L-carnitine Group Research Articles

The capability of L-carnitine-mediated antioxidant on cock during aging: evidence for the improved semen quality and enhanced testicular expressions of GnRH1, GnRHR, and melatonin receptors MT 1/2.

Precise natural anti-oxidative compounds have facilitated the research of infertile gametes and the development of novel bio-therapeutics, especially the molecules that are based on the reduction of oxidative stress, such as L-carnitine (LC). In addition to, the defect in the functioning of sperm mitochondrial and the decreasing seminal antioxidant ability due to aging, its essential role in permitting the mitochondrial import and oxidation of long chain fatty acids is worthy. Therefore, current study was designed to investigate the effects of dietary LC on semen quality, seminal antioxidant activity, and their implications for the fertility in aged cocks for 12 wk. Supplementation of the feed with two different doses of LC (50 and 150mg/kg body weight/day) for 12 wk showed significantly increased in the reproductive activity of cock, in comparison to the control group. Seminal analysis showed that supplementation of LC significantly increased (P < 0.05) the sperm motility, concentration, livability, semen quality factor, seminal malondialdehyde concentration, catalase, and glutathione peroxidase activities. In addition, addition of LC significantly increased (P < 0.05) the plasma concentration of testosterone and prostaglandin E2 but posed no significant effect on the concentration of follicle-stimulating hormone. Furthermore, the findings of artificial insemination showed significant increased (P < 0.05) in the percentage of fertility in LC groups, while the percentage hatchability and mortality remained unchanged. Immunohistochemistry analysis revealed that LC significantly increased (P < 0.05) the testicular immunopositivity of MT1 and MT2. Moreover, the administration of LC to the aged cocks enhanced (P < 0.05) GnRH1 and GnRHR mRNA levels when compared with untreated cocks. The results of the present study suggest that LC treatment of aged cocks increases the seminal antioxidant enzymes and sexual hormones levels, which may improve the semen quality by increasing the expression of GnRH1 and melatonin receptors (MT1 and MT2) activities. Collectively, LC could be a suitable feed supplementation to increase reproductive activities through enhancing semen quality in aging cocks.

Impact of hormonal and non-hormonal treatments on milk production and reproductive performance of lactating New Zeland White rabbits

The present study aimed to determine the influence of equine chorionic gonadotropin (eCG), L-Carnitine (LC) and Royal jelly (RJ) treatments on milk production and subsequent reproductive performance of lactating NZW rabbits. A total 28 primiparous lactating New Zeland white (NZW) rabbits divided randomly into four groups (7 animals/ group): Group 1 (eCG group) on day 9 postpartum the females were treated with 50 IU eCG IM/ animal at 48hrs before mating. Group 2 (LC group): the rabbits were given 50 mg LC /kg. BW/ day for 21 days orally starting at 24hrs of parturition. Group 3 (RJ group) before mating the rabbits were given 100 mg RJ/ kg. BW/ day for 21 days orally starting at 24hrs of parturition. Group 4 was Control group (without any treatment). The reproductive parameters including receptivity, conception and kindling rate as well as litter size and weight at weaning (LSW & LWW) and pre-weaning mortality (PWM) were recorded. The results revealed that there were no significant differences in the number of services per conception, conception and kindling rate among eCG, LC, RJ and control groups, receptivity. Milk production, LSW and PWM were significantly improved after LC or RJ compared to eCG and control. In conclusion, the non-hormonal treatment (LC or RJ) supplementation can improve milk production and this positively reflected on LSW, LWW and PWM.

Randomized controlled trial of N-acetylcysteine versus l-carnitine among women with clomiphene-citrate-resistant polycystic ovary syndrome.

To compare clinical and metabolic profiles between N-acetylcysteine and l-carnitine among women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). A randomized trial at Zagazig University between January 2017 and March 2018. Women with CC-resistant PCOS were allocated randomly to receive CC plus N-acetylcysteine or CC plus l-carnitine. The primary outcome was clinical pregnancy rate; secondary outcomes were ovulation rate and metabolic changes. Overall, 162 women completed the study (N-acetylcysteine group, n=82; l-carnitine group, n=80). After 3months, there was no difference in pregnancy (P=0.15), ovulation (P=0.21), or spontaneous abortion (P=0.11) rates between the two groups. There was no significant decrease in BMI in either group (both P>0.05). There were improvements in menstrual pattern, follicle-stimulating hormone, luteinizing hormone, free testosterone, and insulin resistance markers in both groups (all P<0.05). An improvement in lipid profile was observed only in the l-carnitine group (P<0.001). N-Acetylcysteine treatment led to significantly greater improvement in free testosterone and insulin resistance parameters as compared with l-carnitine (all P<0.05). Both N-acetylcysteine and l-carnitine were equally effective in improving pregnancy and ovulation rates among women with CC-resistant PCOS. However, N-acetylcysteine was superior in ameliorating insulin resistance and only l-carnitine improved lipid profile. ClinicalTrials.gov: NCT03164421.

Effect of Adding L-Carnitine to Clomiphene Resistant PCOs Women on the Ovulation and the Pregnancy Rate

Background: polycystic ovary (PCO) syndrome is an endocrionologic disorder that affecting about 6-10% of women in their reproductive age. Conception rate with clomiphene citrate treated cycles is about 40% only and the number of ovulated oocyte decrease significantly with repeated cycles of ovulation. Objective: evaluation of the effectiveness of usage of clomiphene citrate with L-carnitine (LC) in induction of ovulation in clomiphene citrate resistant patients. Patients and Methods: Randomized controlled study included a total number of 50 women with clomiphene-resistant PCOs. They were divided into 2 groups, group (A) where patients received 100 to 150 mg clomiphene citrate from day three until day seven of the cycle and L-carnitine (LC) 3g daily till positive pregnancy test and group (B) received 100 to 150 mg clomiphene citrate with placebo. Results: There was statistically significant difference (p-value 17 mm and E2 on day of HCG injection. Conclusion: Adding L-carnitine to clomiphene from the follicular phase and extending through the luteal phase in patients with clomiphene-resistant PCOS, at the given dose and duration, may be of beneficial to the quality of ovulation and the clinical pregnancy rate.

Renal Protective Effect of Ginkgo biloba and L-carnitine Extracts against Pentylenetetrazol Induced Toxicity, Oxidative Stress, Injury and Proliferation Alternation in Epileptic Rats

Objectives: Ginkgo biloba leaf extract (GBLE) and L-carnitine extract are a commercial product used as a nutraceutic herbal widely. They have antioxidant and reactive oxygen species (ROS) scavenger. This study hypothesized that GB and L-carnitine may have protective effects against pentylenetetrazol (PTZ) induced oxidative damage in kidney in male albino rats.&#x0D; Materials and Methods: A total of 80 male albino rats were equally divided into eight groups (G1, control; G2, GBLE; G3, L-carnitine; G4, Pentylenetetrazole; G5&amp;G6, pre and post treated PTZ with L-carnitine groups respectively; G7&amp;G8, pre and post treated PTZ with GBLE respectively). Results: Serum urea, creatinine, uric acid and cystatin c were significantly increased in PTZ group when compared with control. Also; kidney homogenate MDA and DNA fragmentation were increased when compared with control while, significant decrease in CAT, SOD, GST and TAC in PTZ when compared with control. On other hand pre and post-treatment with L-carnitine and GBLE improved these parameters.&#x0D; Conclusions: The results revealed that; the treatment with L-carnitine improved these parameters more than GBLE and the results of post treatment were better than pre-treatment.

L-Carnitine Supplementation During Hepatitis C Virus Treatment with Sofosbuvir/Daclatasvir Plus Ribavirin: Effect on Anemia: A Pilot Study

AbstractBackground: In the direct acting antiviral era, the role of ribavirin (RBV) in the treatment of hepatitis c virus (HCV) remains crucial, especially in patients with liver cirrhosis and treatment experienced patients. L-carnitine was reported to improve anemia in patients with HCV treated with interferon alone or with ribavirin.Aim of Study: To evaluate the effect of L-carnitine on improving ribavirin induced hemolytic anemia in patients with HCV treated with sofosbuvir/daclatasvir plus ribavirin (SOF/DCV/ RBV).Patients and Methods: Naive patients with HCV related liver cirrhosis and treatment experienced patients who received prior interferon therapy were randomized to receive either SOF/DCV/RBV plus L-carnitine (n=49) or SOF/DCV/RBV (n=49) for 12 weeks as a control group. Changes in hemoglobin concentration, reduction of ribavirin dose and its effect on sustained virological response (SVR) were evaluated.Results: After 4 and 12 weeks of treatment, the hemoglobin concentration was significantly higher in the L-carnitine group than in the control group (p<0.001). RBV dose was reduced in 10.2% of patients in the L-carnitine group versus 22.5% in the control group. The adherence of patients to their ribavirin dose was higher in patients treated with L-carnitine than patients in the control group (89.8% vs. 77.5%). SVR12 rate in the L-carnitine group was higher than that in the control group (93.9%% vs. 87.8%).Conclusion: L-carnitine is effective in improving hemo-lytic anemia induced by ribavirin in patients treated for hepatitis C virus and increase patient's adherence to treatment that guarantees the best opportunity to achieve an SVR.

Effects of L-Carnitine on follicular reserve and Caspase-3 in transplanted mouse ovarian tissue

Introdution: One of the major challengs in ovarian tissue transplantation is overcomeing ischemia/ reperfusion injuries. During ischemia–reperfusion processes, oxygen free radicals constitute the most important component that induces damage of the grafted tissues. The aim of this study was to investigate the effect of L-Carnitine (LC) as an antioxidant on heterotopic transplantation of mouse ovarian tissue.&#x0D; Methods: In this laboratory experimental study, 5- week old female NMRI mice were divided into four groups: control, transplanted without administration (autograft), sham group (autograft+ saline) and LC group (autograft+ L- carnitine). Left ovarian tissues were transplanted into the Gluteal muscle for 3 weeks. After this time, ovarian tissues from all groups were removed and fixed in formalin for histological studies. Furthermore, rate of Caspase- 3 was assessed by immunohistochemistry test. Lipid peroxidation was assessed by measuring malondialdehyde (MDA). One-way ANOVA and Tudey test was used to analyze the data using the spss 16 software. Significance was defined as P≤0.0.&#x0D; Results: The study results indicated that total follicular count in transplantedwithout administration and sham groups was significantly lower than the control group (p&lt;0.05), but there was no significant difference between the control and LC groups. In addition, the rate of caspase-3 was decreased in the LC group, but no significant difference existed between all groups (p&lt;0.05). A significant reduction in the concentration of MDA was observed in the LC group than that in the other transplanted groups (p&lt;0.05).&#x0D; Conclusion: In this study, LC could improve the ovarian reserve to some extent, but its effect was not significant.

L-carnitine ameliorated weight loss in fasting therapy: A propensity score-matched study

l-carnitine infusion has been proven to reduce fasting-induced fatigue and hunger in patients with metabolic syndrome in our former study. However, the association between l-carnitine and clinical outcomes of fasting therapy is yet to be investigated. In this study, data from 192 patients who finished fasting therapy from September 2008 to July 2018 were reviewed, among which 142 patients received l-carnitine infusion in fasting regimen. Propensity matching was used to overcome retrospective bias. Patients’ anthropometric measurements and metabolic markers were evaluated. After propensity matching, 40 patients were included in each group. Weight (-4.05 ± 1.65 kg vs -3.25 ± 1.68 kg, P = 0.031) and BMI (-1.51±0.61 kg/m2 vs -1.20 ± 0.62 kg/m2, P = 0.036) decreased in both groups, but significantly more in l-carnitine group, while diastolic blood pressure (-1.67±9.82 mmHg vs -6.21±8.83 mmHg, P = 0.043) and triglycerides (-0.18±0.63 mmol/L vs -1.05±1.70 mmol/L, P = 0.007) decreased significantly more in non-l-carnitine group compared between groups, blood glucose did not differ significantly between groups. l-carnitine can boost the positive effects of fasting therapy on weight loss and maintain the stability of blood pressure.

Effects of cell proliferation and apoptosis of L-carnitine combined with epirubicin on different human lung adenocarcinoma cells

Objective To investigate the effect of L-carnitine (LCNT) combined with epirubicin (EPI) on cell proliferation and apoptosis of two lung adenocarcinoma cell lines (GLC-82 and A549). Methods GLC-82 and A549 cells were divided into control group, EPI group, LCNT group and EPI+LCNT group, respectively. The cell proliferation rate was examined by MTT assay 24 h after the treatment, and the cell cycle and cell early apoptosis were analyzed by flow cytometry. The expression of P53 and Bcl-2 proteins were detected by Western Blot. Results Compared with the control group, the proliferation rate of GLC-82 and A549 cells was 37.56%(P 0.05) after 24 hours of 20.00 μg/ml LCNT treatment indicating LCNT could promote the proliferation of GLC-82 cells. Compared with the EPI group, EPI+LCNT had smaller inhibitory effect on the proliferation of GLC-82 cells, and the inhibition rate of the EPI+LCNT group was 12.14% lower than that of EPI group (P 0.05). Conclusions Comparing with the EPI, the combination of LCNT and EPI has less proliferation inhibition and apoptosis induction on GLC-82 cells, and without significant effect on A549 cells. LCNT can promote the proliferation of GLC-82 cells and block the cell cycle at G0/G1 phase. This mechanism may be related to down-regulation of P53 protein and up-regulation of Bcl-2 protein expression. Key words: Lung neoplasms; Adenocarcinoma; Cell proliferation; Cell apoptosis; L-carnitine; Epirubicin

L-Carnitine plus metformin in clomiphene-resistant obese PCOS women, reproductive and metabolic effects: a randomized clinical trial

To evaluate the reproductive and metabolic effects of L-carnitine plus metformin in clomiphene citrate (CC) resistant obese polycystic ovary syndrome (PCOS) women. A double-blinded randomized controlled clinical trial, clomiphene-citrate resistant obese women were allocated randomly to receive CC plus metformin and L-carnitine (n = 138) or CC plus metformin and placebo (n = 136). The primary outcome was clinical pregnancy rate. The secondary outcomes were hormonal and metabolic profile changes in addition to ovulation and first trimester (13 weeks) miscarriage rates. Clomiphene-citrate, L-carnitine, and metformin group showed significant improvement in the menstrual regularity, ovulation rate, and pregnancy rate compared to CC plus metformin and placebo group (29% vs. 9%, 34.7% vs.11%, and 28.2% vs. 6.6%, respectively). No statistically significant difference in the miscarriage rate between the two groups (p = .08). After three months of treatment, the reduction in body mass index (BMI) was non-significant (p = .061) between both groups. The hormonal and metabolic parameters were more significantly improved in the L-carnitine group compared with the placebo group. l-Carnitine may act synergistically with metformin for improvement of reproductive performance, insulin resistance, and lipid profile in clomiphene-resistant obese PCOS women.

Antioxidant, antiapoptotic, antigenotoxic, and hepatic ameliorative effects of L-carnitine and selenium on cadmium-induced hepatotoxicity and alterations in liver cell structure in male mice

L-carnitine (LC) and selenium (Se) have significant protective and antioxidant effects on several tissues. Cadmium (Cd), widely used in some industries and emitted from fossil fuels, is a heavy metal having a number of side effects, including hepatotoxicity. This study aims to assess the ameliorative function of both LC and SeCl4 on cadmium chloride (CdCl2)-induced liver toxicity. In total, 70 male mice included in this study were allocated to seven groups: control, CdCl2, LC, SeCl4, CdCl2 plus SeCl4, CdCl2 plus LC, CdCl2 plus SeCl4 and LC groups. Hepatic aminotransferase (aspartate aminotransferase [AST] and alanine transaminase [ALT]) activity and tumor necrosis factor-alpha [TNF-α] levels, as well as the antioxidant biomarkers (superoxide dismutase [SOD], glutathione reductase [GRx], glutathione-S-transferase [GST] and catalase [CAT], were examined. Histological and transmission electron microscopic [TEM] variations in the liver were used as indicators of liver damage after the administration of CdCl2-alone or CdCl2 with LC, SeCl4, or both. Genotoxic effects of CdCl2 were also evaluated and the possible roles of SeCl4 and/or LC on the expression of the antioxidant enzymes were studied. Results showed that administration of LC and SeCl4 decreased CdCl2-induced increase in ALT and AST levels and reduced oxidative stress to normal levels. In addition, LC combined with SeCl4 had a highly synergistic effect and elevated significantly the enzymatic antioxidants and decreased lipid peroxidation levels compared with those in the CdCl2-treated group. It is clear from the data that both LC and SeCl4 inhibit liver injury and improve the redox state in mice.

Effects of pre-transplant L-carnitine supplementation on primary graft dysfunction in liver transplant recipients: a pilot, randomized, placebo-controlled clinical trial.

Primary graft dysfunction (PGD) and non-function (PNF) happen in 8.7-24.7% and 0.9-7.2% of liver transplant recipients, respectively. These phenomena increase treatment cost and patients’ death. This study assessed the effect of L-carnitine supplementation on the incidences of PNF/PGD in liver transplant recipients. This randomized, placebo-controlled, clinical trial was performed on adult liver transplant recipients. Patients took L-carnitine syrup 500 mg three times daily or placebo from the time of including in transplant waiting list until the day of transplant surgery (median 14 days, 1-192 days). Thirty-three patients in L-carnitine and 39 patients in placebo group completed the study. Although not statistically significant, PNF and PGD happened less frequently among recipients in L-carnitine compared with placebo group (3% vs. 12.8% for PNF; 15.2% vs. 30.8% for PGD). Alanine aminotransferase (ALT) and aspartate aminotransferase were lower in L-carnitine group at day 3 after transplantation. ALT declined more significantly within 48 h after transplantation in L-carnitine arm (median 120.50 vs. 79 IU/L; P = 0.03). One-month patients’ survival was significantly higher in L-carnitine versus placebo group (97% vs. 74.4%; P = 0.008). The rates of PNF and PGD in L-carnitine group were approximately one-fourth and one-half of placebo group respectively. One-month patients’ survival was higher in L-carnitine group.

Effects of L-carnitine and betamethasone on ischemia-reperfusion injuries and sperm parameters following testicular torsion in a rat model.

Testicular torsion is a consequence of spermatic cord twisting which causes progressive damage to the structure of the testis and reduces sperm quality and usually results in infertility. In the present study, with the assumption of the protective effects of L-carnitine and betamethasone against ischemia-reperfusion (IR) injuries, their effects on twisted testicles were evaluated and compared. Twenty Wistar rats were randomly divided into four groups and used in this study. Except for the Sham (S) group, testicular IR was induced surgically in three other groups, including Control (C), Betamethasone (BM), and L-carnitine (LC) groups. Betamethasone and L-carnitine were injected before detorsion in the BM and LC groups, respectively. After twelve hours of reperfusion, the testicles were detached, and prepared for sperm parameters evaluation such as sperm count, motility, viability, morphology, and chromatin quality, and histopathologic evaluations, including mean seminiferous tubular diameter (MSTD), germinal epithelial cell thickness (GECT), and Johnsen’s mean testicular biopsy scoring (MTBS). The MSTD, GECT, and healthy sperms in the C group were significantly lower than the other groups, while the BM and LC groups were significantly different from others in MTBS. The number of sperms and sperm motility in the BM group was significantly higher than the C group. Sperm viability in the BM and LC groups were significantly higher than the C group. The results of this study showed that both L-carnitine and betamethasone similarly can be effective in treating testicular IR injuries.

Effect of L-carnitine supplementation during in vitro maturation and in vitro culture on oocyte quality and embryonic development rate of bovines

Objective: To assess the effect of L-carnitine supplementation during in vitro oocyte maturation and in vitro culture process of bovine oocytes. Methods: L-carnitine (3.8 mM) was added to maturation medium and the effect was assessed in the quality (Experiment 1) and in the cleavage and 4-cells stage (Experiment 2). Besides, the effect of L-carnitine addition on maturation medium (3.8 mM) and culture medium (1.5 mM) on embryo rate production was assessed. In Experiment 1, bovine oocytes from abattoir were randomly separated into two groups (the control group and L-carnitine group) for in vitro maturation. Matured oocytes were examined for cumulus cells expansion as an indicator of maturation, and the content of the mitochondrial activity, the presence of lipid droplets, the reduced glutathione, and the reactive oxygen species were measured by using specific fluorochromes. In Experiment 2, oocytes were matured as performed in Experiment 1, afterward fertilized and cultured until day 3, and cleavage rate and 4-cells stage rate were determinated. In Experiment 3, in vitro maturation and fertilization were done as performed in Experiment 2, but at day 3 of culture, each group of embryos was separated into two new groups, and L-carnitine (1.5 mM) was added in culture media until day 8. The cleavage and embryo development rate were determined on the basis with the oocytes put on maturation. Hatching rate was calculated from cleaved embryos. Results: The cumulus expansion rate at grade III and mitochondrial activity were significantly higher in the L-carnitine group in comparison with the control group (P 0.05). In addition, cleavage and the proportion of embryo development and hatching rate were similar for all groups (P >0.05). Received 30 March 2019 Revision 10 May 2019 Accepted 18 July 2019 Available online 7 November 2019 Antioxidants Culture supplement Embryo development Lipid droplets Maturation Mitochondria Conclusions: L-carnitine as a supplement in culture media improves the cumulus expansion and increases the mitochondrial activity during in vitro maturation process but has no apparent effect on the cleavage and development of bovine embryos. Further investigations of L-carnitine addition on in vitro culture are needed to test their effect on embryo quality.

Effects of nine weeks L-Carnitine supplementation on exercise performance, anaerobic power, and exercise-induced oxidative stress in resistance-trained males.

[Purpose]Studies of L-carnitine in healthy athletic populations have yielded equivocal results. Further scientific-based knowledge is needed to clarify the ability of L-carnitine to improve exercise capacity and expedite the recovery process by reducing oxidative stress. This study aimed to examine the 9-week effects of L-carnitine supplementation on exercise performance, anaerobic capacity, and exercise-induced oxidative stress markers in resistance-trained males.[Methods]In a double-blind, randomized, and placebo-controlled treatment, 23 men (age, 25±2y; weight, 81.2±8.31 kg; body fat, 17.1±5.9%) ingested either a placebo (2 g/d, n=11) or L-carnitine (2 g/d, n=12) for 9 weeks in conjunction with resistance training. Primary outcome measurements were analyzed at baseline and at weeks 3, 6, and 9. Participants underwent a similar resistance training (4 d/w, upper/lower body split) for a 9-week period. Two-way ANOVA with repeated measures was used for statistical analysis.[Results]There were significant increases in bench press lifting volume at wk-6 (146 kg, 95% CI 21.1, 272) and wk-9 (245 kg, 95% CI 127, 362) with L-carnitine. A similar trend was observed for leg press. In the L-carnitine group, at wk-9, there were significant increases in mean power (63.4 W, 95% CI 32.0, 94.8) and peak power (239 W, 95% CI 86.6, 392), reduction in post-exercise blood lactate levels (-1.60 mmol/L, 95% CI -2.44, -0.75) and beneficial changes in total antioxidant capacity (0.18 mmol/L, 95% CI 0.07, 0.28).[Conclusion]L-carnitine supplementation enhances exercise performance while attenuating blood lactate and oxidative stress responses to resistance training.

Effects of l-carnitine administration on health-related quality of life during cisplatin-based chemoradiotherapy in patients with head and neck squamous cell carcinoma

ObjectivesCancer-related fatigue impairs daily functioning and negatively impacts health-related quality of life (HRQoL). Our previous study revealed that cisplatin-based chemoradiotherapy (CRT) impairs the carnitine system and carnitine deficiency leads to poor physical functioning. This open label, randomized, controlled prospective study investigated the effects of l-carnitine administration on plasma carnitine concentration, CRT-induced fatigue, and decline in HRQoL in patients with head and neck squamous cell carcinoma (HNSCC). MethodsPatients were divided into experimental group (received 1000mg of oral liquid l-carnitine once daily for 8 weeks) and control group. The primary and secondary endpoints were the change in HRQoL scores and the change in carnitine levels, respectively, from baseline (pre-CRT) to after CRT. ResultsThe mean total plasma carnitine concentration in the control group decreased significantly, 2 weeks after the end of chemotherapy, while no significant differences were seen in the l-carnitine group. l-carnitine administration, therefore, kept the physical functioning score unchanged. ConclusionOur study shows that patients who receive CRT experience chemotherapy-induced damage of carnitine homeostasis leading to deficiency of carnitine and impairment of HRQoL. l-carnitine administration is beneficial in improving the HRQoL in patients with HNSCC.

L-Carnitine as an additive in Tyrode's buffer during platelet storage.

: Platelets are stored at 22-24°C for 5 days, with gentle agitation. Platelet storage lesion decreases efficacy and safety of stored platelets. L-Carnitine is a nonessential amino acid. Its interference with arachidonic acid metabolism affects platelet functions and oxidative stress. Hence, our study focuses on the use of L-carnitine in storage solution and investigates its influence on platelet functions and oxidative stress. Platelets isolated from 4-month-old male Wistar rats were stored with and without L-carnitine (10, 50 and 100 mmol/l) at 22°C for 12 days. Various markers were analyzed on days 0, 4, 8 and 12. Aggregation with collagen decreased in LC100 (day 12), whereas adenosine triphosphate secretion increased in all L-carnitine groups. Glucose consumption was less in L-carnitine groups and pH was maintained at 7.4 in LC50 (day 8). Conjugate dienes (day 4) and thiobarbituric acid reactive substances (day 8) increased in LC10 and LC100. Protein carbonyls were maintained in L-carnitine groups. Catalase activity and total antioxidant capacity increased gradually. L-Carnitine proved to be beneficial in platelet storage solution. There was improvement in platelet metabolism, decrements in lipid peroxidation and elevations in total antioxidant capacity up to 12 days. However, pH results emphasize that platelets with L-carnitine (50 mmol/l) could be stored up to 8 days. Therefore, Tyrode's buffer with L-carnitine can be an effective storage solution for extended platelet storage. This study contributes towards the development of better storage solutions for platelets.

Effects of L-Carnitine on Mineral Metabolism in the Multicentre, Randomized, Double Blind, Placebo-Controlled CARNIDIAL Trial

Background: The use of L-carnitine has been proposed in haemodialysis (HD) when deficiency is present to improve anaemia resistant to erythropoietin stimulating agent, intradialytic hypotension or cardiac failure. We tested the effects of L-carnitine supplementation on parameters of chronic kidney disease-mineral bone disorder. Methods: CARNIDIAL was a randomized, double-blinded trial having included 92 incident HD subjects for a 1-year period to receive L-carnitine versus placebo. Determinant factors of C-terminal fibroblast growth factor 23 (cFGF23) and intact FGF23 were studied including Klotho level. The L-carnitine effect on mineral metabolism was analyzed between groups by mixed linear models for repeated measurements. Results: Klotho was below the lower limit of quantification (LLOQ) in 55% of the 163 samples. In multivariate analysis, cFGF23 was positively correlated with calcium and phosphate and was higher in subjects having Klotho > LLOQ. No correlation existed between Klotho and phosphate and phosphate was even higher in subjects having Klotho > LLOQ (p < 0.001). Both forms of FGF23 were not related to iron markers nor to IV iron dose. No L-carnitine effect was detected on parathyroid hormone (PTH) or FGF23 during the study period where PTH slightly decreased over time, whereas FGF23 increased. But calcium and phosphate increased more in the L-carnitine group. Conclusion: L-carnitine supplementation increased calcium and phosphate plasma concentrations with no detected downregulation effect on PTH and FGF23. (Clinical Trial 00322322, May 5, 2006).

L-Carnitine for the Treatment of Overt Hepatic Encephalopathy in Patients with Advanced Liver Cirrhosis.

Hepatic encephalopathy is a major complication in patients with advanced cirrhosis and is associated with poor prognosis. To evaluate the effectiveness of L-carnitine supplementation in patients with overt hepatic encephalopathy (OHE), outcomes were retrospectively analyzed in patients with OHE who were treated with intravenous branched-chain amino acids (BCAA), with or without intravenous L-carnitine. Twenty-six patients were treated with intravenous BCAA in addition to conventional agents such as lactulose and non-absorbable antibiotics (Group A), and 19 patients were treated with these agents plus intravenous L-carnitine (Group L). Changes in blood ammonia concentrations, hepatic coma grade and the Glasgow Coma Scale (GCS) were compared in the two groups. Recurrence-free survival (RFS) was evaluated in the two groups and in patients who were and were not administered oral L-carnitine supplementation. At baseline, GCS scores were significantly lower and deterioration in liver function greater in Group L. After 3 d of intravenous L-carnitine, however, GCS showed a significantly greater improvement in Group L than in Group A. Blood ammonia levels improved stably over time in Group L. Overall survival and RFS were similar in Group L and Group A, but median RFS was significantly longer in patients who did than did not receive oral L-carnitine supplementation (735 versus 497 d, p=0.03). Although these findings are preliminary, L-carnitine supplementation may be a therapeutic option for patients with OHE and disturbed consciousness.

Efficacy of L-carnitine supplementation for improving lean body mass and physical function in patients on hemodialysis: a randomized controlled trial.

Carnitine deficiency is common in patients on hemodialysis. However, the efficacy of L-carnitine supplementation for improving lean body mass (LBM) and physical function has not yet been evaluated. In this multicenter, prospective, parallel, randomized, controlled trial, 91 patients on hemodialysis who developed carnitine deficiency were randomly assigned to receive injections of 1,000 mg L-carnitine 3 times per week after each hemodialysis session (L-carnitine group) or no injections (control group) with monitoring for 12 months. The data for 84 of the 91 patients were available for analysis (L-carnitine group, n = 42; control group, n = 42). Dry weight and body mass index did not significantly change in the L-carnitine group, but significantly decreased in the control group. Arm muscle area (AMA) did not change significantly in the L-carnitine group but decreased significantly in the control group; the difference in mean AMA between the groups was 6.22% (95% confidence interval [CI] 1.90-10.5; P = 0.037). Hand grip strength did not change significantly in the L-carnitine group, but decreased significantly in the control group. The difference in change in hand grip strength between the groups was 4.27% (95% CI 0.42-8.12; P = 0.030). Furthermore, LBM did not change significantly in the L-carnitine group but decreased significantly in the control group; the difference in mean LBM between the groups was 2.92 % (95% CI 1.28-4.61; P = 0.0007). L-carnitine supplementation is useful in patients who develop carnitine deficiency on hemodialysis because it maintains physical function and LBM.