Protective Effects of L-Carnitine on Myocardium of Experimentally Diabetic Rats with Additional Ischaemia and Reperfusion

We investigated the protective effects of L-carnitine against damage to the heart caused by diabetes-induced alterations and additional ischaemia and reperfusion in diabetic BB/OK rats using histological techniques, morphometry, biochemical parameters of oxidative stress, and SOD expression. The results revealed that diabetes-induced morphological changes were partly improved or nearly prevented by substitution of L-carnitine, which also seemed to improve the reduced tolerance of diabetic myocardium towards ischaemia/reperfusion with respect to morphological parameters. Immunohistochemical and biochemical parameters of oxidative stress such as SOD protein expression as well as SOD and GPx activity indicate increased free oxygen radical level in the ischaemic/reperfused diabetic myocardium, which is clearly decreased by L-carnitine treatment. We suggest that L-carnitine may be an adequate “causal” agent in the protection of myocardial alterations in diabetes with additional ischaemia and reperfusion, as it stabilizes mitochondrial and cellular function and acts through its antioxidative or radical scavenging potential. Further investigations are necessary to determine an approach towards adjuvant treatment of diabetic myocardial complications using L-carnitine.     

Effects of L-Carnitine and its Derivatives – Studies on Isolated Hearts

Summary. The metabolism in the heart prefers long-chain fatty acids to other substrates. L-Carnitine, a co-factor of coenzyme A, plays an essential role in the transport of long-chain fatty acids through the inner mitochondrial membrane. Without carnitine, metabolisation of long-chain fatty acids in the mitochondria is not possible. In addition, acyl groups from acyl-CoA compounds can be transferred to L-carnitine, thus influencing the enzymatic activities of important mitochondrial enzymes.The isolated heart model developed by Langendorff was used to investigate the effects of L-carnitine on the heart. During aerobic perfusion, the hemodynamic parameters of isolated hearts reacted in a very sensitive way to alterations in the external conditions (temperature, preload, composition of the perfusion solution). During postischemic perfusion, recovery of the hearts was also influenced by the composition of the perfusion. The hemodynamic parameters of the reperfused hearts increased markedly if there was a sufficiently high supply of long-chain fatty acids and/or glucose. The insufficient recovery of hearts perfused without glucose and at low fatty acid concentrations could be improved by adding L-carnitine. Determination of carnitine levels in heart tissue found that the heart loses about 30% of its carnitine content during ischemia, and that exogenous carnitine is taken up by the heart during reperfusion. There it effects the restoration of sufficient concentrations of creatine phosphate and ATP, a fact that was confirmed by ³¹P NMR spectroscopy. NMR spectroscopy also established that L-carnitine lessens the harmful effects of ischemia-induced metabolic acidosis.The favourable influence of L-carnitine on the heart in the reperfusion period could be due to a reduction in oxygen radicals (lowering of MDA concentrations during reperfusion, raising of GP_x and SOD activities).The findings of these experiments on isolated hearts as well as the favourable results of two placebo-controlled and double-blind clinical studies (investigating the effects of carnitine in cardiomyopathy patients and the effects of L-carnitine in hemodialysis patients) demonstrate that L-carnitine produces positive therapeutic effects, particularly in heart and circulatory diseases.     

What to Learn from a Comparative Genomic Sequence Analysis of <Emphasis Type="Italic">L</Emphasis>-Carnitine Dehydrogenase

Summary. In contrast to eukaryotic cells certain eubacterial strains have acquired the ability to utilize L-carnitine (R-(–)-3-hydroxy-4-(trimethylamino)butyrate) as sole source of energy, carbon and nitrogen. The first step of the L-carnitine degradation to glycine betaine is catalysed by L-carnitine dehydrogenase (L-CDH, EC 1.1.1.108) and results in the formation of the dehydrocarnitine. During the oxidation of L-carnitine a simultaneous conversion of the cofactor NAD⁺ to NADH takes place. This catabolic reaction has always been of keen interest, because it can be exploited for spectroscopic L-carnitine determination in biological fluids – a quantification method, which is developed in our lab – as well as L-carnitine production.Based on a cloned L-CDH sequence an expedition through the currently available prokaryotic genomic sequence space began to mine relevant information about bacterial L-carnitine metabolism hidden in the enormous amount of data stored in public sequence databases. Thus by means of homology-based and context-based protein function prediction is revealed that L-CDH exists in certain eubacterial genomes either as a protein of approximately 35 kDa or as a homologous fusion protein of approximately 54 kDa with an additional putative domain, which is predicted to possess a thioesterase activity. These two variants of the enzyme are found on one hand in the genome sequence of bacterial species, which were previously reported to decompose L-carnitine, and on the other hand in gram-positive bacteria, which were not known to express L-CDH. Furthermore we could not only discover that L-CDH is located in a conserved genetic entity, which genes are very likely involved in this L-carnitine catabolic pathway, but also pinpoint the exact genomic sequence position of several other enzymes, which play an essential role in the bacterial metabolism of L-carnitine precursors.     

Effects of <Emphasis Type="Italic">L</Emphasis>-Carnitine Supplementation in Sows

Summary. In recent years L-carnitine has been used increasingly in animals. This review gives an overview of the effects of dietary L-carnitine supplementation during pregnancy and lactation on the reproductive performance of sows. In one investigation L-carnitine supplementation during pregnancy increased the number of piglets born to sows. Other studies showed heavier litters in sows supplemented with L-carnitine compared with control sows, and litters of L-carnitine supplemented sows gained more weight during the suckling period than litters of control sows. This effect might be due to more vigorous suckling by piglets of L-carnitine supplemented sows, causing the sows’ milk production to rise. At negative energy balance during lactation L-carnitine supplemented sows are able to mobilize more energy from adipose tissue, which can be used for the production of surplus milk. In conclusion, recent studies clearly show that dietary L-carnitine supplementation increases the reproductive performance of sows. This finding suggests that the amount of L-carnitine synthesized endogenously does not cover the requirement for maximum sow performance during pregnancy and lactation.     

Current Methods for Determination of <Emphasis Type="Italic">L</Emphasis>-Carnitine and Acylcarnitines

Summary. L-Carnitine as endogenous compound plays an important role within several metabolic pathways and a deficiency of L-carnitine can cause adverse effects in physiological and/or mental state of health and disease. The prevention of diseases related to carnitine deficiency requires, first of all, the exact determination of L-carnitine and its esters in biological material at pmol/cm³ level. A series of analytical procedures based on biochemical assays as well as on physical methods are available today. Determination of free and total carnitine is sometimes sufficient for a clinical diagnosis, but in most cases, such as in newborn screening for genetic disorders, detailed qualitative and quantitative L-carnitine/acylcarnitine profiling is needed. Technological progress has also revolutionized the determination of carnitines. Today, comprehensive and diagnostically relevant information can be obtained by mass spectrometry. An overview is given of the technical and methodological developments in carnitine analysis and some applications, such as in neonatal screening, diabetes mellitus, and cardiomyopathy.     

<Emphasis Type="Italic">L</Emphasis>-Carnitine Supplementation: A New Paradigm for its Role in Exercise

Summary. Early research investigating the effects of L-carnitine supplementation has examined its role in substrate metabolism and in acute exercise performance. These studies have yielded equivocal findings, partially due to difficulties in increasing muscle carnitine concentrations. However, recent studies have proposed that L-carnitine may play a different role in exercise physiology, and preliminary results have been encouraging. Current investigations have theorized that L-carnitine supplementation facilitates exercise recovery. Proposed mechanism is as follows: 1) increased serum carnitine concentration enhances capillary endothelial function; 2) increased blood flow and reduced hypoxia mitigate the cascade of ensuing, destructive chemical events following exercise; 3) thus allowing reduced structural damage of skeletal muscle mediated by more intact receptors in muscle needed for improved protein signaling. This paradigm explains decreased markers of purine catabolism, free radical formation, and muscle tissue disruption after resistance exercise and the increased repair of muscle proteins following long-term L-carnitine supplementation.     

Large Scale Bioprocess for the Production of Optically Pure <Emphasis Type="Italic">L</Emphasis>-Carnitine

Summary. A competitive production method using the biotransformation of 4-butyrobetaine to enantiomerically pure L-carnitine was developed and scaled-up by Lonza. The process produces L-carnitine in 99.5% yield, and >99.9% enantiomeric excess (ee). Continuous and discontinuous processes were developed but the fed-batch process was found to be economically the most favourable process mode.     

Effects of <Emphasis Type="Italic">L</Emphasis>-Carnitine on Sucrose-Induced Hyperlipidaemia

Summary. L-Carnitine, L-(−)-β-hydroxy-γ-trimethylaminobutyrate, plays an important role as a factor necessary for the transport of long-chain fatty acids into the mitochondria. In order to investigate the influence of L-carnitine on hyperlipidaemias, the experimental model of the sucrose-induced hypertriglyceridaemia of the rat was used. In these experiments L-carnitine in the dose of 11 mg per day and 100 g body weight (over the period of 1 week) was able to antagonize the sucrose-induced hypertriglyceridaemia and the increase of serum free fatty acid level in female rats of the Wistar strain. Carnitine administration did not change the activities of lipogenic enzymes and fatty acid synthesis in the liver. However, L-carnitine increases the rate of hepatic fatty acid oxidation. Our results indicate a hypotriglyceridemic and free fatty acid lowering effect of L-carnitine, and suggest the use of this compound in the therapy of hyperlipidaemias.     

Oral <Emphasis Type="Italic">L</Emphasis>-Carnitine Supplementation and Exercise Metabolism

Summary. Oral L-carnitine supplementation is frequently reported to have beneficial effects on exercise capacity in clinical populations and has been considered as a potential ergogenic aid for endurance athletes. However, this latter view is largely unsubstantiated possibly due to many experimental studies being poorly controlled or difficult to compare. The potential for oral L-carnitine supplementation to influence skeletal muscle carnitine content has been questioned and there are several key factors identified that may explain variations between study outcomes. Recent more well controlled research suggests some potential for L-carnitine to act as a key regulator of cellular stress, possibly through an impact on the integration of carbohydrate and lipid metabolism, and this work should be followed up in future by well controlled studies in both athlete and clinical subject groups.     

What to Learn from a Comparative Genomic Sequence Analysis of L-Carnitine Dehydrogenase

In contrast to eukaryotic cells certain eubacterial strains have acquired the ability to utilize L-carnitine (R-(–)-3-hydroxy-4-(trimethylamino)butyrate) as sole source of energy, carbon and nitrogen. The first step of the L-carnitine degradation to glycine betaine is catalysed by L-carnitine dehydrogenase (L-CDH, EC 1.1.1.108) and results in the formation of the dehydrocarnitine. During the oxidation of L-carnitine a simultaneous conversion of the cofactor NAD⁺ to NADH takes place. This catabolic reaction has always been of keen interest, because it can be exploited for spectroscopic L-carnitine determination in biological fluids – a quantification method, which is developed in our lab – as well as L-carnitine production.Based on a cloned L-CDH sequence an expedition through the currently available prokaryotic genomic sequence space began to mine relevant information about bacterial L-carnitine metabolism hidden in the enormous amount of data stored in public sequence databases. Thus by means of homology-based and context-based protein function prediction is revealed that L-CDH exists in certain eubacterial genomes either as a protein of approximately 35 kDa or as a homologous fusion protein of approximately 54 kDa with an additional putative domain, which is predicted to possess a thioesterase activity. These two variants of the enzyme are found on one hand in the genome sequence of bacterial species, which were previously reported to decompose L-carnitine, and on the other hand in gram-positive bacteria, which were not known to express L-CDH. Furthermore we could not only discover that L-CDH is located in a conserved genetic entity, which genes are very likely involved in this L-carnitine catabolic pathway, but also pinpoint the exact genomic sequence position of several other enzymes, which play an essential role in the bacterial metabolism of L-carnitine precursors.     

L-Carnitine Supplementation: A New Paradigm for its Role in Exercise

Early research investigating the effects of L-carnitine supplementation has examined its role in substrate metabolism and in acute exercise performance. These studies have yielded equivocal findings, partially due to difficulties in increasing muscle carnitine concentrations. However, recent studies have proposed that L-carnitine may play a different role in exercise physiology, and preliminary results have been encouraging. Current investigations have theorized that L-carnitine supplementation facilitates exercise recovery. Proposed mechanism is as follows: 1) increased serum carnitine concentration enhances capillary endothelial function; 2) increased blood flow and reduced hypoxia mitigate the cascade of ensuing, destructive chemical events following exercise; 3) thus allowing reduced structural damage of skeletal muscle mediated by more intact receptors in muscle needed for improved protein signaling. This paradigm explains decreased markers of purine catabolism, free radical formation, and muscle tissue disruption after resistance exercise and the increased repair of muscle proteins following long-term L-carnitine supplementation.     

Effects of L-Carnitine Supplementation in Sows

In recent years L-carnitine has been used increasingly in animals. This review gives an overview of the effects of dietary L-carnitine supplementation during pregnancy and lactation on the reproductive performance of sows. In one investigation L-carnitine supplementation during pregnancy increased the number of piglets born to sows. Other studies showed heavier litters in sows supplemented with L-carnitine compared with control sows, and litters of L-carnitine supplemented sows gained more weight during the suckling period than litters of control sows. This effect might be due to more vigorous suckling by piglets of L-carnitine supplemented sows, causing the sows’ milk production to rise. At negative energy balance during lactation L-carnitine supplemented sows are able to mobilize more energy from adipose tissue, which can be used for the production of surplus milk. In conclusion, recent studies clearly show that dietary L-carnitine supplementation increases the reproductive performance of sows. This finding suggests that the amount of L-carnitine synthesized endogenously does not cover the requirement for maximum sow performance during pregnancy and lactation.     

Current Methods for Determination of L-Carnitine and Acylcarnitines

L-Carnitine as endogenous compound plays an important role within several metabolic pathways and a deficiency of L-carnitine can cause adverse effects in physiological and/or mental state of health and disease. The prevention of diseases related to carnitine deficiency requires, first of all, the exact determination of L-carnitine and its esters in biological material at pmol/cm³ level. A series of analytical procedures based on biochemical assays as well as on physical methods are available today. Determination of free and total carnitine is sometimes sufficient for a clinical diagnosis, but in most cases, such as in newborn screening for genetic disorders, detailed qualitative and quantitative L-carnitine/acylcarnitine profiling is needed. Technological progress has also revolutionized the determination of carnitines. Today, comprehensive and diagnostically relevant information can be obtained by mass spectrometry. An overview is given of the technical and methodological developments in carnitine analysis and some applications, such as in neonatal screening, diabetes mellitus, and cardiomyopathy.     

Effects of L-Carnitine on Sucrose-Induced Hyperlipidaemia

L-Carnitine, L-(−)-β-hydroxy-γ-trimethylaminobutyrate, plays an important role as a factor necessary for the transport of long-chain fatty acids into the mitochondria. In order to investigate the influence of L-carnitine on hyperlipidaemias, the experimental model of the sucrose-induced hypertriglyceridaemia of the rat was used. In these experiments L-carnitine in the dose of 11 mg per day and 100 g body weight (over the period of 1 week) was able to antagonize the sucrose-induced hypertriglyceridaemia and the increase of serum free fatty acid level in female rats of the Wistar strain. Carnitine administration did not change the activities of lipogenic enzymes and fatty acid synthesis in the liver. However, L-carnitine increases the rate of hepatic fatty acid oxidation. Our results indicate a hypotriglyceridemic and free fatty acid lowering effect of L-carnitine, and suggest the use of this compound in the therapy of hyperlipidaemias.     

锰离子参与的类Fenton反应的HPLC和ESR波谱研究

利用自旋捕捉-ESR技术及芳环羟基化反应-高效液相色谱(HPLC)法两种方法研究了Mn^2＋参与的类Fenton反应. 两种方法均检测到Mn^2＋与H₂O₂反应产生•OH. 建立了HPLC-荧光检测器对•OH的高灵敏快速检测方法. 检测了超氧化物歧化酶以及几种Mn^2＋配体对产生•OH的影响. 结果显示, Mn^2＋与H₂O₂反应可以发生类Fenton反应, 产生•OH. 这一现象可能是Mn^2＋引起生物体内氧化损伤的重要原因.     

Large Scale Bioprocess for the Production of Optically Pure L-Carnitine

A competitive production method using the biotransformation of 4-butyrobetaine to enantiomerically pure L-carnitine was developed and scaled-up by Lonza. The process produces L-carnitine in 99.5% yield, and >99.9% enantiomeric excess (ee). Continuous and discontinuous processes were developed but the fed-batch process was found to be economically the most favourable process mode.     

<Emphasis Type="Italic">L</Emphasis>-Carnitine,Immunomodulation, and Human Immunodeficiency Virus (HIV)-related Disorders

Summary. The use of pharmacologic doses of the conditionally-essential nutrient L-carnitine (LC) has been associated with positive effects on the immune system. We have recently suggested that this property of LC could be mediated through activation of the glucocorticoid receptor alpha. Human immunodeficiency virus (HIV)-infected individuals, especially those on antiretroviral therapy, may become LC-deficient. This evidence, together with the immunomodulatory properties of LC, its known major role in lipid and energy metabolisms, and its proposed antiapoptotic and neuroprotective actions, have encouraged the use of LC supplementation as a potential treatment for HIV-related disorders, such as lipodystrophy and peripheral neuropathy. Preliminary results, mostly from small-scale uncontrolled studies are conflicting, whilst larger controlled trials are warranted.     

Protective effect of ischemic postconditioning against ischemia reperfusion-induced myocardium oxidative injury in IR rats

Brief episodes of myocardial ischemia-reperfusion (IR) employed during reperfusion after a prolonged ischemic insult may attenuate the total ischemia-reperfusion injury. This phenomenon has been termed ischemic postconditioning. In the present study, we studied the possible effect of ischemic postconditioning on an ischemic reperfusion (IR)-induced myocardium oxidative injury in rat model. Results showed that ischemic postconditioning could improve arrhythmia cordis, reduce myocardium infarction and serum creatin kinase (CK), lactate dehydrogenase (LDH) and aspartate transaminase (AST) activities in IR rats. In addition, ischemic postconditioning could still decrease myocardium malondialdehyde (MDA) level, and increased myocardium Na+-K+-ATPase, Ca2+-Mg2+-ATPase, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and glutathione reductase (GR) activities. It can be concluded that ischemic postconditioning possesses strong protective effects against ischemia reperfusion-induced myocardium oxidative injury in IR rats.