L-carnitine Supplementation Research Articles

Assessment of the Preventive Effect of L-carnitine on Post-statin Muscle Damage in a Zebrafish Model

Statins, such as lovastatin, are lipid-lowering drugs (LLDs) that have been used to treat hypercholesterolaemia, defined as abnormally elevated cholesterol levels in the patient’s blood. Although statins are considered relatively safe and well tolerated, recipients may suffer from adverse effects, including post-statin myopathies. Many studies have shown that supplementation with various compounds may be beneficial for the prevention or treatment of side effects in patients undergoing statin therapy. In our study, we investigated whether L-carnitine administered to zebrafish larvae treated with lovastatin alleviates post-statin muscle damage. We found that exposure of zebrafish larvae to lovastatin caused skeletal muscle disruption observed as a reduction of birefringence, changes in muscle ultrastructure, and an increase in atrogin-1. Lovastatin also affected heart performance and swimming behaviour of larvae. Our data indicated that the muscle-protective effect of L-carnitine is partial. Some observed myotoxic effects, such as disruption of skeletal muscle and increase in atrogin-1 expression, heart contraction could be rescued by the addition of L-carnitine. Others, such as slowed heart rate and reduced locomotion, could not be mitigated by L-carnitine supplementation.

In vitro production of desired sex ovine embryos modulating polarity of oocytes for sex-specific sperm binding during fertilization

The present study aimed to modulate the oxidative status-mediated polarity of the oocytes for sex-specific sperm fertilization to generate desired sex embryos. In vitro embryos were produced at different oxidative status, varying O2 concentrations, and without/with l-carnitine in maturation and culture media. The majority of the embryos produced at high oxidative stress were males whereas; low oxidative status favoured female embryos production. Low O2 doubled the proportion of female embryos (10.59 vs 21.95%); however, l-carnitine supplementation in media increased approximately seven-folds of the female embryos (12.26 vs. 77.62%) production. Oocytes matured at high oxidative status were in the repolarized state favouring positively charged Y sperm fertilization to produce significantly more male embryos. Low oxidative status favoured negatively charged X sperm fertilization to the oocytes in the depolarized state to produce more female embryos. Intracellular ROS was significantly low in female embryos than in males; however, female embryos were more stressful than males. The study concluded that the oxidative status-mediated alteration in pH of the medium to modulate the intracellular positive ions is the main critical factor to influence the sex of embryos through sex-specific sperms fertilization to the oocytes as per their polarity.

Effects of L-Carnitine and Fish Oil Supplementations in the Diet to Digestibility of Crude Fat, Fiber, and Feed Conversion in Native Chicken

The aim of this study was to find out the effect of L-carnitine and fish oils on crude fat and fiber digestibilities, and feed conversion in native chicken. This study used 100 Kampung chickens aged 20 weeks. Feed treatments were divided into four groups consisted of basal diet, basal diet supplemented by L-carnitine, basal diet supplemented by L-carnitine and Tuna fish oil, and basal diet supplemented by L-carnitine and Lemuru fish oil. The data observed in this study were crude fat consumption and digestibility, crude fiber consumption and digestibility, feed consumption, and feed conversion ratio (FCR). Those data were analyzed using analysis of variance and an orthogonal contrast test was applied to distinguish among groups. Statistical analysis showed that highly significant effects of L-carnitine and fish oils supplementation on crude fat and fiber consumptions, and crude fat digestibility were found in this study (P<0.01). Moreover, L-carnitine and fish oils supplementation in the diet significantly affected crude fiber digestibility, feed consumption, and FCR (P<0.05). In conclusion, supplementation of Tuna and Lemuru fish oils until 4% containing 30 ppm L-carnitine improved crude fat consumption, digestibilities of crude fat and fiber, and decreased crude fiber digestibility, feed consumption, and FCR.

The protective effect of L-carnitine supplementation on retinopathy of prematurity: A retrospective cohort study

Background/Aim: Retinopathy of prematurity (ROP) is important morbidity in premature infants and is the most common preventable cause of blindness in childhood. Carnitine is a key molecule in energy metabolism and in oxidation of fatty acids, which are the main structural component of phospholipid membrane of the brain and retinal cells. Premature babies are born with insufficient carnitine pools. This study aimed to evaluate the effect of carnitine replacement on ROP in premature infants aged < 34 gestational weeks. Methods: Premature infant records between 2014 and 2019 were retrospectively examined. All premature infants at gestational ages < 34 weeks were included. Data from the two groups who received/did not receive carnitine supplementation in total parenteral nutrition (TPN) over two consecutive time periods and whose ROP examination was complete were recorded retrospectively. Fifty-eight out of 125 infants were in the carnitine group, and 67 formed the non-carnitine group (CG and NCG, respectively). The morbidity data from subjects, especially those with ROP, who received (CG) and did not receive carnitine (NCG), were compared. Results: Of the 125 infants enrolled, no significant differences in gestational age (P = 0.323) or birth weight (P = 0.597) between the groups was found. The Cox regression analysis revealed that carnitine replacement in the premature infant was a protective factor for ROP (P=0.045, B= −0.933, hazard ratio 0.393, 95% confidence interval 0.158–0.978). Conclusion: Carnitine supplementation may offer protection from developing ROP during exposure to oxygen in premature infants.

Effects of dietary lipid, L-carnitine and L-lysine supplementation on the growth performance and body composition of Epinephelus lanceolatus larvae

The effects of different combinations of dietary lipid, L-carnitine and L-lysine on the growth performance and fatty acid profiles of larval grouper Epinephalus lanceolatus were evaluated. Eight treatment diets were formulated based on a 2x2x2 factorial design, namely 5 and 14% dietary oil mixture (3:1 fish oil/soybean oil), 0 and 0.5% L-carnitine and 0 and 2.83% L-lysine. Each diet was randomly assigned to triplicate groups of ten 0.08g E. lanceolatus larvae for 42 days. The grouper larvae fed with diets containing 14% lipid had significantly higher weight gain percentages than those fed with diets containing 5% lipid. The weight gain percentage of the grouper larvae fed with a diet containing both 14% lipid and 0.5% L-carnitine without added L-lysine was found to be the highest, while the addition of dietary 2.83% L-lysine failed to have any additive effect on the growth performance. With the dietary lipid being 14%, not only dietary L-carnitine but also L-lysine is able to decrease lipid and increase protein levels in grouper muscle. The supplementation of dietary L-carnitine with a high level of lipid is also able to reduce liver lipid level of groupers. The levels of n-3 highly unsaturated fatty acid (n-3 HUFA) analyzed from muscle and liver of grouper larvae fed with diets supplemented with L-carnitine were significantly lower than those of grouper larvae fed with diets devoid of L-carnitine. This study indicated that the diets containing a high lipid level supplemented with L-carnitine are able to enhance the growth performance of grouper larvae.

Dietary L-Carnitine Affects Leukocyte Count and Function in Dairy Cows Around Parturition.

In early lactation, an energy deficit leading to a negative energy balance (NEB) is associated with increased susceptibility to disease and has been shown to be an important factor during transition in dairy cows. L-carnitine as a key factor in the mitochondrial transport of fatty acids and subsequently for β-oxidation and energy release is known to modulate mitochondrial biogenesis and thus influence metabolism and immune system. In the current study, we characterized hematological changes around parturition and investigated the potential effects of dietary L-carnitine supplementation on immune cell functions. For this approach, dairy cows were assigned either to a control (CON, n = 30) or an L-carnitine group [CAR, n = 29, 25 g rumen-protected L-carnitine per cow and day (d)]. Blood samples were taken from d 42 ante partum (ap) until d 110 post-partum (pp), with special focus and frequent sampling from 0.5 to72 h post-calving to clarify the impact of L-carnitine supplementation on leukocyte count, formation of reactive oxygen species (ROS) in polymorphonuclear cells (PMN) and peripheral mononuclear cells (PBMC) and their phagocytosis activity. Blood cortisol concentration and the capacity of PBMC proliferation was also investigated. All populations of leukocytes were changed during the peripartal period, especially granulocytes showed a characteristic increase up to 4 h pp. L-carnitine supplementation resulted in increased levels of eosinophils which was particularly pronounced one day before to 4 h pp, indicating a possible enhanced support for tissue repair and recovery. Non-supplemented cows showed a higher phagocytic activity in PBMC as well as a higher phagocytic capacity of PMN during the most demanding period around parturition, which may relate to a decrease in plasma levels of non-esterified fatty acids reported previously. L-carnitine, on the other hand, led to an increased efficiency to form ROS in stimulated PMN. Finally, a short period around calving proved to be a sensitive period in which L-carnitine administration was effective.

Association Between Plasma L-Carnitine and Cognitive Impairment in Patients with Acute Ischemic Stroke.

L-carnitine has been shown to exert neuroprotective effects on cerebral ischemia, mainly by improving mitochondrial function and reducing inflammation. L-carnitine supplementation has also been promoted to enhance cognitive function. However, the relationship between L-carnitine and cognitive impairment after ischemic stroke has seldom been studied. We aimed to evaluate the association between plasma L-carnitine and poststroke cognitive impairment. The study sample population was drawn from the China Antihypertensive Trial in Acute Ischemic Stroke. Plasma L-carnitine were measured at baseline in 617 patients with ischemic stroke using ultrahigh-performance liquid chromatography-tandem mass spectrometry. Cognitive function was evaluated using the Montreal Cognitive Assessment at 3-month follow-up after ischemic stroke. Plasma L-carnitine were inversely associated with cognitive impairment at 3 months after ischemic stroke, and the adjusted odds ratio (95% CI) for the highest versus lowest quartiles of L-carnitine was 0.60 (0.37, 0.98; p for trend = 0.04). Each 1-SD increase in log-transformed L-carnitine concentration was significantly associated with a 15% (95% CI: 1%, 29%) reduction in the risk of cognitive impairment after stroke. The addition of L-carnitine to the model including conventional risk factors significantly improved the risk reclassification for cognitive impairment (net reclassification improvement: 17.9%, integrated discrimination improvement: 0.8%; both p < 0.05). Furthermore, joint effects of L-carnitine and inflammation markers were observed, and patients with higher L-carnitine and a lower inflammatory status simultaneously had the lowest risk of poststroke cognitive impairment. The present study provided prospective evidence on the inverse association between plasma L-carnitine and cognitive impairment after ischemic stroke.

Dietary Administration of L-Carnitine During the Fattening Period of Early Feed Restricted Lambs Modifies Ruminal Fermentation but Does Not Improve Feed Efficiency.

Early feed restriction of lambs may program animals to achieve reduced feed efficiency traits as a consequence of permanent mitochondrial dysfunction. The hypothesis at the background of the present study is that dietary administration of L-Carnitine (a compound that promotes the activation and transportation of fatty acids into the mitochondria) during the fattening period of early feed restricted lambs can: (a) improve the biochemical profile of early feed restricted lambs, (b) improve feed efficiency, (c) modulate the ruminal and intestinal microbiota, and (d) induce changes in the gastrointestinal mucosa, including the immune status. Twenty-two newborn male Merino lambs were raised under natural conditions but separated from the dams for 9 h daily to allow feed restriction during the suckling period. At weaning, lambs were assigned to a control group being fed ad libitum a complete pelleted diet during the fattening phase (CTRL, n = 11), whereas the second group (CARN, n = 11) received the same diet supplemented with 3 g of L-Carnitine/kg diet. The results revealed that even though L-Carnitine was absorbed, feed efficiency was not modified by dietary L-Carnitine during the fattening period (residual feed intake, p > 0.05), whereas ruminal fermentation was improved [total short-chain fatty acids (SCFAs), 113 vs. 154 mmol/l; p = 0.036]. Moreover, a trend toward increased concentration of butyrate in the ileal content (0.568 vs. 1.194 mmol/100 ml SCFA; p = 0.074) was observed. Other effects, such as reduced heart weight, lower levels of markers related to muscle metabolism or damage, improved renal function, and increased ureagenesis, were detected in the CARN group. Limited changes in the microbiota were also detected. These findings suggest that L-Carnitine may improve ruminal fermentation parameters and maintain both the balance of gut microbiota and the health of the animals. However, the improved ruminal fermentation and the consequent greater accumulation of intramuscular fat might have hidden the effects caused by the ability of dietary L-Carnitine to increase fatty acid oxidation at the mitochondrial level. This would explain the lack of effects of L-Carnitine supplementation on feed efficiency and points toward the need of testing lower doses, probably in the context of animals being fed in excess non-protein nitrogen.

The effects of l-carnitine supplementation on inflammatory factors, oxidative stress, and clinical outcomes in patients with sepsis admitted to the intensive care unit (ICU): study protocol for a double blind, randomized, placebo-controlled clinical trial

BackgroundSepsis is a common cause for admission to the intensive care unit (ICU), and its incidence has been increasing. It is associated with a significant increase in serum inflammatory biomarkers such as C-reactive protein (CRP) and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF). Sepsis is also associated with pathophysiological changes that include fluid accumulation in the lungs, eventually leading to acute respiratory distress syndrome (ARDS), tissue edema, hypotension, and acute kidney injury (AKI). Conventional therapies include antibiotics, but these may have important adverse effects, so novel therapeutic approaches are required. In animal studies, l-carnitine improves antioxidant status, and in some clinical trials, it has been shown to reduce inflammation. It has also been shown to improve respiratory distress and help maintain coenzyme A homeostasis, metabolic flexibility, promoting the normal function of the tricarboxylic acid (TCA) cycle, and oxidation of fatty acids by peroxisomes. We aim to determine the effects of very high doses of l-carnitine on inflammatory factors, oxidative stress, and clinical outcomes of patients with sepsis in ICU.Method and designIn this double-blind, randomized controlled clinical trial, we will use block randomization of 60 patients with sepsis, aged between 20 and 65 years from Al-Zahra Hospital, Isfahan, Iran. The intervention group (n = 30) will receive three capsules of l-carnitine (each capsule contains 1000 mg l-carnitine; totally 3000 mg/day) for 7 days, and a control group (n = 30) will receive a placebo with the same dose and for the same duration in addition to usual care. At baseline, scores for clinical and nutritional status (Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), and NUTRIC Score) will be assessed. At beginning and end point of the study, inflammatory markers (CRP, erythrocyte sedimentation rate (ESR)), oxidative stress status (total oxidative stress (TOS), total antioxidant capacity (TAC)), and clinical variables will be evaluated also. The mortality rate will be assessed within 28 days of the beginning of the intervention.DiscussionBecause of the anti-inflammatory and antioxidant properties of l-carnitine, it is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis.Trial registrationIranian Registry of Clinical Trials IRCT20201129049534N1. Registered on 2 May 2021.

L-Carnitine alleviates hepatic and renal mitochondrial-dependent apoptotic progression induced by letrozole in female rats through modulation of Nrf-2, Cyt c and CASP-3 signaling

Letrozole (LTZ) is a non-steroidal aromatase inhibitor that is commonly used in breast cancer therapy. It has several side effects that might lead to the drug's cessation and data of LTZ's potential adverse effects on the hepatorenal microenvironment was conflicting. In addition, searching for therapeutic interventions that could modulate its adverse effects will be very beneficial. So, this study aims to determine the impact of LTZ on the hepatorenal microenvironment in cyclic female rats with a proposed regulatory role of L-Carnitine (LC) supplementation giving molecular insights into its possible mechanism of action. LTZ (1 mg/kg using 0.5% carboxy methyl cellulose as a vehicle for 21 consecutive days orally) to assess its impact on hepatorenal microenvironment. After treatment with LC (100 mg/kg orally) for 14 days, hepatorenal redox state (lipid peroxides (MDA), reduced glutathione (GSH) and catalase enzyme (CAT)), as well as relative gene expression of nuclear factor erythroid 2-related factor 2 (Nrf-2), cytochrome-c (Cyt c) and caspase-3 (CASP-3) were evaluated. Histopathological examination and immunohistochemical staining of CASP-3 in both liver and kidney were done. LTZ altered hepatic and renal functions. Relative gene expression of hepatorenal Nrf-2, Cyt c and CASP-3 as well as redox state revealed significant deterioration. Also, the liver and kidney tissues showed several micromorphological changes and intense reaction to CASP-3 upon immunohistochemical staining. It can be concluded that LC alleviates LTZ induced hepatorenal oxidative stress (OS) and mitochondrial-dependent apoptotic progression through modulation of Nrf-2, Cyt c, and CASP-3 signaling in female rats.

Randomized Controlled Trial of Combined L-Carnitine Supplementation and Moderate-Intensity Exercises on Cardiovascular Markers and Bone Health Status in Overweight and Obese Individuals

This article aimed to determine effects of 12 weeks of combined L-carnitine supplementation and moderate-intensity exercise on cardiovascular markers and bone health status in overweight and obese individuals. Sixty-eight participants (mean age: 29.03 ± 6.02 years old) were divided into control (C), L-carnitine supplement (S), exercise (E), combined L-carnitine and exercise (SE) groups. Participants in S and SE groups consumed 1 tablet of 1000mg L-carnitine daily. Participants in E and SE groups performed 30 minutes of brisk walking (50% HRmax), and continued with 10 to 20 minutes of Tabata exercise per session, 3 times per week. After 12 weeks of intervention, there were significant reduction in body weight (p&lt; 0.05), body mass index (p&lt; 0.05), fat percentage (p&lt; 0.05), fat mass (p&lt; 0.05), and increases fat free mass (p&lt; 0.01) in S, E and SE groups. Regarding waist to hip ratio, blood glucose and total cholesterol, only E and SE groups showed improvements (p&lt;0.05) and the greatest reduction was observed in SE group. No significant changes in insulin resistance in any groups. Additionally, S, E and SE groups also showed enhancement in both dominant and non-dominant radial and tibial speed of sound (p&lt; 0.05) within and between the groups.

Randomized Controlled Trial of Combined L-Carnitine Supplementation and Moderate-Intensity Exercises on Cardiovascular Markers and Bone Health Status in Overweight and Obese Individuals

Randomized Controlled Trial of Combined L-Carnitine Supplementation and Moderate-Intensity Exercises on Cardiovascular Markers and Bone Health Status in Overweight and Obese Individuals

Beneficial impact of dietary methyl methionine sulfonium chloride and/or L-carnitine supplementation on growth performance, feed efficiency, and serum biochemical parameters in broiler chicken: role of IGF-1 and MSTN genes.

The purpose of this study was to examine the effect of dietary supplementation with methyl methionine sulfonium chloride (MMSC), and L-carnitine (L-CAR) alone or in combination on the growth performance of broilers through their impact on the expression of IGF-1 and MSTN genes associated with growth in broilers. One-day-old female Ross 308 broiler chicks were allocated into four groups, each of which received a broiler starter diet and water daily ad libitum. The control group (group 1) was given drinking water without any additives. Group 2 received 0.25g L-carnitine per liter of drinking water, group 3 received 0.25g MMSC per liter of drinking water, and group 4 received 0.25g of both L-carnitine and MMSC per liter of drinking water. Birds were given a starter diet to 21days after which they received a broiler grower diet to 35days when the experiment ended. There were five replicate groups of 12 birds per treatment. Body weights and feed intake were recorded weekly. Compared to the control group of birds, supplementation with MMSC either alone or in combination with L-carnitine resulted in an increase in growth rate or feed utilization efficiency; L-carnitine by itself had no effect. MMSC supplementation, again either alone or in combination with L-carnitine, increased jejunal and ileal villi height, increased serum total proteins and globulins, downregulated myostatin (MSTN) mRNA, and upregulated insulin growth factor-1 (IGF-1) mRNA expression. Supplementation with L-carnitine alone showed none of these effects. We conclude that MMSC supplementation improved growth performance through the upregulation of IGF-1 mRNA expression and downregulation of MSTN mRNA expression.

Dietary l-carnitine supplementation recovers the increased pH and hardness in fillets caused by high-fat diet in Nile tilapia (Oreochromis niloticus)

The wide use of high-fat diet (HFD) causes negative effects on flesh quality in farmed fish. l-carnitine, a lipid-lowering additive, enhances mitochondrial fatty acid β-oxidation. However its roles in alleviating the effects of HFD on flesh quality in fish are unknown. We fed Nile tilapia with medium-fat diet (MFD, 6% dietary lipid), high-fat diet (HFD, 12% dietary lipid) and HFCD supplemented with l-carnitine (HFCD + 400 mg/kg l-carnitine) for 10 weeks. The HFD-fed fish had higher fat deposition, pH value, myofiber density and flesh hardness than those fed on MFD. However, feeding the fish with the HFCD improved lipid catabolism, which increased significantly lactic acid content and myofiber diameter in muscle, thus reduced pH and hardness values. HFCD also reduced endoplasmic reticulum stress and myofiber apoptosis caused by HFD in the fish. Our study suggests that dietary l-carnitine supplementation alleviates the negative effects of HFD on flesh quality of farmed fish.

Effect of l-carnitine and mildronate on the mitochondrial metabolism of heart and bacterial composition of the gut microbiome in ageing mice

Ageing is the most significant risk factor for cardiovascular diseases. l-Carnitine has a potent cardioprotective effect and its synthesis decreases during ageing. At the same time, there are pharmaceuticals, such as mildronate which, on the contrary, are aimed at reducing the concentration of l-carnitine in the heart and lead to slows down the oxidation of fatty acids in mitochondria. Despite this, both l-carnitine and mildronate are positioned as cardio protectors. We showed that l-carnitine supplementation to the diet of 15-month-old mice increased expression of the PGC-1α gene, which is responsible for the regulation of fatty acid oxidation, and the Nrf2 gene, which is responsible for protecting mitochondria by regulating the expression of antioxidants and mitophagy, in the heart. Mildronate activated the expression of genes that regulate glucose metabolism. Probably, this metabolic shift may protect the mitochondria of the heart from the accumulation of acyl-carnitine, which occurs during the oxidation of fatty acids under oxygen deficiency. Both pharmaceuticals impacted the gut microbiome bacterial composition. l-Carnitine increased the level of Lachnoanaerobaculum and [Eubacterium] hallii group, mildronate increased the level of Bifidobacterium, Rikinella, Christensenellaceae. Considered, that these bacteria for protection the organism from various pathogens and chronic inflammation. Thus, we suggested that the positive effects of both drugs on the mitochondria metabolism and gut microbiome bacterial composition may contribute to the protection of the heart during ageing.

Effects of L‐carnitine supplementation on growth performance, histomorphology, antioxidant and immune function of Rhynchocypris lagowskii fed dietary fish oil replaced with corn oil

The effects of L-carnitine (LC) and dietary lipid on the growth and health of farmed fish are still conflicting. This study aimed to explore the effects of LC supplementation and dietary fish oil replacement by corn oil on growth performance, antioxidant, immune function and histomorphology of Rhynchocypris Lagowskii. Six diets were evaluated as follows: dietary fish oil as 50% and 100% replacement by corn oil, and differing in LC supplementation (0 and 400 mg/kg), were tested in R. Lagowskii for 8 weeks. The highest weight gain rate, specific growth rate and feed efficiency were observed in mix oil diets with LC. The diet with LC significantly increased the total antioxidant capacity level, total superoxide dismutase, alkaline phosphatase, lysozyme activities and immunoglobulin M, complement levels in liver and intestine compared with corn oil diet (p < 0.05). Moreover, the diet with LC significantly up-regulated the nuclear factor E2-related factor 2 (p < 0.05), and significantly down-regulated the interleukin-1-beta and tumour necrosis factor-alpha expression in liver and intestine compared with corn oil diet (p < 0.05). In conclusion, LC supplementation improved the weakening of growth performance, antioxidant capacity, immune function and tissue health caused by R. lagowskii intake of corn oil diets.

Effect of chitosan and L-carnitine supplementation on carcass characteristics of broiler chicken

The experiment was conducted to compare the effect of chitosan and L-carnitine supplementation on carcass characteristics of broiler chicken. A total of 150, day-old Vencobb 430Y broiler chicks were randomly selected and divided into three treatments with five replicates of ten birds each. The dietary treatment groups were as follows: T1 -standard broiler ration (SBR) formulated as per BIS (2007); T2–SBR supplemented with chitosan at 30 g/kg diet; T3–SBR supplemented with L-carnitine at 0.05 g/kg diet. The results indicated that the mean abdominal fat pad per cent of broilers in chitosan supplemented group (T2) was significantly (p&lt;0.01) lower than L-carnitine supplemented group (T3) and both were statistically lower than the control group. However, there was no significant difference in other carcass characteristics among treatment groups except the heart yield percentage. The mean heart yield per cent of broilers showed a significantly (p&lt;0.05) lower value in broilers fed with chitosan as compared to the other treatment groups. The results obtained from the study indicated that supplementation of chitosan and L-carnitine caused a significant reduction in the abdominal fat pad per cent without any adverse effects on growth performance as well as carcass characteristics of broiler chicken.

The supplementation of L-carnitine in septic shock patients: Systematic review and meta-analysis

BackgroundSepsis and septic shock are severe and difficult-to-treat conditions with high lethality. There is interest in identifying new adjunct therapies that are effective in reducing mortality. In this context, L-carnitine has been investigated in trials as a potentially beneficial drug. Therefore, the aim of this systematic review was to assess the clinical evidence to support the use of L-carnitine in septic shock patients to reduce the risk of mortality. The objective of this review was to evaluate the effect of L-carnitine compared to placebo or Usual Care (UC) on the mortality rate in hospitalized adult septic shock patients. MethodsThe authors exclusively included randomized clinical trials that compared the use of L-carnitine versus placebo in adult (> 18 years old) septic shock patients. The outcome was a mortality rate of 28 days. This systematic review and meta-analysis were performed following the PRISMA guidelines and registered in PROSPERO with the ID CRD42020180499. ResultsFollowing the initial search, 4007 citations were identified, with 2701 remaining after duplicate removal. Eight citations were selected for body text reading, and two were selected for inclusion. The studies enrolled 275 patients, with 186 in the carnitine arm and 89 in the placebo arm. The effect of L-carnitine uses in septic shock patients showed a difference risk of -0.03 (95% Confidence Interval: -0.15–0.10, I2 = 77%, p = 0.69) compared to placebo/in mortality rate with low quality of evidence. ConclusionsThere is low-quality evidence that the use of L-carnitine has no significant effect on reducing 28-day mortality in septic shock patients.

Development and validation of an UHPLC-Orbitrap-HRMS method for rapid determination of endogenous L-carnitine in patients on hemodialysis/peritoneal dialysis and its application to promote rational drug use.

BackgroundL-carnitine is an endogenous vitamin-like amino acid derivate which plays an essential role in energy metabolism and can be easily lost via dialysis. Deficiency of L-carnitine has great effects on many aspects of bodily functions. To determine the deficiency degree and adjust the supplementation dose, a rapid, sensitive, and specific method for the detection of endogenous L-carnitine in the plasma of dialysis patients using ultra-high performance liquid chromatography-Orbitrap high resolution mass spectrometry (UHPLC-Orbitrap-HRMS) was developed and validated.MethodsThe plasma samples were processed by protein precipitation and centrifugation before analysis using UHPLC-Orbitrap-HRMS. Sample separation was achieved with a hydrophilic interaction liquid chromatography (HILIC) column, using an isocratic elution with a runtime of 5 min. The separated analytes were detected by positive ionization mode in full scan mode and targeted-single ion monitoring (t-SIM) mode. Mildronate was used as the internal standard (IS).ResultsAll the plasma could be detected in the range of 6.169 to 197.394 µM, with adequate accuracy, precision, and recovery. The method was validated in fortified validation with relative standard deviations (RSD) 5.15–8.74%. This method was applied to the analysis of 105 dialysis patients and 39 healthy participants, the results revealed that peritoneal dialysis patients without L-carnitine supplementation should pay more attention to L-carnitine monitoring, meanwhile, all the hemodialysis patients were advised to be routinely given a full dose of L-carnitine, no matter whether they had taken L-carnitine or not.ConclusionsThis study developed a simple and rapid UHPLC-Orbitrap-HRMS method for detection of endogenous L-carnitine in dialysis patients, which could be useful to promote rational drug use.

In vitro maturation medium supplementation: utilization of repaglinide, L-carnitine, and mesenchymal stem cell-conditioned medium to improve developmental competence of oocytes derived from endometriosis mouse models

Endometriosis (EMS) is one of the most prevalent causes for female infertility. Herein, we investigated the effect of the repaglinide (RG), L-carnitine (LC), and bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM) supplementation during in vitro maturation (IVM) on the quality, maturation, and fertilization rates, as well as embryonic quality and development of oocytes derived from normal and EMS mouse model. Immature oocytes were collected from two groups of normal and EMS-induced female NMRI mice at 6-8 weeks of age. Oocytes were cultured in IVM medium unsupplemented (control group), or supplemented with 1 M RG, 0.3 and 0.6 mg/mL LC, and 25 and 50% BMSC-CM. After 24 h of oocyte incubation, IVM rate and antioxidant status were assessed. Subsequently, the rates of fertilization, cleavage, blastulation, and embryonic development were assessed. Our results demonstrated that supplementation of IVM medium with LC and BMSC-CM, especially 50% BMSC-CM, significantly enhanced IVM and fertilization rates, and markedly improved blastocyst development and total blastocyst cell numbers in EMS-induced mice compared to the control group (53.28±0.24 vs 18.09±0.10%). Additionally, LC and BMSC-CM were able to significantly modulate EMS-induced nitro-oxidative stress by boosting total antioxidant capacity (TAC) and mitigating nitric oxide (NO) levels. Collectively, LC and BMSC-CM supplementation improved oocyte quality and IVM rates, pre-implantation developmental competence of oocytes after in vitro fertilization, and enhanced total blastocyst cell numbers probably by attenuating nitro-oxidative stress and accelerating nuclear maturation of oocytes. These outcomes may provide novel approaches to refining the IVM conditions that can advance the efficiency of assisted reproductive technologies in infertile couples.