Effects of L-carnitine on erythrocyte acyl-CoA, free CoA, and glycerophospholipid acyltransferase in uremia

Abstract

We studied the effects of L-carnitine treatment in the acyl flux of erythrocyte membranes from uremic patients. We found a significantly lower relative proportion of long-chain acyl-CoA (LCCoA) to free CoA (FCoA) in patients than in control subjects. In addition, patients had reduced activities of both carnitine palmitoyltransferase (CPT) and glycerophospholipid acyltransferase (LAT; CoA dependent), and increased ratios of long-chain acylcarnitine (LCAC) to free carnitine in their erythrocytes. These data support the hypothesis that acyl-trafficking is altered in erythrocytes in uremia. After treatment with L-carnitine, we observed a significant increase in CPT and LAT activities as well as in the LCCoA-FCoA ratio, and a significant decrease in the ratio of LCAC to free carnitine. These results support the conclusion that L-carnitine supplementation improves erythrocyte flux in uremic patients.

Inflammatory Syndrome in Patients on Hemodialysis

“…It would be through this mechanism, by elimination of proinflammatory substances, that the preservation of renal function correlates inversely with inflammatory markers (67). HD regimens with greater depuration of all kinds of substances, such as nocturnal HD, also would have this effect (68). Techniques with a high middle molecule clearance, such as on-line hemodiafiltration, may contribute to decreasing inflammation in HD patients.…”

“…HD often is associated with an oxidative imbalance, in which oxidation of different lipids and proteins are predominant (68). Loss of some antioxidants, such as carnitine, during HD may contribute to this disorder (70).…”

Carnitine supplementation improves cardiac strain rate in children on chronic hemodialysis

“…Chronic HD results in a decrease in acetyl acylcarnitine and a concurrent increase in non-acetyl aclycarnitine over time, and supplementation with carnitine reverses this by increasing plasma and muscle acetyl acylcarnitine while decreasing the harmful non-acetyl groups [7]. Non-acetyl acylcarnitines impair energy production in the myocardial mitochondria that can be restored by carnitine supplementation [28,29]. The harmful non-acetyl acylcarnitines may have improved in response to carnitine supplementation in our study to a greater degree than what may be reflected in the total A:F ratio because the expected increase in acetyl acylcarnitine would partially mask a decrease in nonacetyl aclycarnitine.…”

Use of agents stimulating erythropoiesis in digestive diseases

“…Carnitine may improve anemia in hemodialysis patients with EPO resistance [182] by mechanisms not yet known [183] , or stabilizing the membrane as an antioxidant agent, or by stimulating erythropoiesis, by the increase in the number of reticulocytes demonstrated in some patients on hemodialysis treated with L-carnitine [184] . The dose used in patients with EPO resistence is 1 g iv posthemodialysis [185] .…”