Acetyl-L-carnitine
Acetyl L-carnitine is the acetyl ester of
carnitine, a biological compound which plays a key role in the transport of fatty acids from the cytosol into the mitochondrial matrix of B-oxidation. Carnitine, once referred to as vitamin Bt, is a substance participating in the metabolism of fatty acids and the DL-form thereof has heretofore been used as a stomachic. Recently, attention has been directed particularly to L-form thereof. L-carnitine plays a fundamental role in metabolism, being a key element in the oxidation of long-chain fatty acids and thus in the production of energy. L-carnitine is an essential substance for mediating long-chain fatty acid transport through the mitochondrian membrane prior to intracellular beta-oxidation, and hence a deficiency of L-carnitine causes disorders in fatty acid and its related metabolisms. The oral administration of L-carnitine has been shown to be an effective therapy for cardiovascular diseases. L-carnitine plays a crucial role in the energy supply of tissues by modulating the entry of long-chain fatty acids into the mitochondrial matrix and their subsequent oxidation. Consistent with such a metabolic role, L-carnitine has been shown to be effective in lowering the serum levels of cholesterol, triglyceride, and free fatty acids, while increasing high density lipoprotein (HDL) cholesterol which is antiatherogenic. L-carnitine and its salts are also known to be useful as dietary supplements, in particular for the facilitation of the metabolism of lipids. Various therapeutic uses of L-carnitine and alkanoyl derivatives thereof are already known. For instance, L-carnitine has been used in the cardiovascular field for the treatment of acute and chronic myocardial ischaemia, angina pectoris, heart failure and cardiac arrhythmias. It is believed that disorders of the skeletal muscle and cardiac muscle, both of which are high energy consumption tissues depending on carnitine and lacking in carnitine generation, occur from such deficiency. The salts of L(-)-carnitine and its alkanoyl derivatives present the same therapeutic or nutritional activities as those of the so-called inner salts. Acetyl L-carnitine modulates, through regulation of acetyl Co-A intracellular concentration, the metabolisms of sugars, lipids and amino acids, this way playing a pivotal role in cellular energy and turn over of cell membranes and proteins. Acetyl L-carnitine is capable of restoring the integrity of the cardiac mitochondrial membrane altered by aging (specifically the cardiolipin content), thereby restoring the normal activity of cytochrome oxidase, adenine nucleotide translocase, and phosphate carrier. Acetyl-L-carnitine intracellular CoA homeostatic function with carnitine. It is the prevalent ester of carnitine in tissue, freely exchangeable across subcellular membranes, and can serve as a pool of acetyl groups to regenerate acetyl-CoA.
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