Lカルニチンと悪液質

Lカルニチンと悪液質に関するレビュー論文を紹介します。

Renata Silvério, Alessandro Laviano, Filippo Rossi Fanelli, and Marília Seelaender: l-carnitine and cancer cachexia: Clinical and experimental aspects. Journal of Cachexia, Sarcopenia and Muscle. DOI 10.1007/s13539-011-0017-7, Published online: 26 January 2011

下記HPで全文PDFファイルを見ることができます。

http://www.springerlink.com/content/22161240166555m0/fulltext.pdf

Lカルニチンに関しては、下記のHPに比較的詳しく解説されています。

食品成分有効性評価及び健康影響評価プロジェクト解説集 L-カルニチンについて

http://www.nih.go.jp/eiken/chosa/karuni.html

エビデンスとしてはまだ不十分ですが、Lカルニチンが疲労やQOLの改善に有効という予備研究の結果が出ています。 メカニズムとしては図のように抗酸化能力の炎症性サイトカインの改善が考えられています。

今後、さらなるエビデンスが出てくれば、悪液質の患者にLカルニチンを投与したほうがよいとなってくるかもしれません。現状で投与を検討するのは、エイコサペンタエン酸か六君子湯あたりでしょう。

Abstract
Cancer cachexia is a multifaceted syndrome characterized, among many symptoms, by extensive muscle wasting. Chronic systemic inflammation, partly triggered and sustained by cytokines, as well as increased oxidative stress contributes to the pathogenesis of this complex metabolic disorder. l-carnitine plays a central role in the metabolism of fatty acids and shows important antioxidant and anti-inflammatory properties. Systemic carnitine depletion has been described in several diseases, and it is characterized by fatigue, muscle weakness, and decreased tolerance to metabolic stress. In cachectic cancer patients, low serum carnitine levels have been reported, and this change has been suggested to play an important contributory role in the development of cachexia. Based on these data, carnitine supplementation has been tested in preliminary studies concerning human cachexia, resulting in improved fatigue and quality of life. We present here a review of clinical and experimental evidence regarding the use of carnitine supplementation in the management of cancer cachexia.