Effects of acetyl-l-carnitine in diabetic neuropathy and other geriatric disorders
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A long history of diabetes mellitus and increasing age are associated with the onset of diabetic neuropathy, a painful and highly disabling complication with a prevalence peaking at 50% among elderly diabetic patients. Acetyl-l-carnitine (ALC) is a molecule derived from the acetylation of carnitine in the mitochondria that has an essential role in energy production. It has recently been proposed as a therapy to improve the symptoms of diabetic neuropathy. ALC is widely distributed in mammalian tissues, including the brain, blood–brain barrier, brain neurons, and astrocytes. Aside from its metabolic activity, ALC has demonstrated cytoprotective, antioxidant, and antiapoptotic effects in the nervous system. It exerts an analgesic action by reducing the concentration of glutamate in the synapses. It facilitates nerve regeneration and damage repair after primary trauma: its positive effects on metabolism promote the synthesis, fluidity, and functionality of neuronal membranes, increase protein synthesis, and improve the axonal transport of neurofilament proteins and tubulin. It also amplifies nerve growth factor responsiveness, an effect that is believed to enhance overall neurite growth. ALC has been proposed for the treatment of various neurological and psychiatric diseases, such as mood disorders and depression, dementias, Alzheimer’s disease, and Parkinson’s disease, because synaptic energy states and mitochondrial dysfunction are core factors in their pathogenesis.
KeywordsAcetyl-l-carnitine Diabetic neuropathy Analgesia Neurotrophic effect
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Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 7.McCall KD, Holliday D, Dickerson E, Wallace B, Schwartz AL, Schwartz C, Lewis CJ, Kohn LD, Schwartz FL (2010) Phenylmethimazole blocks palmitate-mediated induction of inflammatory cytokine pathways in 3T3L1 adipocytes and RAW 264.7 macrophages. J Endocrinol 207:343–353. doi: 10.1677/JOE-09-0370 CrossRefPubMedGoogle Scholar
- 10.Januszewicz E, Pajak B, Gajkowska B, Samluk L, Djavadian R, Hinton B, Nalecz K (2009) Organic cation/carnitine transporter OCTN3 is present in astrocytes and is up-regulated by peroxisome proliferators-activator receptor agonist. Int J Biochem Cell Biol 41:2599–2609. doi: 10.1016/j.biocel.2009.08.020 CrossRefPubMedGoogle Scholar
- 12.Chiechio S, Copani A, Zammataro M, Battaglia G, Gereau RW 4th, Nicoletti F (2010) Transcriptional regulation of type-2 metabotropic glutamate receptors: an epigenetic path to novel treatments for chronic pain. Trends Pharmacol Sci 31:153–160. doi: 10.1016/j.tips.2009.12.003 CrossRefPubMedGoogle Scholar
- 17.Veronese N, Sergi G, Stubbs B, The EUGMS special interest group on diabetes, Bourdel-Marchasson I, Tessier D, Sieber C, Strandberg T, Gillain S, Barbagallo M, Crepaldi G, Maggi S, Manzato E (2017) Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy: a systematic review and meta-analysis. Eur Geriatr Med. doi: 10.1016/j.eurger.2017.01.002 Google Scholar
- 19.Pisano C, Pratesi G, Laccabue D, Zunino F, Lo Giudice P, Bellucci A, Pacifici L, Camerini B, Vesci L, Castorina M, Cicuzza S, Tredici G, Marmiroli P, Nicolini G, Galbiati S, Calvani M, Carminati P, Cavaletti G (2003) Paclitaxel and cisplatin-induced neurotoxicity: a protective role of acetyl-l-carnitine. Clin Cancer Res 9:5756–5767PubMedGoogle Scholar
- 28.Sun Y, Shu Y, Liu B, Liu P, Wu C, Zheng R, Zhang X, Zhuang Z, Deng Y, Zheng L, Xu Q, Jiang B, Ouyang X, Gao J, Xu N, Li X, Jiang S, Liang C, Yao Y (2016) A prospective study to evaluate the efficacy and safety of oral acetyl-l-carnitine for the treatment of chemotherapy-induced peripheral neuropathy. Experimental and therapeutic. Medicine (Baltimore) 12:4017–4024Google Scholar