TY - JOUR
T1 - Acetyl-L-Carnitine in dementia and other cognitive disorders
T2 - A critical update
AU - Pennisi, Manuela
AU - Lanza, Giuseppe
AU - Cantone, Mariagiovanna
AU - D’amico, Emanuele
AU - Fisicaro, Francesco
AU - Puglisi, Valentina
AU - Vinciguerra, Luisa
AU - Bella, Rita
AU - Vicari, Enzo
AU - Malaguarnera, Giulia
PY - 2020/5
Y1 - 2020/5
N2 - Several studies explored the effects of acetyl-L-carnitine (ALC) in dementia, suggesting a role in slowing down cognitive decline. Nevertheless, in 2003 a systematic review concluded there was insufficient evidence to recommend a clinical use, although a meta-analysis in the same year showed a significant advantage for ALC for clinical scales and psychometric tests. Since then, other studies have been published; however, a critical review is still lacking. We provide an update of the studies on ALC in primary and secondary dementia, highlighting the current limitations and translational implications. Overall, the role of ALC in dementia is still under debate. The underlying mechanisms may include restoring of cell membranes and synaptic functioning, enhancing cholinergic activity, promoting mitochondrial energy metabolism, protecting against toxins, and exerting neurotrophic effects. The effects of ALC on the gut–liver–brain axis seem to identify the category of patients in which the new insights contribute most to the mechanisms of action of ALC, likely being the liver metabolism and the improvement of hepatic detoxifying mechanisms the primary targets. In this framework, our research group has dealt with this topic, focusing on the ALC-related cross-talk mechanisms. Further studies with homogeneous sample and longitudinal assessment are needed before a systematic clinical application.
AB - Several studies explored the effects of acetyl-L-carnitine (ALC) in dementia, suggesting a role in slowing down cognitive decline. Nevertheless, in 2003 a systematic review concluded there was insufficient evidence to recommend a clinical use, although a meta-analysis in the same year showed a significant advantage for ALC for clinical scales and psychometric tests. Since then, other studies have been published; however, a critical review is still lacking. We provide an update of the studies on ALC in primary and secondary dementia, highlighting the current limitations and translational implications. Overall, the role of ALC in dementia is still under debate. The underlying mechanisms may include restoring of cell membranes and synaptic functioning, enhancing cholinergic activity, promoting mitochondrial energy metabolism, protecting against toxins, and exerting neurotrophic effects. The effects of ALC on the gut–liver–brain axis seem to identify the category of patients in which the new insights contribute most to the mechanisms of action of ALC, likely being the liver metabolism and the improvement of hepatic detoxifying mechanisms the primary targets. In this framework, our research group has dealt with this topic, focusing on the ALC-related cross-talk mechanisms. Further studies with homogeneous sample and longitudinal assessment are needed before a systematic clinical application.
KW - Acetyl-L-carnitine
KW - Biochemistry
KW - Brain axis
KW - Dementia
KW - Gut
KW - Hepatic encephalopathy
KW - Liver
KW - Memory loss
KW - Mild cognitive impairment
KW - Neurodegeneration
KW - Neuroplasticity
UR - http://www.scopus.com/inward/record.url?scp=85084785433&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084785433&partnerID=8YFLogxK
U2 - 10.3390/nu12051389
DO - 10.3390/nu12051389
M3 - Review article
C2 - 32408706
AN - SCOPUS:85084785433
VL - 12
JO - Nutrients
JF - Nutrients
SN - 2072-6643
IS - 5
M1 - 1389
ER -