Xiang Feng, Zhang Zhimin, Xie Jingchen, Xiong Suhui, Yang Chen, Liao Duanfang, Xia Bohou, Lin Limei
Key Laboratory for Quality Evaluation of Bulk Herbs of Hunan Province, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, China.
J Transl Med. 2025 Mar 14;23(1):324. doi: 10.1186/s12967-025-06341-5.
Traditionally, the carnitine pool is closely related to fatty acid metabolism. However, with increasing research, the pleiotropic effects of the carnitine pool have gradually emerged. The purpose of this review is to comprehensively investigate of the emerging understanding of the pleiotropic role of the carnitine pool, carnitine/acylcarnitines are not only auxiliaries or metabolites of fatty acid oxidation, but also play more complex and diverse roles, including energy metabolism, mitochondrial homeostasis, epigenetic regulation, regulation of inflammation and the immune system, tumor biology, signal transduction, and neuroprotection. This review provides an overview of the complex network of carnitine synthesis, transport, shuttle, and regulation, carnitine/acylcarnitines have the potential to be used as communication molecules, biomarkers and therapeutic targets for multiple diseases, with profound effects on intercellular communication, metabolic interactions between organs and overall metabolic health. The purpose of this review is to comprehensively summarize the multidimensional biological effects of the carnitine pool beyond its traditional role in fatty acid oxidation and to summarize the systemic effects mediated by carnitine/acylcarnitine to provide new perspectives for pharmacological research and treatment innovation and new strategies for the prevention and treatment of a variety of diseases.
传统上，肉碱池与脂肪酸代谢密切相关。然而，随着研究的不断深入，肉碱池的多效性作用逐渐显现出来。本综述的目的是全面探讨对肉碱池多效性作用的新认识，肉碱/酰基肉碱不仅是脂肪酸氧化的辅助因子或代谢产物，还发挥着更为复杂多样的作用，包括能量代谢、线粒体稳态、表观遗传调控、炎症和免疫系统调节、肿瘤生物学、信号转导以及神经保护等。本综述概述了肉碱合成、转运、穿梭和调节的复杂网络，肉碱/酰基肉碱有潜力作为多种疾病的通讯分子、生物标志物和治疗靶点，对细胞间通讯、器官间代谢相互作用和整体代谢健康产生深远影响。本综述的目的是全面总结肉碱池超越其在脂肪酸氧化中传统作用的多维生物学效应，并总结肉碱/酰基肉碱介导的全身效应，为药理学研究和治疗创新提供新视角，为多种疾病的预防和治疗提供新策略。
