Moghaddas Azadeh, Dashti-Khavidaki Simin
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Nephrology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Clin Nutr. 2016 Aug;35(4):783-90. doi: 10.1016/j.clnu.2015.07.001. Epub 2015 Jul 10.
BACKGROUND & AIM: Ischemia-reperfusion (I/R) injury plays important role in morbidity and mortality in several pathologies, including myocardial infarction, ischemic stroke, acute kidney injury, trauma, and circulatory arrest. An imbalance in metabolic supply and tissue's demand during ischemia results in profound tissue hypoxia and microvascular dysfunction. Subsequently, reperfusion further results in activation of immune responses and cell death programs. l-carnitine and its derivatives have been administered to improve tolerance against I/R injury in various tissues. Anti-ischemic properties of l-carnitine and its derivative in neuromuscular organs will be reviewed here at the light of pertinent results from basic and clinical researches.
All available in vitro and in vivo studies, patents, clinical trials, and meeting abstracts in English language that examined the protective effects of l-carnitine against I/R induced injury in neuromuscular organs were reviewed. Materials were obtained by searching ELSEVIER, web of knowledge, PubMed, Scopus, clinical trials, and Cochrane database of systematic reviews.
Although animal studies on central nervous system and some human studies on muscular system were in favors of effects of l-carnitine against I/R injury, however, more clinical trials are needed to clarify the clinical importance of l-carnitine as a treatment option to manage I/R-induced injury of neuromuscular system.
缺血再灌注(I/R)损伤在包括心肌梗死、缺血性中风、急性肾损伤、创伤和循环骤停在内的多种病症的发病和死亡中起重要作用。缺血期间代谢供应与组织需求的失衡导致严重的组织缺氧和微血管功能障碍。随后,再灌注进一步导致免疫反应激活和细胞死亡程序。左旋肉碱及其衍生物已被用于提高各种组织对I/R损伤的耐受性。本文将根据基础和临床研究的相关结果,综述左旋肉碱及其衍生物在神经肌肉器官中的抗缺血特性。
对所有以英文发表的体外和体内研究、专利、临床试验以及会议摘要进行综述,这些研究探讨了左旋肉碱对神经肌肉器官I/R诱导损伤的保护作用。通过检索爱思唯尔、科学网、PubMed、Scopus、临床试验和Cochrane系统评价数据库获取资料。
尽管关于中枢神经系统的动物研究和关于肌肉系统的一些人体研究支持左旋肉碱对I/R损伤的作用,然而,需要更多的临床试验来阐明左旋肉碱作为治疗神经肌肉系统I/R诱导损伤的一种治疗选择的临床重要性。