L-Carnitine and Potential Protective Effects Against Ischemia-Reperfusion Injury in Noncardiac Organs: From Experimental Data to Potential Clinical Applications

ABSTRACT

The mechanism of ischemia-reperfusion (I/R) injury is complex and multifactorial. In this condition, systemic event results in morbidity and mortality in several pathologies, including myocardial infarction, ischemic stroke, acute kidney injury, trauma, and circulatory arrest. Hypoxia over ischemia phase leads to energy imbalance and changes of cellular homeostasis and functional or structural alterations. In addition, during the reperfusion period, some events, including calcium influx, release of intracellular enzymes, and cell membrane integrity breakdown, cause cell death. L-carnitine (LC) and its derivatives have been suggested to improve tolerance against I/R injury in various tissues. The favorable effects of LC are possibly mediated by its antioxidant and anti-inflammatory effects or by other capability due to increase in the intracellular carnitine content. In this article, anti-ischemic properties of LC and its derivative in noncardiac organs are reviewed using relative animal and human research. Although most of the studies on noncardiac internal organs have shown protective effects of LC administration against I/R injury, more clinical trials are needed to clarify the clinical importance of LC as a treatment option for I/R-induced injury.

KEYWORDS:

• acetyl carnitine
• in vitro
• in vivo
• ischemia reperfusion injury
• L-carnitine
• reactive oxygen species

Declaration of interest

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

The authors declare no source of funding.

About the authors

Azadeh Moghaddas is an assistant professor of clinical pharmacy at the Isfahan University of Medical Sciences, Isfahan, Iran. She is performing researches in the field of cancer and related issue. Simin Dashti-Khavidaki is professor of clinical pharmacy at the Tehran University of Medical Sciences, Tehran, Iran. She is one of the active members of Nephrology Research Center affiliated by Tehran University of Medical Sciences, Tehran, Iran.