Activated peroxisomal fatty acid metabolism improves cardiac recovery in ischemia-reperfusion

Depressed oxidation of long chain fatty acids (LCFA) in heart ischemia leads to acute accumulation of LCFA metabolites that impair the functioning of the mitochondria. We hypothesized that reduced activity of carnitine palmitoyltransferase-I (CPT-I) might activate peroxisomal LCFA oxidation and protect mitochondrial function in ischemia and reperfusion. In the present study, despite the long-term threefold reduction in L-carnitine content by 3-(2,2,2-trimethylhydrazinium)-propionate, the uptake and oxidation rates of LCFA in the heart in normoxia were not significantly influenced. The significant increase in PPARα and PGC1α nuclear content, observed in this study, were followed by increased expression of genes involved in peroxisomal fatty acid oxidation (FAO) which compensated for the limited CPT-I-dependent FA transport into the mitochondria. In ischemia followed by reperfusion, the redirection of LCFA oxidation from mitochondria to peroxisomes protected the mitochondria from the accumulation of LCFA. In turn, the recovery of FAO resulted in significant reduction of myocardial infarct size. In conclusion, the decreased L-carnitine content in the heart preserves its peroxisomal and mitochondrial function after ischemia and improves cardiac recovery during reperfusion. The functional interplay between the decrease in L-carnitine and the PPARα/PGC1α pathway-induced redirection of FA metabolism protects the mitochondria against LCFA overload and provides a foundation for novel cardioprotective mechanisms.     

Mildronate treatment alters γ-butyrobetaine and l-carnitine concentrations in healthy volunteers

Objectives In this study, we aimed to investigate the effects of long‐term administration of the cardioprotective drug mildronate on the concentrations of l ‐carnitine and γ‐butyrobetaine in healthy volunteers. Methods Mildronate was administered perorally, at a dosage of 500 mg, twice daily. Plasma and urine samples were collected weekly. Daily meat consumption within an average, non‐vegetarian diet was monitored. l ‐Carnitine, γ‐butyrobetaine and mildronate concentrations were measured using the UPLC/MS/MS method. Key findings After 4 weeks, the average concentrations of l ‐carnitine in plasma significantly decreased by 18%. The plasma concentrations of γ‐butyrobetaine increased about two‐fold, and this effect was statistically significant in both the male and female groups. In urine samples, a significant increase in l ‐carnitine and γ‐butyrobetaine levels was observed, which provides evidence for increased excretion of both substances during the mildronate treatment. At the end of the treatment period, the plasma concentration of mildronate was 20 µm on average. There were no significant differences between the effects observed in female and male volunteers. Meat consumption partially reduced the l ‐carnitine‐lowering effects induced by mildronate. Conclusions Long‐term administration of mildronate significantly lowers l ‐carnitine plasma concentrations in non‐vegetarian, healthy volunteers.     

The cardioprotective effect of mildronate is diminished after co-treatment with L-carnitine

Mildronate, an inhibitor of L-carnitine biosynthesis and uptake, is a cardioprotective drug whose mechanism of action is thought to rely on the changes in concentration of L-carnitine in heart tissue. In the present study, we compared the cardioprotective effect of mildronate (100 mg/kg) and a combination of mildronate and L-carnitine (100 + 100 mg/kg) administered for 14 days with respect to the observed changes in l-carnitine level and carnitine palmitoyltransferase I (CPT-I)-dependent fatty acid metabolism in the heart tissues. Concentrations of L-carnitine and its precursor γ-butyrobetaine (GBB) were measured by ultraperformance liquid chromatography with tandem mass spectrometry. In addition, mitochondrial respiration, activity of CPT-I, and expression of CPT-IA/B messenger RNA (mRNA) were measured. Isolated rat hearts were subjected to ischemia-reperfusion injury. Administration of mildronate induced a 69% decrease in L-carnitine concentration and a 6-fold increase in GBB concentration in the heart tissue as well as a 27% decrease in CPT-I-dependent mitochondrial respiration on palmitoyl-coenzyme A. In addition, mildronate treatment induced a significant reduction in infarct size and also diminished the ischemia-induced respiration stimulation by exogenous cytochrome c. Treatment with a combination had no significant impact on L-carnitine concentration, CPT-I-dependent mitochondrial respiration, and infarct size. Our results demonstrated that the mildronate-induced decrease in L-carnitine concentration, concomitant decrease in fatty acid transport, and maintenance of the intactness of outer mitochondrial membrane in heart mitochondria are the key mechanisms of action for the anti-infarction activity of mildronate.     

Effect of inhibiting carnitine biosynthesis on male rat sexual performance

l-carnitine has a documented role as a cofactor in cellular energy metabolism and fatty acid β-oxidation pathways and it has also been considered to function in reproductive biology. We investigated whether decreasing concentrations of l-carnitine using an inhibitor of its biosynthesis, mildronate (3-(2,2,2-trimethylhydrazinium)-propionate), would influence the sexual behavior or sperm quality in male rats. Mildronate treatment induced a significant decrease in carnitine concentration and an increase in γ-butyrobetaine (GBB) concentration in both plasma and testes extracts. However, the expression of carnitine palmitoyltransferase I in testes and testosterone concentration in plasma was not changed in mildronate treated rat. Behavioral experiments demonstrated that mildronate treatment did not decrease the sexual motivation in both sexually naive and sexually experienced rats. The densities of spermatozoa in the cauda epididymis, as well as motility, were unchanged after mildronate treatment at a dose of 100 mg/kg. In conclusion, our study provides experimental evidence that mildronate induces decrease in the free carnitine concentration in rat testes, but does not decrease the sexual activity or sperm quality of male rats.