Preventive effect of l-carnitine and its derivatives on endothelial dysfunction and platelet aggregation

Abstract

Background and aim: Oxidative stress plays an important role in platelet activation and endothelial dysfunction. Exogenous and endogenous reactive oxygen species are associated with platelet activation and vascular dysfunction. Antioxidants have been shown to attenuate oxidative stress and consequently endothelial dysfunction by preventing inflammation, regulating vascular tone, and promoting antiadhesive and antithrombotic properties. l-carnitine and its derivatives have been demonstrated to improve endothelial and platelet function against oxidative stress by several mechanisms, some of which cannot be found in other antioxidants. The role of l-carnitine and its derivatives in endothelial dysfunction and platelet activation will be reviewed here from the perspective of basic and clinical research.

Method: This study reviews in vitro and in vivo studies, clinical trials, and abstracts in the English language that have examined the protective effects of l-carnitine and its derivatives on endothelial dysfunction and platelet aggregation in pathological conditions. We searched experimental studies, clinical trials, and other review articles to obtain the materials.

Conclusions: Although in vitro physiological models, animal studies on vascular and platelet function, and some human studies on these systems are in favor of the preventive effects of l-carnitine and its derivatives on endothelial dysfunction and platelet aggregation, more clinical trials are needed to clarify the clinical importance of l-carnitine as a supportive option to maintain the normal homeostatic function of the vasculature and to prevent platelet activation.

Keywords: Acetyl-l-carnitine; Endothelial cell; NADPH oxidase; Platelet; Propionyl-l-carnitine; Reactive oxygen species; l-carnitine.