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Am J Physiol Cell Physiol 283: C802-C810, 2002. First published May 22, 2002; doi:10.1152/ajpcell.00046.2002
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Vol. 283, Issue 3, C802-C810, September 2002

L-Carnitine: a potential treatment for blocking apoptosis and preventing skeletal muscle myopathy in heart failure

Giorgio Vescovo1, Barbara Ravara2, Valerio Gobbo2, Marco Sandri2, Annalisa Angelini3, Mila Della Barbera3, Massimo Dona2, Gianfranco Peluso4, Menotti Calvani5, Luigi Mosconi5, and Luciano Dalla Libera2

1 Internal Medicine, City Hospital, 45011 Adria; 2 Consiglio Nazionale delle Ricerche Institute of Neuroscience, Unit for Muscle Biology and Pathophysiology, Department of Biomedical Sciences, and 3 Department of Cardiovascular Pathology, University of Padua, 35100 Padua; 4 Department of Experimental Oncology, National Cancer Institute, 80072 Naples; 5 Scientific Department, Sigma Tau, 00040 Rome, Italy

Skeletal muscle in congestive heart failure is responsible for increased fatigability and decreased exercise capacity. A specific myopathy with increased expression of fast-type myosins, myocyte atrophy, secondary to myocyte apoptosis triggered by high levels of circulating tumor necrosis factor-alpha (TNF-alpha ) has been described. In an animal model of heart failure, the monocrotaline-treated rat, we have observed an increase of apoptotic skeletal muscle nuclei. Proapoptotic agents, caspase-3 and -9, were increased, as well as serum levels of TNF-alpha and its second messenger sphingosine. Treatment of rats with L-carnitine, known for its protective effect on muscle metabolism injuries, was found to inhibit caspases and to decrease the levels of TNF-alpha and sphingosine, as well as the number of apoptotic myonuclei. Staurosporine was used in in vitro experiments to induce apoptosis in skeletal muscle cells in culture. When L-carnitine was applied to skeletal muscle cells, before staurosporine treatment, we observed a reduction in apoptosis. These findings show that L-carnitine can prevent apoptosis of skeletal muscles cells and has a role in the treatment of congestive heart failure-associated myopathy.

tumor necrosis factor; sphingosine; caspases; staurosporine


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