Potential protective effects of L-carnitine against neuromuscular ischemia-reperfusion injury: From experimental data to potential clinical applications

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. Method: 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. Conclusion: 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. (C) 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.