Skip to main content
Current Therapeutic Research, Clinical and Experimental logoLink to Current Therapeutic Research, Clinical and Experimental
. 2007 Jan;68(1):32–46. doi: 10.1016/j.curtheres.2007.02.002

The effects of exogenous l-carnitine on lipid peroxidation and tissue damage in an experimental warm hepatic ischemia-reperfusion injury model*

Hakan Canbaz 1,5, Tamer Akca 1, Canten Tataroglu 2, Mehmet Caglikulekci 1, Musa Dirlik 1, Lokman Ayaz 3, Ali Bora Ustunsoy 1, Bahar Tasdelen 4, Suha Aydin 1
PMCID: PMC3965977  PMID: 24678117

Abstract

Background:l-Carnitine is the essential endogenous factor for the transport of long-chain fatty acids from the cytoplasm to within the mitochondrion where the β-oxidation process takes place. l-Carnitine is a superoxide scavenger and an antioxidant that possesses an anti-ischemic action and a stabilizing effect on cell membranes. It may be of help in liver ischemia reperfusion injury. Results regarding the effects of l-carnitine on liver ischemia and reperfusion injury are few and conflicting.

Objective: The aim of this study was to investigate the efficacy of exogenous l-carnitine on lipid peroxidation and protecting liver at different stages of experimental total warm hepatic ischemia-reperfusion (TWHIR) procedure in rats.

Methods: This experimental study in healthy, weanling, male Wistar rats (weighing 180–200 g) was conducted at the Experimental Animal Research Laboratory of the Faculty of Medicine of Mersin University, Mersin, Turkey. Rats were randomly divided into 5 groups: (A) Control group; (B) TWHIR procedure only; (C) l-carnitine administered 2 hours before the TWHIR procedure; (D) l-carnitine administered just before the TWHIR procedure; and (E) l-carnitine administered after total warm hepatic ischemia but just before the reperfusion procedure. Total warm hepatic ischemia (via the Pringle maneuver) and reperfusion were performed for 45 and 30 minutes, respectively. l-Carnitine (200 mg/kg) was administered intravenously. At the end of each procedure a blood sample was drawn and total hepatectomy was performed following reperfusion. Malondialdehyde (MDA) and myeloperoxidase (MPO) levels of both plasma and liver tissue, total antioxidant capacity (TAOC), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in plasma, and histopathologic examination were analyzed to assess lipid peroxidation and damage in liver tissue.

Results: Thirty-four rats (mean [SD]age, 59.26 [1.2]days; mean [SD] weight, 194.1 [5.1] g) were used in the study. There was a significant difference observed between groups A (n = 5) and B (n = 5) for all evaluation parameters. The TWHIR procedure performed in group B was associated with significant increases versus baseline in ALT, AST, MDA, and MPO in plasma, and MDA and MPO in liver tissue, but a significant decrease of TAOC in plasma. ALT, AST, serum and liver MDA, and MPO levels of group B were significantly higher than all groups administered l-carnitine. l-Carnitine administration between total warm hepatic ischemia and reperfusion was associated with a significant attenuation in all parameters. The liver MDA levels of groups C (n = 8) and D (n = 8) were significantly lower than that of group E (n = 8) (mean [SD]: C, 16.53 [3.32] and D, 18.28 [1.67] vs E, 23.05 [3.52]; P = 0.001 and P = 0.016, respectively). The mean (SD) liver MPO level of group C (1.09 [0.16]) was significantly lower than that of groups D (2.12 [0.25]) and E (2.11 [0.28]) (both, P = 0.001). The TAOC of group B (0.77 [0.12]) was significantly lower than that of groups C (1.34 [0.19]) and D (1.08 [0.20]) (P = 0.001 and P = 0.015, respectively). The TAOC of group C was significantly higher than that of the other l-carnitine groups (E, 0.94 [0.13]) (P = 0.023 vs group D; and P = 0.001 vs group E). Histopathologic scores of groups A, C, and E were significantly lower than that of group B, but the difference between groups B and D was not statistically significant.

Conclusions: In this experimental study, administration of exogenous l-carnitine was associated with significantly decreased lipid peroxidation in plasma and liver tissue when administered prior to a TWHIR procedure. In addition, l-carnitine seemed to be more effective with regard to decreasing lipid peroxidation in liver tissue when administered before warm hepatic ischemia. l-Carnitine was associated with significantly decreased leukocyte sequestration in plasma and liver tissue. A significant increase in TAOC was associated with l-carnitine administered prior to ischemia. These observations suggest that l-carnitine might have a protective effect against ischemia-reperfusion injury in rat liver tissue.

Key Words: l-carnitine, experimental, liver, ischemia, reperfusion

Full Text

The Full Text of this article is available as a PDF (174.2 KB).

Footnotes

*

This study was presented in part at the 7th National Congress of Hepatopancreatobiliary Surgery, May 5–8, 2005, Adana, Turkey, and at the 6th Congress of the European Hepato-Pancreato-Biliary Association (EHPBA), May 25–28, 2005, Heidelberg, Germany.

References

  • 1.Teoh NC, Farrell GC. Hepatic ischemia reperfusion injury: Pathogenic mechanisms and basis for hepatoprotection. J Gastroenterol Hepatol. 2003;18:891–902. doi: 10.1046/j.1440-1746.2003.03056.x. [DOI] [PubMed] [Google Scholar]
  • 2.Paulson DJ, Shug AL. Experimental evidence of the anti-ischemic effect of l-carnitine. In: de Jong JW, Ferrari R, editors. The Carnitine System: A New Therapeutical Approach to Cardiovascular Diseases. 1st ed. Kluwer Academic Publishers; Dordrecht, The Netherlands: 1995. pp. 183–197. [Google Scholar]
  • 3.Jaeschke H. Role of reactive oxygen species in hepatic ischemia-reperfusion injury and preconditioning. J Invest Surg. 2003;16:127–140. [PubMed] [Google Scholar]
  • 4.Yonezawa K, Tolba RH, Wetter A. l-carnitine could not improve hepatic warm ischemia-reperfusion injury despite ameliorated blood flow. J Surg Res. 2005;125:16–22. doi: 10.1016/j.jss.2004.11.016. [DOI] [PubMed] [Google Scholar]
  • 5.Atila K, Coker A, Sagol O. Protective effects of carnitine in an experimental ischemia-reperfusion injury. Clin Nutr. 2002;21:309–313. doi: 10.1054/clnu.2002.0544. [DOI] [PubMed] [Google Scholar]
  • 6.Puetz U, Tolba RH, Akbar S. Vol. 33. 2001. Effects of l-carnitine-hydrochloride in the cold ischemic preservation of fatty liver grafts; pp. 2523–2524. (Transplant Proc). [DOI] [PubMed] [Google Scholar]
  • 7.Akar H, Sarac A, Konuralp C. Comparison of histopathologic effects of carnitine and ascorbic acid on reperfusion injury. Eur J Cardiothorac Surg. 2001;19:500–506. doi: 10.1016/s1010-7940(01)00615-7. [DOI] [PubMed] [Google Scholar]
  • 8.Vanella A, Russo A, Acquaviva R. l-propionyl-carnitine as superoxide scavenger, antioxidant, and DNA cleavage protector. Cell Biol Toxicol. 2000;16:99–104. doi: 10.1023/a:1007638025856. [DOI] [PubMed] [Google Scholar]
  • 9.Mister M, Noris M, Szymczuk J. Propionyl-l-carnitine prevents renal function deterioration due to ischemia/reperfusion. Kidney Int. 2002;61:1064–1078. doi: 10.1046/j.1523-1755.2002.00212.x. [DOI] [PubMed] [Google Scholar]
  • 10.Akgun S, Tekeli A, Kurtkaya O. Neuroprotective effects of FK-506, l-carnitine and azathioprine on spinal cord ischemia-reperfusion injury. Eur J Cardiothorac Surg. 2004;25:105–110. doi: 10.1016/s1010-7940(03)00582-7. [DOI] [PubMed] [Google Scholar]
  • 11.Tellioglu AT, Uras KA, Yilmaz T. The effect of carnitine on random-pattern flap survival in rats. Plast Reconstr Surg. 2001;108:959–962. doi: 10.1097/00006534-200109150-00021. [DOI] [PubMed] [Google Scholar]
  • 12.http://www.cevreorman.gov.tr/yasa/k/25509.doc
  • 13.World Medical Association (WMA) statement on animal use in biomedical research [WMA Web site] WMA; Hong Kong: 1989. Available at: http://www.wma.net/e/policy/a18.htm. Accessed July 18, 2006. [Google Scholar]
  • 14.Yagi K. Lipid peroxides and related radicals in clinical medicine. In: Armstrong D, editor. Free Radicals in Diagnostic Medicine. Plenum Press; New York, NY: 1994. pp. 1–15. [DOI] [PubMed] [Google Scholar]
  • 15.Colowick SP, Kaplan NO, editors. Methods in Enzymology. Academic Press Inc; New York, NY: 1955. p. 769. [Google Scholar]
  • 16.Miller NJ, Rice-Evans C, Davies MJ. A novel method for measuring antioxidant capacity and its application to monitoring the antioxidant status in premature neonates. Clin Sci (Lond) 1993;84:407–412. doi: 10.1042/cs0840407. [DOI] [PubMed] [Google Scholar]
  • 17.Rosai J. Special techniques in surgical pathology. In: Rosai J, editor. Ackerman's Surgical Pathology. 8th ed. Mosby; St Louis, Mo: 1996. pp. 29–62. [Google Scholar]
  • 18.Bismuth H, Fecteau A. Hepatobiliary surgery. In: Bacon BR, Di Bisceglie AM, editors. Liver Disease: Diagnosis and Management. 1st ed. Churchill Livingstone; Philadelphia, Pa: 2000. pp. 370–382. [Google Scholar]
  • 19.Lentsch AB, Kato A, Yoshidome H. Inflammatory mechanisms and therapeutic strategies for warm hepatic ischemia/reperfusion injury. Hepatology. 2000;32:169–173. doi: 10.1053/jhep.2000.9323. [DOI] [PubMed] [Google Scholar]
  • 20.Marubayashi S, Dohi K, Ochi K, Kawasaki T. Role of free radicals in ischemic rat liver cell injury: Prevention of damage by alpha-tocopherol administration. Surgery. 1986;99:184–192. [PubMed] [Google Scholar]
  • 21.Marubayashi S, Dohi K, Yamada K, Kawasaki T. Changes in the levels of endogenous coenzyme Q homologs, alpha-tocopherol, glutathione in rat liver after hepatic ischemia and reperfusion, and the effect of pretreatment with coenzyme Q10. Biochim Biophys Acta. 1984;797:1–9. [PubMed] [Google Scholar]
  • 22.Serracino-Inglott F, Habib NA, Mathie RT. Hepatic ischemia-reperfusion injury. Am J Surg. 2001;181:160–166. doi: 10.1016/s0002-9610(00)00573-0. [DOI] [PubMed] [Google Scholar]
  • 23.Jaeschke H. Reactive oxygen and ischemia/reperfusion injury of the liver. Chem Biol Interact. 1991;79:115–136. doi: 10.1016/0009-2797(91)90077-k. [DOI] [PubMed] [Google Scholar]
  • 24.Kobayashi T, Esato K, Morita N, Noshima NS. Effects of thromboxane A2 synthesis inhibitor (OKY-046) on total liver ischemia in rats. Int Surg. 1996;81:115–118. [PubMed] [Google Scholar]
  • 25.Koster JF. Free radical-mediated damage and carnitine esters. In: de Jong JW, Ferrari R, editors. The Carnitine System: A New Therapeutical Approach to Cardiovascular Diseases. 1st ed. Kluwer Academic Publishers; Dordrecht, The Netherlands: 1995. pp. 123–132. [Google Scholar]
  • 26.Liu Z, Xu Z, Shen W. Effect of pharmacologic preconditioning with tetrandrine on subsequent ischemia/reperfusion injury in rat liver. World J Surg. 2004;28:620–624. doi: 10.1007/s00268-004-7172-3. [DOI] [PubMed] [Google Scholar]
  • 27.Tselepidis S, Papazoglou L, Dessiris A. Liver injury after ischemia and reperfusion: The role of oxygen free radicals. Mil Med. 2004;169:531–535. doi: 10.7205/milmed.169.7.531. [DOI] [PubMed] [Google Scholar]
  • 28.Su JF, Guo CJ, Wei JY. Protection against hepatic ischemia-reperfusion injury in rats by oral pretreatment with quercetin. Biomed Environ Sci. 2003;16:1–8. [PubMed] [Google Scholar]
  • 29.Demirdag K, Bahcecioglu IH, Ozercan IH. Role of l-carnitine in the prevention of acute liver damage induced by carbon tetrachloride in rats. J Gastroenterol Hepatol. 2004;19:333–338. doi: 10.1111/j.1440-1746.2003.03291.x. [DOI] [PubMed] [Google Scholar]
  • 30.Shen YC, Chen CF, Sung YJ. Tetrandrine ameliorates ischaemia-reperfusion injury of rat myocardium through inhibition of neutrophil priming and activation. Br J Pharmacol. 1999;128:1593–1601. doi: 10.1038/sj.bjp.0702958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Vollmar B, Richter S, Menger MD. Liver ischemia/reperfusion induces an increase of microvascular leukocyte flux, but not heterogeneity of leukocyte trafficking. Liver. 1997;17:93–98. doi: 10.1111/j.1600-0676.1997.tb00787.x. [DOI] [PubMed] [Google Scholar]
  • 32.Gorur S, Bagdatoglu OT, Polat G. Protective effect of l-carnitine on renal ischaemiareperfusion injury in the rat. Cell Biochem Funct. 2005;23:151–155. doi: 10.1002/cbf.1159. [DOI] [PubMed] [Google Scholar]
  • 33.Yu BP. Cellular defenses against damage from reactive oxygen species [published correction appears in Physiol Rev. 1995;75:preceding 1] Physiol Rev. 1994;74:139–162. doi: 10.1152/physrev.1994.74.1.139. [DOI] [PubMed] [Google Scholar]
  • 34.Bykov IL, Mal'tsev AN, Gurinovich VA, Nefedov LI. Biochemical basis of valproic acid toxicity: Role of oxidative stress and effects of l-carnitine [in Russian] Biomed Khim. 2004;50:384–389. [PubMed] [Google Scholar]

Articles from Current Therapeutic Research, Clinical and Experimental are provided here courtesy of Elsevier

RESOURCES