A Randomised, Controlled Clinical Trial Evaluating Changes in Therapeutic Efficacy and Oxidative Parameters after Treatment with Propionyl L-Carnitine in Patients with Peripheral Arterial Disease Requiring Haemodialysis

Signorelli, Salvatore Santo; Fatuzzo, Pasquale; Rapisarda, Francesco; Neri, Sergio; Ferrante, Margherita; Conti, Gea Oliveri; Fallico, Roberto; Pino, Luigi Di; Pennisi, Giuseppe; Celotta, Gabriella; Anzaldi, Massimiliano

doi:10.2165/00002512-200623030-00008

Cited by 35 publications

(27 citation statements)

References 27 publications

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“…Previous studies have shown that oxidative stress is associated with PAD in hemodialysis patients. Reducing oxidative stress in these patients with propionyl L-carnitine can significantly increase nitric oxide formation, decrease vasoconstrictive endothelin-1 production, and improve vascular hemodynamic flow 46, 47 . Together, these findings suggest that the association between L5% and lower-extremity PAD in uremia patients may in part be attributed to the promotion of oxidative stress by L5 LDL.…”

Section: Discussionmentioning

confidence: 99%

Electronegative low-density lipoprotein increases the risk of ischemic lower-extremity peripheral artery disease in uremia patients on maintenance hemodialysis

Chang¹,

Shen²,

Lee³

et al. 2017

Sci Rep

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Electronegative low-density lipoprotein (LDL) has been shown to increase coronary artery disease risk in hemodialysis patients, but its effect on the risk of peripheral artery disease (PAD) remains unclear. We separated plasma LDL from 90 uremia patients undergoing hemodialysis into 5 subfractions (L1–L5) according to charge by using fast-protein liquid chromatography with an anion-exchange column and examined the distribution of L5—the most electronegative LDL subfraction—in total LDL (i.e. L5%). During a 5-year period, we followed up with these patients until the occurrence of ischemic lower-extremity PAD. During the follow-up period, ischemic lower-extremity PAD developed in 24.4% of hemodialysis patients. L5% was higher in hemodialysis patients in whom ischemic lower-extremity PAD occurred (3.03% [IQR, 2.36–4.54], n = 22) than in hemodialysis patients in whom PAD did not occur (1.13% [IQR, 0.90–1.83], n = 68) (p < 0.001). Furthermore, L5% significantly increased the adjusted hazard ratio of ischemic lower-extremity PAD (1.54 [95% CI, 1.14–2.10]) (p = 0.005). Flow-mediated dilation was negatively associated with L5% (p < 0.001). Additionally, in vivo experiments from mice showed that L5 compromised endothelium-dependent vascular relaxation through a nitric oxide–related mechanism. Our findings indicate that increased L5% may be associated with the occurrence of ischemic lower-extremity PAD in hemodialysis patients.

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Section: Discussionmentioning

confidence: 99%

Electronegative low-density lipoprotein increases the risk of ischemic lower-extremity peripheral artery disease in uremia patients on maintenance hemodialysis

Chang¹,

Shen²,

Lee³

et al. 2017

Sci Rep

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“…In recent years, PLC has shown therapeutic benefits in the management of disease such as peripheral vascular disease, myocardial ischemia, congestive heart failure, and erectile dysfunction ( Table 2) [68][69][70][71][72][73][74][75][76][77][78][79].…”

Section: Clinical Indication Of Propionyl-l-carnitinementioning

confidence: 99%

Carnitine derivatives

Malaguarnera

2012

Current Opinion in Gastroenterology

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“…A significant increase in ABI was observed in several studies [54,55,[59][60][61]65], but other studies produced no differences or reductions. In addition, some of these studies also observed a reduced peripheral resistance measured by Continuous Wave Doppler of the lower limbs [61,65].…”

Section: Hemodynamic Effectsmentioning

confidence: 99%

“…The activity of propionyl L-carnitine on oxidative profile has been evaluated in two studies in patients with chronic renal insufficiency [54] or PAD associated with type 2 diabetes [59]. These studies showed positive effects on plasma markers of oxidation [malondialdehyde (MDA), 4-hydroxynonenal (4-HNE) and the nitrite/nitrate (NO 2 /NO 3 ) ratio] after 12 months treatment.…”

Section: Oxidative Profile and Endothelial Functionmentioning

confidence: 99%

Propionyll-carnitine: intermittent claudication and peripheral arterial disease

2009

Expert Opinion on Pharmacotherapy

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Peripheral arterial disease (PAD) is a clinical manifestation of underlying aorto-iliac and leg atherosclerosis that is characterized by different stages of stenosis and obstruction. It affects approximately 12% of the adult population and about 20% of people over the age of 70 years, and is associated with increased cardiovascular (CV) and cerebrovascular morbidity. Intermittent claudication (IC) is the major symptom of PAD; it is defined as cramping leg pain (in the buttock, thigh, or calf) while/after clim bing one or two flights of stairs, or during walking. The goals of IC management are to: slow the progression of local and systemic atherosclerosis, prevent major fatal and nonfatal CV events (myocardial infarction and stroke), improve walking capacity, prevent and reduce resting pain and cutaneous lesions. Propionyl L-carnitine is an acyl derivative of levocarnitine (L-carnitine) and is indicated for patients with peripheral arterial occlusive disease. It corrects secondary muscle carnitine deficiency in patients with PAD, significantly improving the walking capacity; it is a free radical that produces positive effects on endothelial function; it protects from oxidative stress; and it enhances most measures of quality of life. The recent Trans-Atlantic Inter-Society Consensus II update recommends the use of propionyl L-carnitine in combination with physical training to improve the symptoms associated with PAD.

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A Randomised, Controlled Clinical Trial Evaluating Changes in Therapeutic Efficacy and Oxidative Parameters after Treatment with Propionyl L-Carnitine in Patients with Peripheral Arterial Disease Requiring Haemodialysis

Abstract: Intravenous administration of propionyl L-carnitine to haemodialysis patients with PAD improves both haemodynamic flow and the oxidative profile.

Cited by 35 publications

References 27 publications

Electronegative low-density lipoprotein increases the risk of ischemic lower-extremity peripheral artery disease in uremia patients on maintenance hemodialysis

Electronegative low-density lipoprotein increases the risk of ischemic lower-extremity peripheral artery disease in uremia patients on maintenance hemodialysis

Carnitine derivatives

Propionyll-carnitine: intermittent claudication and peripheral arterial disease

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