L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response

Vazelov, Evgueniy; Borissova, A M; Кirilov, Georgi; Assenova, B; Tchetirska, M; Krivoshiev, S

doi:10.1177/039139880302600405

Cited by 7 publications

(3 citation statements)

References 14 publications

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“…Carnitine is available for oral intake and is an approved medication for supplementation in different forms of carnitine deficiency states. There is compelling evidence for carnitine to have beneficial effects on cardiovascular, immune, and nervous systems and in diseases such as cancer and diabetes [33][34][35][36]. Therefore, it is clear that carnitine, though an endogenous metabolite, has therapeutic potential as a nutritional supplement and as a drug in a variety of diseases.…”

Section: Transport Of Carnitine Via Atb 0+mentioning

confidence: 99%

Amino Acid Transporter ATB0,+ as a Delivery System for Drugs and Prodrugs

Ganapathy¹,

Ganapathy²

2005

curr drug targets immune endocr metabol disord

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ATB(0,+) is a unique amino acid transporter because of its broad substrate specificity and concentrative ability. This transporter recognizes neutral as well as cationic amino acids. It is energized by Na(+) and Cl(-) gradients and membrane potential. Many of the amino acids and amino acid derivatives that are substrates for ATB(0,+) serve as therapeutic agents (e.g., D-serine, carnitine, and nitric oxide synthase inhibitors). Recent studies have shown that the potential of ATB(0,+) as a drug delivery system may be greater than previously envisaged. ATB(0,+) can transport antiviral drugs such as acyclovir and ganciclovir when they are covalently coupled to the side chain of anionic amino acids. Chemical modification of the carboxyl groups in the side chain of aspartate and glutamate with drugs converts these anionic amino acids into neutral amino acid derivatives. Therefore, the modified drugs are recognized by ATB(0,+). Interestingly, even when acyclovir and ganciclovir are coupled as esters with alpha-carboxyl group of neutral amino acids, the modified drugs are transported via ATB(0,+). Similarly, the hydroxyl group in the side chains of serine and threonine can also be used to covalently couple drugs for delivery into cells via ATB(0,+). This increases the potential for designing a wide variety of amino acid-based prodrugs that can utilize ATB(0,+) as drug delivery system. Furthermore, the transporter is expressed in the colon, lung, and eye, the tissues easily amenable for drug delivery. These findings argue strongly in support of ATB(0,+) as a potential delivery system for a wide variety of drugs and prodrugs.

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Section: Transport Of Carnitine Via Atb 0+mentioning

confidence: 99%

Amino Acid Transporter ATB0,+ as a Delivery System for Drugs and Prodrugs

Ganapathy¹,

Ganapathy²

2005

curr drug targets immune endocr metabol disord

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“…Levocarnitine administration was associated with a significant increase in the rate constant for plasma glucose disappearance, with no effect of placebo. In an additional study by Vazelov et al, 86 1 month of L-carnitine supplementation (1 g IV after each hemodialysis) to a group of hemodialysis patients was associated with a significant increase in serum C-peptide secretion and a decrease in plasma glucose on tolbutamide testing, indicating an improvement of the stimulated ␤ cell response. Longer-term studies are required to see whether improvement of insulin sensitivity occurs with chronic levocarnitine therapy in dialysis patients.…”

Section: Effect Of Levocarnitine On Biochemical Abnormalities In Dialmentioning

confidence: 90%

Levocarnitine and Dialysis: A Review

Schreiber

2005

Nut in Clin Prac

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Among the various metabolic abnormalities documented in dialysis patients are abnormalities related to the metabolism of fatty acids. Aberrant fatty-acid metabolism has been associated with the promotion of free-radical production, insulin resistance, and cellular apoptosis. These processes have been identified as important contributors to the morbidity experienced by dialysis patients. There is evidence that levocarnitine supplementation can modify the deleterious effects of defective fatty-acid metabolism. Patients receiving hemodialysis and, to a lesser degree, peritoneal dialysis have been shown to be carnitine deficient, as manifested by reduced levels of plasma free carnitine and an increase in the acyl:free carnitine ratio. Cardiac and skeletal muscles are particularly dependent on fatty-acid metabolism for the generation of energy. A number of clinical abnormalities have been correlated with a low plasma carnitine status in dialysis patients. Clinical trials have examined the efficacy of levocarnitine therapy in a number of conditions common in dialysis patients, including skeletal-muscle weakness and fatigue, cardiomyopathy, dialysis-related hypotension, hyperlipidemia, and anemia poorly responsive to recombinant human erythropoietin therapy (rHuEPO). This review examines the evidence for carnitine deficiency in patients requiring dialysis, and documents the results of relevant clinical trials of levocarnitine therapy in this population. Consensus recommendations by expert panels are summarized and contrasted with present guidelines for access to levocarnitine therapy by dialysis patients.

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“…Recently, venous L-carnitine administration after HD was found to increase the peripheral effectiveness of insulin, simultaneously improving the b-cell response (Vazelov et al 2003).…”

Section: Alterations Of Glucose Metabolismmentioning

confidence: 99%

Pathophysiological and clinical aspects of malnutrition in chronic renal failure

2005

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Kidney diseases are the ninth leading cause of death in the USA. In these patients cardiovascular mortality is greater than in the general population. This observation, not completely explained by the so-called ‘traditional’ cardiovascular risk factors, lead the authors to postulate other ‘emerging’ ones found in chronic renal failure patients. Among these new findings, nutritional status, considered as the balance existing between nutrient requirements and intakes, plays an important role for the development of cardiovascular diseases. In fact several nutritional parameters are widely known as pathophysiological determinants of cardiovascular disturbances, which are based on accelerated atherosclerosis, due especially to enhanced oxidative stress and endothelial dysfunction. Chronic renal failure is a clinical condition that from many points of view seems to be a chronic inflammatory state, and many studies confirm this observation. This influences nutritional status especially in dialysis patients. Malnutrition is related in turn to accelerated atherosclerosis thus leading to a postulated ‘malnutrition, inflammation, atherosclerosis’ (MIA) syndrome in which malnutrition, inflammation and atherosclerosis contribute to an elevated cardiovascular mortality rate. The present review explores this issue, first by describing epidemiological aspects of malnutrition in chronic renal failure patients and then by analysing the specific biochemical and metabolic features of these patients.

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L-Carnitine Consecutively Administered to Patients on Hemodialysis Improves Beta-Cell Response

Cited by 7 publications

References 14 publications

Amino Acid Transporter ATB0,+ as a Delivery System for Drugs and Prodrugs

Amino Acid Transporter ATB0,+ as a Delivery System for Drugs and Prodrugs

Levocarnitine and Dialysis: A Review

Pathophysiological and clinical aspects of malnutrition in chronic renal failure

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