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Issue 1033 coverCarnitine: The Science behind a Conditionally Essential Nutrient Volume 1033 published November 2004
Ann. N.Y. Acad. Sci. 1033: 132–138 (2004). doi: 10.1196/annals.1320.012
Copyright © 2004 by the New York Academy of Sciences
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Carnitines and Its Congeners: A Metabolic Pathway to the Regulation of Immune Response and Inflammation

GIUSEPPE FAMULAROa, CLAUDIO DE SIMONEb,c, VITO TRINCHIERId AND LUCIANA MOSCAc

aDepartment of Internal Medicine, San Camillo Hospital, Rome, Italy
bDepartment of Internal Medicine, University of L'Aquila, L'Aquila, Italy
cVSL Pharmaceuticals, Fort Lauderdale, Florida, USA
dDepartment of Infectious Diseases, University "La Sapienza", Rome, Italy

Address for correspondence: Dr. Giuseppe Famularo, Department of Internal Medicine, San Camillo Hospital, Circonvallazione Gianicolense, 00152 Rome, Italy. Voice/fax: +0039-6-7847528. gfamularo{at}scamilloforlanini.rm.it

Carnitine and its congeners may regulate the immune networks, and their influence on functions of immune cells predominantly or exclusively relies on carnitine-dependent energy production from fatty acids. A reduced pool of carnitines has been demonstrated in either serum or tissues, or both, from patients with a wide spectrum of disorders characterized by unregulated or impaired immune responses ranging from sepsis syndrome to systemic sclerosis, infection with human immunodeficiency virus, and chronic fatigue syndrome. Furthermore, experimental studies have consistently reported that the deranged immune responses and the less efficient inflammation towards infectious organisms associated with aging may be enhanced or modulated by treatment with carnitines. There is also evidence that carnitine deprivation could adversely affect the course of the sepsis syndrome, at least in experimental models, and preliminary studies suggest that carnitine deficiency is ultimately implicated in the pathophysiology of endotoxin-mediated multiple organ failure. Several data indicate that carnitine deficiency is a contributing factor to the progression of infection with human immunodeficiency virus, and carnitine therapy in those patients could counteract the unregulated process of lymphocyte apoptosis and improve CD4 counts. Some case reports have suggested the use of carnitine for the treatment of the severe lactic acidosis that complicates in some patients the use of reverse transcriptase inhibitors.

Key Words: carnitine • immune response • inflammation • aging • sepsis • human immunodeficiency virus • apoptosis






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