L-carnitine: Searching for New Therapeutic Strategy for Sepsis Management

Abstract

: In this review, we discussed the biological targets of carnitine, its effects on immune function, and how L-carnitine supplementation may help critically ill patients. L-carnitine is a potent antioxidant. L-carnitine depletion has been observed in prolonged intensive care unit (ICU) stays, while L-carnitine supplementation has beneficial effects in health promotion and regulation of immunity. It is essential for the uptake of fatty acids into mitochondria. By inhibiting the ubiquitin-proteasome system, down-regulation of apelin receptor in cardiac tissue, and reducing β-oxidation of fatty acid, carnitine may decrease vasopressor requirement in septic shock and improve clinical outcomes of this group of patients. We also have an overview of animal and clinical studies that have been recruited for evaluating the beneficial effects of L-carnitine in the management of sepsis/ septic shock. Additional clinical data are required to evaluate the optimal daily dose and duration of L-carnitine supplementation.

Effects of L-carnitine supplementation in patients with mild-to-moderate COVID-19 disease: a pilot study

“…It should also be noted that L-carnitine inhibits lipid peroxidation, reduces oxidative stress, such as ROS, improves mitochondrial function, and thus plays a pivotal role in reducing inflammation [ 29 ]. Additionally, L-carnitine is thought to be a booster of the immune system (such as increasing the function of macrophages), which is involved in reducing infection and inflammation [ 30 ].…”

Recommendations for nutritional supplements for dry eye disease: current advances

“…L-carnitine also impacts lipid metabolism by influencing various transcription factors related to lipolysis and adipogenesis, reducing lipid synthesis and deposition ( Förster et al, 2021 ). Moreover, it exhibits antioxidant properties ( Sahebnasagh et al, 2022 ), balancing hypertonicity-induced imbalances between oxygenase and antioxidant enzymes, reducing ROS production, inhibiting lipid peroxidation, preventing oxidative DNA damage, and suppressing the production of heme oxygenase-1 and cyclooxygenase-2. Commonly used as a dietary supplement, L-carnitine is acclaimed for its benefits in boosting metabolic energy, aiding in weight loss ( Talenezhad et al, 2020 ), and improving cardiovascular ( Nakajima et al, 2024 ) and cognitive functions ( Zhao et al, 2023 ).…”

The effect of l-carnitine supplementation on mortality and clinical outcomes in ventilator-dependent critically ill patients with obesity and COVID-19: Protocol for a randomized double-blind placebo-controlled trial

“…According to previous studies, l -carnitine supplementation greater than 2 gr/day might have a greater beneficial effect. Finally, we decided to select 3 gr as the appropriate intervention with low adverse effects [ 19 , 20 ]. The l -carnitine capsule and identical placebo will be labeled by the clinical pharmacist with a unique code that will be produced by the www.sealedenvelope.com website and prescribed to the patients using a double-blind procedure.…”