左卡尼汀联合蔗糖铁对血液透析患者肾性贫血及氧化应激的影响

目的:探讨左卡尼汀联合蔗糖铁对血透患者肾性贫血及氧化应激的影响。方法:抽选我院2010年3月-2013年5月行维持血透治疗的肾性贫血患者79例,采用数字表法分为对照组(39例)和观察组(40例),对照组采用促红细胞生成素(EPO)、单用蔗糖铁及常规对症治疗,观察组在对照组基础上联用左卡尼汀治疗。比较两组患者治疗前、治疗6个月后血红蛋白(Hb)、血细胞比容(Hct)、血浆铁蛋白(SF)、转铁蛋白饱和度(TSAT)、晚期蛋白质氧化产物(AOPP)及血丙二醛(MDA)水平,并对两组治疗开始时、治疗3、6个月时EPO使用剂量进行比较。结果:治疗6个月后,观察组患者Hb、Hct、SF、TSAT明显高于对照组(P0.05),AOPP、MDA明显低于对照组(P0.05);对照组从治疗开始到治疗6个月时一直维持较高的EPO使用剂量,而观察组EPO用量依次递减,至治疗6个月时EPO用量显著低于对照组(P0.05)。结论:左卡尼汀能联合蔗糖铁治疗肾性贫血的疗效显著,能有效缓解氧化应激反应,降低EPO用量,值得临床推广。     

左旋卡尼汀对脂多糖诱导小鼠肺微血管内皮细胞自噬和凋亡的影响*

目的:探讨左旋卡尼汀(LC)对脂多糖(LPS)损伤的小鼠肺微血管内皮细胞(PMVECs)的保护作用及自噬、凋亡的影响。方法:采用体外培养的小鼠PMVECs,分为对照组(Control组)、LPS组(10 μg/ ml,3、6、12、24 h)、LPS(10 μg/ ml,24 h)+LC(终浓度为2.5、5、10 μg/ml)(LC组)。Annexin V-FITC/PI双标记法检测细胞凋亡,细胞免疫荧光染色法检测自噬小体,Western blot法检测自噬相关蛋白LC3及凋亡蛋白Caspase-3的含量,CCK-8法检测细胞活力。结果:① 与Control组比较,LPS 6 h、12 h、24 h组PMVECs细胞活力显著受到抑制,细胞凋亡率、自噬蛋白LC3Ⅱ表达显著增高(P均＜0.01),LC3蛋白阳性表达。②与LPS 24 h组比较,各浓度LC组PMVECs细胞活力显著提高、自噬蛋白LC3II表达水平显著升高(P均＜0.01),而PMVECs凋亡率和凋亡蛋白Caspase-3表达水平均明显降低 (P＜0.05)。结论:LC具有提高LPS刺激的小鼠PMVECs活性、促进PMVECs自噬、抑制凋亡的作用。     

Effects of dietary L-carnitine and coenzyme Q10 supplementation on performance and ascites mortality of broilers

The study was conducted to determine the effects of dietary L-carnitine and coenzyme Q₁₀ (CoQ₁₀) supplementation on growth performance and ascites mortality of broilers. A 3 × 3 factorial arrangement was employed with three levels (0, 75 and 150 mg/kg) of L-carnitine and three levels of CoQ₁₀ (0, 20 and 40 mg/kg) supplementation during the experiment. Five hundred and forty one-day-old Arbor Acre male broiler chicks were randomly allocated into nine groups with six replicates each. All birds were fed with the basal diets from day 1 to 7 and changed to the experimental diets from day 8. During day 15 to 21 all the birds were exposed to low ambient temperature (15 - 18°C) to induce ascites. The results showed that under this condition, growth performance of broilers were not significantly affected by CoQ₁₀ or L-carnitine + CoQ₁₀ supplementation during week 0 - 3 and 0 - 6, but body weight gain (BWG) of broilers was significantly reduced by 150 mg/kg L-carnitine during week 0 - 6. Packed cell volume (PCV) of broilers was significantly decreased by L-carnitine and L-carnitine + CoQ₁₀ supplementation (P < 0.05). Erythrocyte osmotic fragility (EOF), ascites heart index (AHI) and ascites mortality of broilers were significantly decreased by L-carnitine, CoQ₁₀ and L-carnitine + CoQ₁₀ supplementation. Though no significant changes were observed in total antioxidative capability (T-AOC), total superoxide dismutase (T-SOD) was increased by L-carnitine, CoQ₁₀ and L-carnitine + CoQ₁₀ supplementation (P < 0.05). Malonaldehyde (MDA) content was significantly decreased by CoQ₁₀ and L-carnitine + CoQ₁₀ supplementation. The results indicate that dietary L-carnitine and CoQ₁₀ supplementation reduce ascites mortality of broilers; the reason may be partially associated with their antioxidative effects.     

Effects of L-carnitine against oxidative stress in human hepatocytes: involvement of peroxisome proliferator-activated receptor alpha

Background

Excessive oxidative stress and lipid peroxidation have been demonstrated to play important roles in the production of liver damage. L-carnitine is a natural substance and acts as a carrier for fatty acids across the inner mitochondrial membrane for subsequent beta-oxidation. It is also an antioxidant that reduces metabolic stress in the cells. Recent years L-carnitine has been proposed for treatment of various kinds of disease, including liver injury. This study was conducted to evaluate the protective effect of L-carnitine against hydrogen peroxide (H₂O₂)-induced cytotoxicity in a normal human hepatocyte cell line, HL7702.

Methods

We analyzed cytotoxicity using MTT assay and lactate dehydrogenase (LDH) release. Antioxidant activity and lipid peroxidation were estimated by reactive oxygen species (ROS) levels, activities and protein expressions of superoxide dismutase (SOD) and catalase (CAT), and malondialdehyde (MDA) formation. Expressions of peroxisome proliferator-activated receptor (PPAR)-alpha and its target genes were evaluated by RT-PCR or western blotting. The role of PPAR-alpha in L-carnitine-enhanced expression of SOD and CAT was also explored. Statistical analysis was performed by a one-way analysis of variance, and its significance was assessed by Dennett''s post-hoc test.

Results

The results showed that L-carnitine protected HL7702 cells against cytotoxity induced by H₂O₂. This protection was related to the scavenging of ROS, the promotion of SOD and CAT activity and expression, and the prevention of lipid peroxidation in cultured HL7702 cells. The decreased expressions of PPAR-alpha, carnitine palmitoyl transferase 1 (CPT1) and acyl-CoA oxidase (ACOX) induced by H₂O₂ can be attenuated by L-carnitine. Besides, we also found that the promotion of SOD and CAT protein expression induced by L-carnitine was blocked by PPAR-alpha inhibitor MK886.

Conclusions

Taken together, our findings suggest that L-carnitine could protect HL7702 cells against oxidative stress through the antioxidative effect and the regulation of PPAR-alpha also play an important part in the protective effect.     

Regulation of carbohydrate and fatty acid utilization by L-carnitine during cardiac development and hypoxia

This study is designed to investigate whether substrate preference in the myocardium during the neonatal period and hypoxia-induced stress is controlled intracellularly or by extracellular substrate availability. To determine this, the effect of exogenous L-carnitine on the regulation of carbohydrate and fatty acid metabolism was determined during cardiac stress (hypoxia) and during the postnatal period. The effect of L-carnitine on long chain (palmitate) and medium chain (octonoate) fatty acid oxidation was studied in cardiac myocytes isolated from less than 24 h old (new born; NB), 2 week old (2 week) and hypoxic 4 week old (HY) piglets. Palmitate oxidation was severely decreased in NB cells compared to those from 2 week animals (0.456 ± 0.04 vs. 1.207 ± 0.52 nmol/mg protein/30 min); surprisingly, cells from even older hypoxic animals appeared shifted toward the new born state (0.695 ± 0.038 nmol/mg protein/30 min). Addition of L-carnitine to the incubation medium, which stimulates carnitine palmitoyl-transferase I (CPTI) accelerated palmitate oxidation 3 fold in NB and approximately 2 fold in HY and 2 week cells. In contrast, octanoate oxidation which was greater in new born myocytes than in 2 week cells, was decreased by L-carnitine suggesting a compensatory response. Furthermore, oxidation of carbohydrates (glucose, pyruvate, and lactate) was greatly increased in new born myocytes compared to 2 week and HY cells and was accompanied by a parallel increase in pyruvate dehydrogenase (PDH) activity. The concentration of malonyl-CoA, a potent inhibitor of CPTI was significantly higher in new born heart than at 2 weeks. These metabolic data taken together suggest that intracellular metabolic signals interact to shift from carbohydrate to fatty acid utilization during development of the myocardium. The decreased oxidation of palmitate in NB hearts probably reflects decreased intracellular L-carnitine and increased malonyl-CoA concentrations. Interestingly, these data further suggest that the cells remain compliant so that under stressful conditions, such as hypoxia, they can revert toward the neonatal state of increased glucose utilization.     

L-carnitine enhances oocyte maturation and development of parthenogenetic embryos in pigs

The objective was to determine whether adding L-carnitine in IVM/IVC medium enhanced maturation and developmental competence of porcine oocytes in vitro. Oocyte maturation rates did not differ significantly among groups supplemented with 0, 0.25, 0.5, or 1 mg/mL of L-carnitine added during IVM (although 2 mg/mL of L-carnitine reduced maturation rate). Compared with control oocytes, those treated with 0.5 mg/mL of L-carnitine during IVM had greater (P < 0.05) rates of blastocyst formation after parthenogenetic activation, and these blastocysts had less (P < 0.05) apoptosis. Adding 0.5 mg/mL of L-carnitine during IVM also significantly reduced intracellular reactive oxygen species (ROS), and increased glutathione (GSH) concentrations. With or without glucose supplementation, 0.5 mg/mL of L-carnitine in the IVM medium significantly hastened nuclear maturation of oocytes. Moreover, supplementing the IVM medium with either glucose or L-carnitine increased (P < 0.05) percentages of oocytes that reached the metaphase II (MII) stage, relative to a control group. Final maturation rates in IVM medium containing either glucose or L-carnitine were not significantly different. Adding L-carnitine (0 to 2 mg/mL) to IVC medium for activated porcine oocytes did not significantly affect development. However, 0.5 mg/mL of L-carnitine in IVC medium significantly reduced reactive oxygen species levels and apoptosis in activated blastocysts, although glutathione concentrations were not significantly altered. In conclusion, adding L-carnitine during IVM/IVC improved developmental potential of porcine oocytes, and also the quality of parthenogenetic embryos, probably by accelerating nuclear maturation, and preventing oxidative damage and apoptosis.     

肉碱的生理功能及其应用前景

概述了Ｌ－肉碱的生理功能,及其机能性食品、饲料添加剂、药品方面的应用。     

左卡尼汀与肾脏疾病的关系

左卡尼汀是人体脂类代谢的重要介质,它主要在肾脏代谢,因此肾脏功能与体内左卡尼汀水平直接相关。慢性肾病、终末期肾病及其临床上所采用的血液透析、腹膜透析和肾脏移植等治疗方法对人体内左卡尼汀水平均有影响;人体内左卡尼汀缺乏,易导致在透析过程中出现低血压、贫血、肌无力和疲劳等临床症状,补充左卡尼汀能有效改善这些症状,并能有效减少EPO用量和降低群体反应性抗体水平,减轻环孢素A的肾毒性。因此,本文就肾脏疾病与左卡尼汀的关系和左卡尼汀在肾脏疾病治疗中的应用做一综述。     

醋酸钙联合左卡尼汀对维持性血液透析患者钙磷代谢的影响

目的：研究并评价醋酸钙联合左卡尼汀对维持性血液透析患者钙磷代谢的影响,为临床治疗提供参考依据。方法：以2013 年 8 月至2015 年2 月在我院进行维持性血液透析的50 例患者作为研究对象,按照随机法分为两组,其中对照组患者给予醋酸钙治 疗,研究组患者给予醋酸钙联合左卡尼汀治疗,比较两组患者治疗前后全段甲状旁腺素、血钙、血磷、钙磷乘积的变化。结果：与对 照组比较,研究组患者全段甲状旁腺素、血钙、血磷、钙磷乘积水平均在正常范围内,较对照组有明显改善(P<0.05);研究组全段甲 状旁腺素、血钙、血磷、钙磷乘积达标率分别为68.00%、84.00%、64.00%、80.00%,与对照组比较,血磷达标率不具有统计学差异 (P＞0.05);全段甲状旁腺素、血钙及钙磷乘积达标率差异具有统计学意义(P<0.05)。结论：醋酸钙联合左卡尼汀对维持性血液透析 患者甲状旁腺素、钙磷代谢的改善效果较单用醋酸钙更佳。     

Effects of L-carnitine and its derivatives on postischemic cardiac function,ventricular fibrillation and necrotic and apoptotic cardiomyocyte death in isolated rat hearts

The study aimed to examine whether L-carnitine and its derivatives, acetyl-L-carnitine and propionyl-L-carnitine, were equally effective and able to improve postischemic cardiac function, reduce the incidence of reperfusion-induced ventricular fibrillation, infarct size, and apoptotic cell death in ischemic/reperfused isolated rat hearts. There are several studies indicating that L-carnitine, a naturally occurring amino acid and an essential cofactor, can improve mechanical function and substrate metabolism not only in hypertrophied or failing myocardium but also in ischemic/reperfused hearts. The effects of L-carnitine, acetyl-L-carnitine, and propionyl-L-carnitine, on the recovery of heart function, incidence of reperfusion-induced ventricular fibrillation (VF), infarct size, and apoptotic cell death after 30 min ischemia followed by 120 min reperfusion were studied in isolated working rat hearts. Hearts were perfused with various concentrations of L-carnitine (0.5 and 5 mM), acetyl-L-carnitine (0.5 and 5 mM), and propionyl-L-carnitine (0.05, 0.5, and 5 mM), respectively, for 10 min before the induction of ischemia. Postischemic recovery of CF, AF, and LVDP was significantly improved in all groups perfused with 5 mM of L-carnitine, acetyl-L-carnitine, and propionyl-L-carnitine. Significant postischemic ventricular recovery was noticed in the hearts perfused with 0.5 mM of propionyl-L-carnitine, but not with the same concentration of L-carnitine or L-acetyl carnitine. The incidence of reperfusion VF was reduced from its control value of 90 to 10% (p < 0.05) in hearts perfused with 5 mM of propionyl-L-carnitine only. Other doses of various carnitines failed to reduce the incidence of VF. The protection in CF, AF, LVDP, and VF reflected in a reduction in infarct size and apoptotic cell death in hearts treated with various concentrations of carnitine derivatives. The difference between effectiveness of various carnitines on the recovery of postischemic myocardium may be explained by different membrane permeability properties of carnitine and its derivatives.