McCoin CS, Knotts TA, Ono-Moore KD, Oort PJ, Adams SH. Long-chain acylcarnitines activate cell stress and myokine release in C2C12 myotubes: calcium-dependent and -independent effects. Am J Physiol Endocrinol Metab 308: E990 -E1000, 2015. First published April 7, 2015; doi:10.1152/ajpendo.00602.2014.-Acylcarnitines, important lipid biomarkers reflective of acyl-CoA status, are metabolites that possess bioactive and inflammatory properties. This study examined the potential for long-chain acylcarnitines to activate cellular inflammatory, stress, and death pathways in a skeletal muscle model. Differentiated C2C12 myotubes treated with L-C14, C16, C18, and C18:1 carnitine displayed dose-dependent increases in IL-6 production with a concomitant rise in markers of cell permeability and death, which was not observed for shorter chain lengths. L-C16 carnitine, used as a representative long-chain acylcarnitine at initial extracellular concentrations Ն25 M, increased IL-6 production 4.1-, 14.9-, and 31.4-fold over vehicle at 25, 50, and 100 M. Additionally, L-C16 carnitine activated c-Jun NH2-terminal kinase, extracellular signalregulated kinase, and p38 mitogen-activated protein kinase between 2.5-and 11-fold and induced cell injury and death within 6 h with modest activation of the apoptotic caspase-3 protein. L-C16 carnitine rapidly increased intracellular calcium, most clearly by 10 M, implicating calcium as a potential mechanism for some activities of long-chain acylcarnitines. The intracellular calcium chelator BAPTA-AM blunted L-C16 carnitine-mediated IL-6 production by Ͼ65%. However, BAPTA-AM did not attenuate cell permeability and death responses, indicating that these outcomes are calcium independent. The 16-carbon zwitterionic compound amidosulfobetaine-16 qualitatively mimicked the L-C16 carnitineassociated cell stress outcomes, suggesting that the effects of high experimental concentrations of long-chain acylcarnitines are through membrane disruption. Herein, a model is proposed in which acylcarnitine cell membrane interactions take place along a spectrum of cellular concentrations encountered in physiologicalto-pathophysiological conditions, thus regulating function of membrane-based systems and impacting cell biology. cell death; interleukin-6; skeletal muscle PLASMA ACYLCARNITINES HAVE long been used as surrogate readouts reflecting tissue acyl-CoA pools (6). Thus, these indexes are used in newborn screening as diagnostic biomarkers of inherited disorders of metabolism involving enzymatic lesions in lipid and amino acid metabolism, in which there are increases or decreases in specific acyl-CoA tissue pools (7, 37). For example, long-chain fatty acid oxidation disorders (FAOD) are characterized by defects in mitochondrial oxidative enzymes, i.e., long-chain 3-hydroxyacyl-CoA dehydrogenase and carnitine palmitoyltransferase 2 (CPT2) deficiencies, and these lead to increased tissue, blood, and urine long-chain fatty acylcarnitines. Under certain FAOD conditions, plasma longchain acylcarnitines can increase s...