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Применение Карницетина у пациентов с диабетической полинейропатией
Камчатнов П.Р., Кабанов А.А., Ханмурзаева С.Б. Применение карницетина у пациентов с диабетической полинейропатией. Consilium Medicum. 2017; 19 (2): 136–140.
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Kamchatnov P.R., Kabanov A.A., Khanmurzaeva S.B. The use of Carnicetine in patients with diabetic polyneuropathy. Consilium Medicum. 2017; 19 (2): 136–140.
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Аннотация
Полинейропатия – частое осложнение сахарного диабета, ассоциированное с тяжелой инвалидизацией, снижением качества жизни пациентов, повышением риска наступления летального исхода. Лечение больных с диабетической полинейропатией (ДПНП) включает коррекцию углеводного обмена, восстановление структуры и функций нервных волокон, устранение наиболее значимых симптомов заболевания. В настоящее время накоплены сведения об эффективности ацетил-L-карнитина (Карницетин) у таких пациентов. Рассматриваются сведения о его роли в обмене веществ в норме и в условиях патологии. Приведены результаты рандомизированных клинических исследований и метаанализа по данной проблеме, свидетельствующие об эффективности препарата у пациентов с ДПНП.
Ключевые слова: сахарный диабет, диабетическая полинейропатия, ацетил-L-карнитин, Карницетин, лечение.
Ключевые слова: сахарный диабет, диабетическая полинейропатия, ацетил-L-карнитин, Карницетин, лечение.
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Polyneuropathy is a frequent complication of diabetes mellitus, associated with severe disability, a decrease in the quality of life of patients, an increased risk of death. Treatment of patients with diabetic polyneuropathy (DPNP) includes correction of carbohydrate metabolism, restoration of the structure and functions of nerve fibers, elimination of the most significant symptoms of the disease. At present, information on the efficacy of acetyl-L-carnitine (Carnitine) in such patients is accumulated. Information on its role in metabolism in normal and pathological conditions is considered. The results of randomized clinical trials and meta-analyzes on this issue are presented, which testify to the effectiveness of the drug in patients with DPNP.
Key words: diabetes mellitus, diabetic polyneuropathy, acetyl-L-carnitine, Carnicetine, treatment.
Key words: diabetes mellitus, diabetic polyneuropathy, acetyl-L-carnitine, Carnicetine, treatment.
Полный текст
Список литературы
1. Visser N, Notermans N, Linssen R et al. Incidence of polyneuropathy in Utrecht, the Netherlands. Neurology 2015; 84 (3): 259–64.
2. Vincent A, Calabek B, Roberts L, Feldman E. Biology of diabetic neuropathy. Handb Clin Neurol 2013; 115: 591–606.
3. Sachan DS, Yatim AM. Suppression of aflatoxin B1-induced lipid abnormalities and macromolecule-adduct formation by L-carnitine. J Environ Pathol Toxicol Oncol 1992; 11: 205–10.
4. Mingrone G. Carnitine in type 2 diabetes. Ann N Y Acad Sci 2004; 1033: 99–107.
5. Rahbar AR, Shakerhosseini R, Saadat N et al. Effect of L-carnitine on plasma glycemic andlipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr 2005; 59: 592–6.
6. Power RA, Hulver MW, Zhang JY et al. Carnitine revisited: potential use as adjunctive treatment in diabetes. Diabetologia 2007; 50: 824–832. DOI 10.1007/s00125-007-0605-4
7. Faradji V, Sotelo J. Low serum levels of nerve growth factor in diabetic neuropathy. Acta Neurol Scand 1990; 81: 402–6.
8. Levine J, Panchalingam K, McClure RJ et al. Effects of acetyl-L-carnitine and myo-inositol on high-energy phosphate and membrane phospholipid metabolism in zebra fish: a 31P-NMR-spectroscopy study. Neurochem Res 2003; 28: 687–90.
9. Vivoli E, Di Cesare Mannelli L et al. Acetyl-l-carnitine increases artemin level and prevents neurotrophic factor alterations during neuropathy. Neuroscience. 2010; 167: 1168–74. http://dx.doi.org/10.1016/j.neuroscience.2010.03.017.
10. Sariola H, Saarma M. Novel functions and signalling pathways for GDNF. J CellSci 2003; 116 (Pt 19): 3855–62.
11. Baloh RH, Tansey MG, Lampe PA et al. Artemin, a novel member of the GDNF ligand family, supports peripheral and central neurons and signals through the GFRalpha3-RET receptor complex. Neuron 1998; 21 (6): 1291–302.
12. Traina G. The neurobiology of acetyl-L-carnitine. Front Biosci (Landmark Ed) 2016; 21: 1314–29.
13. Ido Y, McHowat J, Chang KC et al. Neural dysfunction and metabolic imbalances in diabetic rats: prevention by acetyl-L-carnitine. Diabetes 1994; 43: 1469–77. http://dx.doi.org/10.2337/di-abetes. 43.12.1469
14. Chiechio S, Copani A, Iv RWG, Nicoletti F. Acetyl-L-carnitine in neuropathic pain. CNS Drugs 2007; 21 (1): 31–8.
15. Malaguarnera M. Carnitine derivatives: clinical usefulness. Curr Opin Gastroenterol 2012; 28: 166–76. http://dx.doi.org/10.1097/MOG.0b013e3283505a3b
16. Watson JC, Dyck PJB. Peripheral neuropathy: a practical approach to diagnosis and symptom management. Mayo Clin Proc 2015; 90: 940–51. http://dx.doi.org/10.1016/j.mayocp.2015.05.004.
17. Acetyl-L-carnitine. Monograph. Altern Med Rev 2010; 15: 76–83.
18. Curti D, Dagani F, Galmozzi MR, Marzatico F. Effect of aging and acetyl-L-carnitine on energetic and cholinergic metabolism in rat brain regions. Mech Ageing Dev 1989; 47: 39–45. PMID: 2542702
19. Onofrj M, Ciccocioppo F, VaraneseS et al. Acetyl-L-carnitine: from a biological curiosity to a drug for the peripheral nervous system and beyond. Expert Rev Neurother 2013; 13: 925–36. DOI: 10.1586/14737175.2013.814930 PMID: 23965166
20. Scarpini E, Doneda P, Pizzul S et al. L-carnitine and acetyl-Lcarnitine in human nerves from normal and diabetic subjects. J Peripher Nerv Syst 1996; 1: 157–63.
21. Li S, Li Q, Li Y et al. Acetyl-L-carnitine in the treatment of peripheral neuropathic pain: a systematic review and meta-analysis of randomized controlled trials. Plos One 2015; 10: 1–10. http://dx.doi.org/10.1371/ journal.pone.0119479.
22. Pessoa B, Escudeiro G, Nascimento O. Emerging Treatments for Neuropathic Pain. Curr Pain Headache Rep 2015; 19: 56–60.
23. De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R&D 2002; 3: 223–31.
24. Sima AA, Calvani M, Mehra M, Amato A. Acetyl-l-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy an analysis of two randomized placebo-controlled trials. Diabetes Care 2005; 28: 89–94.
25. Li S, Chen X, Li Q et al. Effects of acetyl-L-carnitine andmethylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial. J Diabetes Invest 2016; 7: 777–785. DOI: 10.1111/jdi.12493
26. Veronese N, Sergi G, Stubbs B, the EUGMS special interest group on diabetes. Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy: A systematic review and meta-analysis. Eur Geriatr Med 2017. http://dx.doi.org/10.1016/j.eurger.2017.01.002
27. Mondal S, Choudhury KB, Sharma S et al. Comparative study among glutamine, acetyl-L-carnitine, vitamin-E and methylcobalamine for treatment of paclitaxel-induced peripheral neuropathy. Clin Cancer Investig J 2014; 3: 213–9.
28. Youle M, Osio M. A double-blind, parallel-group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV Med 2007; 8: 241–50.
39. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV ClinTrials 2005; 6: 344–50.
2. Vincent A, Calabek B, Roberts L, Feldman E. Biology of diabetic neuropathy. Handb Clin Neurol 2013; 115: 591–606.
3. Sachan DS, Yatim AM. Suppression of aflatoxin B1-induced lipid abnormalities and macromolecule-adduct formation by L-carnitine. J Environ Pathol Toxicol Oncol 1992; 11: 205–10.
4. Mingrone G. Carnitine in type 2 diabetes. Ann N Y Acad Sci 2004; 1033: 99–107.
5. Rahbar AR, Shakerhosseini R, Saadat N et al. Effect of L-carnitine on plasma glycemic andlipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr 2005; 59: 592–6.
6. Power RA, Hulver MW, Zhang JY et al. Carnitine revisited: potential use as adjunctive treatment in diabetes. Diabetologia 2007; 50: 824–832. DOI 10.1007/s00125-007-0605-4
7. Faradji V, Sotelo J. Low serum levels of nerve growth factor in diabetic neuropathy. Acta Neurol Scand 1990; 81: 402–6.
8. Levine J, Panchalingam K, McClure RJ et al. Effects of acetyl-L-carnitine and myo-inositol on high-energy phosphate and membrane phospholipid metabolism in zebra fish: a 31P-NMR-spectroscopy study. Neurochem Res 2003; 28: 687–90.
9. Vivoli E, Di Cesare Mannelli L et al. Acetyl-l-carnitine increases artemin level and prevents neurotrophic factor alterations during neuropathy. Neuroscience. 2010; 167: 1168–74. http://dx.doi.org/10.1016/j.neuroscience.2010.03.017.
10. Sariola H, Saarma M. Novel functions and signalling pathways for GDNF. J CellSci 2003; 116 (Pt 19): 3855–62.
11. Baloh RH, Tansey MG, Lampe PA et al. Artemin, a novel member of the GDNF ligand family, supports peripheral and central neurons and signals through the GFRalpha3-RET receptor complex. Neuron 1998; 21 (6): 1291–302.
12. Traina G. The neurobiology of acetyl-L-carnitine. Front Biosci (Landmark Ed) 2016; 21: 1314–29.
13. Ido Y, McHowat J, Chang KC et al. Neural dysfunction and metabolic imbalances in diabetic rats: prevention by acetyl-L-carnitine. Diabetes 1994; 43: 1469–77. http://dx.doi.org/10.2337/di-abetes. 43.12.1469
14. Chiechio S, Copani A, Iv RWG, Nicoletti F. Acetyl-L-carnitine in neuropathic pain. CNS Drugs 2007; 21 (1): 31–8.
15. Malaguarnera M. Carnitine derivatives: clinical usefulness. Curr Opin Gastroenterol 2012; 28: 166–76. http://dx.doi.org/10.1097/MOG.0b013e3283505a3b
16. Watson JC, Dyck PJB. Peripheral neuropathy: a practical approach to diagnosis and symptom management. Mayo Clin Proc 2015; 90: 940–51. http://dx.doi.org/10.1016/j.mayocp.2015.05.004.
17. Acetyl-L-carnitine. Monograph. Altern Med Rev 2010; 15: 76–83.
18. Curti D, Dagani F, Galmozzi MR, Marzatico F. Effect of aging and acetyl-L-carnitine on energetic and cholinergic metabolism in rat brain regions. Mech Ageing Dev 1989; 47: 39–45. PMID: 2542702
19. Onofrj M, Ciccocioppo F, VaraneseS et al. Acetyl-L-carnitine: from a biological curiosity to a drug for the peripheral nervous system and beyond. Expert Rev Neurother 2013; 13: 925–36. DOI: 10.1586/14737175.2013.814930 PMID: 23965166
20. Scarpini E, Doneda P, Pizzul S et al. L-carnitine and acetyl-Lcarnitine in human nerves from normal and diabetic subjects. J Peripher Nerv Syst 1996; 1: 157–63.
21. Li S, Li Q, Li Y et al. Acetyl-L-carnitine in the treatment of peripheral neuropathic pain: a systematic review and meta-analysis of randomized controlled trials. Plos One 2015; 10: 1–10. http://dx.doi.org/10.1371/ journal.pone.0119479.
22. Pessoa B, Escudeiro G, Nascimento O. Emerging Treatments for Neuropathic Pain. Curr Pain Headache Rep 2015; 19: 56–60.
23. De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R&D 2002; 3: 223–31.
24. Sima AA, Calvani M, Mehra M, Amato A. Acetyl-l-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy an analysis of two randomized placebo-controlled trials. Diabetes Care 2005; 28: 89–94.
25. Li S, Chen X, Li Q et al. Effects of acetyl-L-carnitine andmethylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial. J Diabetes Invest 2016; 7: 777–785. DOI: 10.1111/jdi.12493
26. Veronese N, Sergi G, Stubbs B, the EUGMS special interest group on diabetes. Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy: A systematic review and meta-analysis. Eur Geriatr Med 2017. http://dx.doi.org/10.1016/j.eurger.2017.01.002
27. Mondal S, Choudhury KB, Sharma S et al. Comparative study among glutamine, acetyl-L-carnitine, vitamin-E and methylcobalamine for treatment of paclitaxel-induced peripheral neuropathy. Clin Cancer Investig J 2014; 3: 213–9.
28. Youle M, Osio M. A double-blind, parallel-group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV Med 2007; 8: 241–50.
39. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV ClinTrials 2005; 6: 344–50.
________________________________________________
1. Visser N, Notermans N, Linssen R et al. Incidence of polyneuropathy in Utrecht, the Netherlands. Neurology 2015; 84 (3): 259–64.
2. Vincent A, Calabek B, Roberts L, Feldman E. Biology of diabetic neuropathy. Handb Clin Neurol 2013; 115: 591–606.
3. Sachan DS, Yatim AM. Suppression of aflatoxin B1-induced lipid abnormalities and macromolecule-adduct formation by L-carnitine. J Environ Pathol Toxicol Oncol 1992; 11: 205–10.
4. Mingrone G. Carnitine in type 2 diabetes. Ann N Y Acad Sci 2004; 1033: 99–107.
5. Rahbar AR, Shakerhosseini R, Saadat N et al. Effect of L-carnitine on plasma glycemic andlipidemic profile in patients with type II diabetes mellitus. Eur J Clin Nutr 2005; 59: 592–6.
6. Power RA, Hulver MW, Zhang JY et al. Carnitine revisited: potential use as adjunctive treatment in diabetes. Diabetologia 2007; 50: 824–832. DOI 10.1007/s00125-007-0605-4
7. Faradji V, Sotelo J. Low serum levels of nerve growth factor in diabetic neuropathy. Acta Neurol Scand 1990; 81: 402–6.
8. Levine J, Panchalingam K, McClure RJ et al. Effects of acetyl-L-carnitine and myo-inositol on high-energy phosphate and membrane phospholipid metabolism in zebra fish: a 31P-NMR-spectroscopy study. Neurochem Res 2003; 28: 687–90.
9. Vivoli E, Di Cesare Mannelli L et al. Acetyl-l-carnitine increases artemin level and prevents neurotrophic factor alterations during neuropathy. Neuroscience. 2010; 167: 1168–74. http://dx.doi.org/10.1016/j.neuroscience.2010.03.017.
10. Sariola H, Saarma M. Novel functions and signalling pathways for GDNF. J CellSci 2003; 116 (Pt 19): 3855–62.
11. Baloh RH, Tansey MG, Lampe PA et al. Artemin, a novel member of the GDNF ligand family, supports peripheral and central neurons and signals through the GFRalpha3-RET receptor complex. Neuron 1998; 21 (6): 1291–302.
12. Traina G. The neurobiology of acetyl-L-carnitine. Front Biosci (Landmark Ed) 2016; 21: 1314–29.
13. Ido Y, McHowat J, Chang KC et al. Neural dysfunction and metabolic imbalances in diabetic rats: prevention by acetyl-L-carnitine. Diabetes 1994; 43: 1469–77. http://dx.doi.org/10.2337/di-abetes. 43.12.1469
14. Chiechio S, Copani A, Iv RWG, Nicoletti F. Acetyl-L-carnitine in neuropathic pain. CNS Drugs 2007; 21 (1): 31–8.
15. Malaguarnera M. Carnitine derivatives: clinical usefulness. Curr Opin Gastroenterol 2012; 28: 166–76. http://dx.doi.org/10.1097/MOG.0b013e3283505a3b
16. Watson JC, Dyck PJB. Peripheral neuropathy: a practical approach to diagnosis and symptom management. Mayo Clin Proc 2015; 90: 940–51. http://dx.doi.org/10.1016/j.mayocp.2015.05.004.
17. Acetyl-L-carnitine. Monograph. Altern Med Rev 2010; 15: 76–83.
18. Curti D, Dagani F, Galmozzi MR, Marzatico F. Effect of aging and acetyl-L-carnitine on energetic and cholinergic metabolism in rat brain regions. Mech Ageing Dev 1989; 47: 39–45. PMID: 2542702
19. Onofrj M, Ciccocioppo F, VaraneseS et al. Acetyl-L-carnitine: from a biological curiosity to a drug for the peripheral nervous system and beyond. Expert Rev Neurother 2013; 13: 925–36. DOI: 10.1586/14737175.2013.814930 PMID: 23965166
20. Scarpini E, Doneda P, Pizzul S et al. L-carnitine and acetyl-Lcarnitine in human nerves from normal and diabetic subjects. J Peripher Nerv Syst 1996; 1: 157–63.
21. Li S, Li Q, Li Y et al. Acetyl-L-carnitine in the treatment of peripheral neuropathic pain: a systematic review and meta-analysis of randomized controlled trials. Plos One 2015; 10: 1–10. http://dx.doi.org/10.1371/ journal.pone.0119479.
22. Pessoa B, Escudeiro G, Nascimento O. Emerging Treatments for Neuropathic Pain. Curr Pain Headache Rep 2015; 19: 56–60.
23. De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R&D 2002; 3: 223–31.
24. Sima AA, Calvani M, Mehra M, Amato A. Acetyl-l-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy an analysis of two randomized placebo-controlled trials. Diabetes Care 2005; 28: 89–94.
25. Li S, Chen X, Li Q et al. Effects of acetyl-L-carnitine andmethylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial. J Diabetes Invest 2016; 7: 777–785. DOI: 10.1111/jdi.12493
26. Veronese N, Sergi G, Stubbs B, the EUGMS special interest group on diabetes. Effect of acetyl-l-carnitine in the treatment of diabetic peripheral neuropathy: A systematic review and meta-analysis. Eur Geriatr Med 2017. http://dx.doi.org/10.1016/j.eurger.2017.01.002
27. Mondal S, Choudhury KB, Sharma S et al. Comparative study among glutamine, acetyl-L-carnitine, vitamin-E and methylcobalamine for treatment of paclitaxel-induced peripheral neuropathy. Clin Cancer Investig J 2014; 3: 213–9.
28. Youle M, Osio M. A double-blind, parallel-group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV Med 2007; 8: 241–50.
39. Herzmann C, Johnson MA, Youle M. Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy. HIV ClinTrials 2005; 6: 344–50.
Авторы
П.Р.Камчатнов*1, А.А.Кабанов1, С.Б.Ханмурзаева2, А.В.Чугунов1, Н.Б.Ханмурзаева2
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России. 367000, Россия, Махачкала, пл. Ленина, д. 1
*pavkam7@gmail.com
1 ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1;
2 ФГБОУ ВО «Дагестанский государственный медицинский университет» Минздрава России. 367000, Россия, Махачкала, пл. Ленина, д. 1
*pavkam7@gmail.com
________________________________________________
P.R.Kamchatnov*1, A.A.Kabanov1, S.B.Khanmurzaeva2, A.V.Chugunov1, N.B.Khanmurzaeva2
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 Dagestan State Medical University. 367000, Russian Federation, Makhachkala, pl. Lenina, d. 1
*pavkam7@gmail.com
1 N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1;
2 Dagestan State Medical University. 367000, Russian Federation, Makhachkala, pl. Lenina, d. 1
*pavkam7@gmail.com
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