Effects of acetyl-l-carnitine in diabetic neuropathy and other geriatric disorders

Abstract

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.

Antioxidants in Down Syndrome: From Preclinical Studies to Clinical Trials

“…Acetyl-l-carnitine is a molecule derived from the acetylation of carnitine that is naturally produced by the body, but it can also be taken as a dietary supplement. This molecule has been demonstrated to possess multiple antioxidant properties in the nervous system, most of them related to its ability to act on mitochondrial metabolism [145,146]. In a double-blind study that enrolled 40 adults with DS between the ages of 18 and 30 years, acetyl-l-carnitine was administered in ascending doses: 10 mg/kg/day in the first month, 20 mg/kg/day in the second month, and 30 mg/kg/day for the rest of the study.…”

Metabolic analysis of the antidepressive effects of Yangxinshi Tablet in a vascular depression model in mice

“…Carnitine can help long‐chain fatty acids cross cytosol to mitochondria for further β ‐oxidization and provide the energy required for the body. Acetyl‐ l ‐carnitine has been proposed not only for the treatment of painful neuropathies but also for many neurological and psychiatric diseases; it has a positive effect in elderly patients with mood disorders and depression (Sergi et al, ).…”

“…4‐Pyridoxic acid is the catabolic product of vitamin B6, which is also known as pyridoxine. Pyridoxine can serve as a dietary supplement to prevent postnatal depression or depressive symptoms (Miller, Murray, Beckmann, Kent, & Macfarlane, ; Sergi et al, ). Inosine and hypoxanthine are involved in purine metabolism; inosine can further metabolize into hypoxanthine (Du et al, ).…”

Impaired nicotinamide adenine dinucleotide (NAD+) metabolism in diabetes and diabetic tissues: Implications for nicotinamide‐related compound treatment

“…Currently, acetyl-Lcarnitine is prescribed for diabetic neuropathy in some countries. There is borderline efficacy for this condition [119][120][121] .…”