L-propionyl-carnitine protects tissues from ischaemic injury in an 'in vivo' human ischaemia-reperfusion model.

OBJECTIVE

To assess the acute effects of L-propionyl-carnitine (LPC) on vaso-motion, tissue perfusion and tissue acidosis during an ischaemia-reperfusion test in patients with intermittent claudication.

DESIGN

Open pharmacodynamic study.

STUDY PARTICIPANTS

Sixteen male patients with intermittent claudication (mean absolute claudication distance 193.19 ± 51.51m).

INTERVENTIONS

Intravenous infusion of LPC 600mg.

MAIN OUTCOME MEASURES AND RESULTS

Laser-Doppler perfusion units and power spectrum, transcutaneous oxygen pressure (TcPO(2)) and transcutaneous carbon dioxide pressure (TcPCO(2)) were measured at baseline, during ischaemia (which was induced by means of an inflated pneumatic cuff wrapped around the calf) and during reperfusion, before and after LPC infusion. Perfusion units and TcPO(2) did not change significantly after LPC infusion compared with pretreatment values. Conversely, mean laser-Doppler power spectrum, which was 0.20 units at rest and 1.13 during reperfusion before treatment, increased significantly to 0.89 and 2.24, respectively, after LPC infusion (p = 0.01 and p = 0.00074, respectively, vs pretreatment values). LPC had no significant effects on resting TcPCO(2), but induced a significant decrease in TcPCO(2) measured at hypoxia point (96.9mm Hg before treatmentvs 90.2mm Hg after treatment; p = 0.001) and during reperfusion (115.9vs 103.5mm Hg, respectively; p = 0.0006).

CONCLUSIONS

These results show that LPC protects tissues from ischaemic injury by improving arteriolar function and reducing acidosis, without affecting arterial inflow. This may explain the beneficial effects of LPC in patients with intermittent claudication and suggests a potential use of this drug in other stages of peripheral arterial disease and in patients undergoing surgery.