L-Carnitine and AIDS

[Guest guest]

http://www.aidsmap.com/treatments/ixdata/english/73C834DE-B6CF-4A87-B277-2AF606E\

401B0.htm

 

L-CarnitineUpdated: Aug 01, 2003 Carnitine is a naturally occurring amino acid

essential to the human body. It is required for energy metabolism and it is

found especially in muscle tissue.

 

In the past carnitine was known as vitamin BT or vitamin B7. However, 25% of a

person’s carnitine needs are made within the human body, which mean it is not

technically a vitamin. Slight chemical variations of carnitine are called

L-acetyl carnitine (LAC - a natural ester of carnitine) and L-carnitine (a

natural isomer of carnitine).

 

When the body doesn't get enough carnitine, fats are trapped in cells, and

immune system cells may be less responsive to infections. Deficiency results in

malfunctioning of the heart. Deficiency has been noted in people with AIDS, and

one study in 20 men with advanced AIDS showed that patients given 6 grammes a

day for two weeks showed marked reduction in serum triglycerides when compared

with a placebo group, and their beta2- microglobulin fell to almost normal

levels.

 

Carnitine, L-carnitine and LAC come in various oral or intravenous formulations.

In the USA, L-carnitine is sold under the tradename Carnitor for the treatment

of people with carnitine or vitamin B7 deficiency.

 

Research into L-carnitine

In the test tube L-carnitine is able to suppress the production of tumour

necrosis factor, elevated levels of which are thought to be responsible for

wasting in HIV-positive people. Researchers also found that those who received

L-carnitine reported less fatigue and greater energy (De Simone).

 

A six-month study of carnitine supplementation significantly reduced the

frequency of CD4 and CD8 cell apoptosis and produced higher CD4 counts

(Moretti). There is substantial in vitro and clinical evidence from an Italian

research group that L-carnitine inhibits HIV-related apoptosis by targetting the

immune system rather than the virus.

 

LAC to reduce side-effects of NRTIs

A specific deficiency in acetyl carnitine may play a role in nerve damage

related to ddI, d4T and ddC (Famularo), and there is emerging evidence that

L-acetyl carnitine (LAC) may reverse the nerve damage caused by these drugs.

Specifically, Dr Mike Youle of the Royal Free Hospital, London, has reported

nerve fibre re-growth in four people with drug-related peripheral neuropathy

after six months treatment with LAC.

 

A larger 14-day trial of LAC for the treatment of peripheral neuropathy is now

recruiting people in London, Manchester and the Netherlands. For details see

L-acetyl carnitine by intramuscular injection for peripheral neuropathy in

Clinical Trials: UK trials: opportunistic infections, side effects and

lipodystrophy.

 

A study of the effects of d4T in mice has found that L-carnitine is able to

counteract the metabolic effects of very high doses of d4T, especially

impairment of fatty acid oxidation and increased hepatic triglycerides (Igoudjil

2003).

 

During the development of the anti-HIV drug adefovir dipivoxil, supplements of

L-carnitine were given to people taking adefovir to reduce the risk of carnitine

deficiency. However, adefovir failed to meet regulatory standards due to its

toxicity profile so L-carnitine is no longer used as a supplement to adefovir.

 

Side-effects of carnitine include mild gastrointestinal upset and diarrhoea.

 

Research into carnitine treatments

 

Youle reported on 4 patients with grade 2-4 drug-related peripheral neuropathy

who received 6 months of LAC (1500 mg twice daily). Skin biopsies were taken

before commencing LAC therapy, and after 6 months of treatment, to assess

re-growth of nerve tissue. Significant improvements in growth of small sensory

fibres and nerve fibres in sweat glands were reported (p<0.001). All four

patients reported a reduction in pain, numbness and tingling.

 

Famularo found that nerve damage related to ddI, d4T and ddC was associated with

a specific deficiency in acetyl carnitine, although interference with the making

of mitochondrial DNA is regarded as the main cause of the toxicity of these

drugs.

 

Mauss reported a pilot study of L-carnitine for treatment of fat and metabolic

changes associated with HIV drug treatment. L-carnitine 1000 mg twice daily for

3 months had no impact on the physical symptoms of lipodystrophy although

cholesterol levels fell.

 

References

 

De Simone C et al. High dose L-carnitine improves immunologic and metabolic

parameters in AIDS patients. Immunopharmacology and Immunotoxicology 15(1):1-12,

1993.

 

De Simone C et al. Carnitine depletion in peripheral blood mononuclear cells

from patients with AIDS: effect of oral L-carnitine. AIDS 8(5):655-660, 1994.

 

Famularo G et al. Carnitine stands on its own in HIV infection treatment.

Archives of Internal Medicine 159:1143-1144, 1999.

 

Famularo G et al. Acetyl-carnitine deficiency in AIDS patients with

neurotoxicity on treatment with antiretroviral nucleoside analogues. AIDS

11(2):185-190, 1997.

 

Igoudjil A et al. L-carnitine prevents mitochondrial and metabolic disturbances

induced by very high dose of stavudine in mice. Tenth Conference on Retroviruses

and Opportunistic Infections, Boston, abstract P725, 2003.

 

Mauss S et al. L-carnitine in the treatment of HIV-associated lipodystrophy

syndrome. HIV Medicine 2(1):59-60, 2001.

 

Moretti S et al. Effect of L-carnitine on human immunodeficiency virus-1

infection-associated apoptosis: a pilot study. Blood, 91(10):3817-3824, 1998.

 

Youle M et al. L-acetyl carnitine (LAC) therapy increases cutaneous innervation

and improves symptoms in antiretroviral therapy-related peripheral neuropathy.

Antiviral Therapy 5(supp 2):32, 2000.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NEW WEB MESSAGE BOARDS - JOIN HERE.

Alternative Medicine Message Boards.Info

http://alternative-medicine-message-boards.info