental and constant work rate cycle capacity, were also assessed. Linear mixed model analyses were performed. Compliance with and side effects of supplement intake and secondary outcomes (quadriceps strength and endurance, and muscle oxidative\/carbonyl stress) were also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Beta\u2010alanine supplementation increased muscle carnosine in comparison with PL in patients with COPD (mean difference [95% confidence interval]; +2.82 [1.49\u20134.14] mmol\/kg wet weight; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Maximal incremental cycling capacity (VO<jats:sub>2<\/jats:sub>peak: +0.5 [\u22120.7 to 1.7] mL\/kg\/min; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.384, Wpeak: +5 [\u22121 to 11] W; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.103) and time to exhaustion on the constant work rate cycle test (+28 [\u2212179 to 236] s; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.782) did not change significantly. Compliance with supplement intake was similar in BA (median (quartile 1\u2013quartile 3); 100 (98\u2013100)%) and PL (98 (96\u2013100)%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.294) groups, and patients did not report side effects possibly related to supplement intake. No change was observed in secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Beta\u2010alanine supplementation is efficacious in augmenting muscle carnosine (+54% from mean baseline value) without side effects\u00a0in patients with COPD in comparison with PL. However, accompanied beneficial changes in exercise capacity, quadriceps function, and muscle oxidative\/carbonyl stress were not observed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13048","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T02:30:00Z","timestamp":1660789800000},"page":"2361-2372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Efficacy of 12\u00a0weeks oral beta\u2010alanine supplementation in patients with chronic obstructive pulmonary disease: a double\u2010blind, randomized, placebo\u2010controlled trial"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3463-1911","authenticated-orcid":false,"given":"Jana","family":"De Brandt","sequence":"first","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL \u2010 Rehabilitation Research Center Hasselt University  Diepenbeek Belgium"},{"name":"BIOMED \u2010 Biomedical Research Institute Hasselt University  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Derave","sequence":"additional","affiliation":[{"name":"Department of Movement and Sports Sciences Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Vandenabeele","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL \u2010 Rehabilitation Research Center Hasselt University  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Pomi\u00e8s","sequence":"additional","affiliation":[{"name":"PhyMedExp University of Montpellier \u2013 INSERM \u2013 CNRS \u2013 CHRU Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Blancquaert","sequence":"additional","affiliation":[{"name":"Department of Movement and Sports Sciences Ghent University  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charly","family":"Keytsman","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL \u2010 Rehabilitation Research Center Hasselt University  Diepenbeek Belgium"},{"name":"BIOMED \u2010 Biomedical Research Institute Hasselt University  Diepenbeek Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina S.","family":"Barusso\u2010Gr\u00fcninger","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL \u2010 Rehabilitation Research Center Hasselt University  Diepenbeek Belgium"},{"name":"LEFiR \u2010 Spirometry and Respiratory Laboratory S\u00e3o Carlos Federal University \u2010 UFSCar  S\u00e3o Carlos S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabiano F.","family":"de Lima","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation Sciences, REVAL \u2010 Rehabilitation Research Center Hasselt University  Diepenbeek Belgium"},{"name":"Faculty of Science and Technology, Department of Physical Therapy, Postgraduate Program in Physical Therapy S\u00e3o Paulo State University (UNESP)  Presidente Prudente S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Hayot","sequence":"additional","affiliation":[{"name":"PhyMedExp University of Montpellier \u2013 INSERM \u2013 CNRS \u2013 CHRU Montpellier  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn A.","family":"Spruit","sequence":"additional","affiliation":[{"name":"Department of Research and Education CIRO+  Horn The Netherlands"},{"name":"Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism Maastricht University Medical Centre  Maastricht The 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