ITRM970143A1 - USE OF ALCANOIL L-CARNITINE FOR THE RECOVERY OF MUSCLE TONE IN IMMOBILIZED SUBJECTS - Google Patents
USE OF ALCANOIL L-CARNITINE FOR THE RECOVERY OF MUSCLE TONE IN IMMOBILIZED SUBJECTS Download PDFInfo
- Publication number
- ITRM970143A1 ITRM970143A1 IT97RM000143A ITRM970143A ITRM970143A1 IT RM970143 A1 ITRM970143 A1 IT RM970143A1 IT 97RM000143 A IT97RM000143 A IT 97RM000143A IT RM970143 A ITRM970143 A IT RM970143A IT RM970143 A1 ITRM970143 A1 IT RM970143A1
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- IT
- Italy
- Prior art keywords
- carnitine
- thymetine
- muscle tone
- recovery
- alkanoyl
- Prior art date
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- 210000003205 muscle Anatomy 0.000 title claims description 13
- 238000011084 recovery Methods 0.000 title claims description 5
- PHIQHXFUZVPYII-ZCFIWIBFSA-N (R)-carnitine Chemical compound C[N+](C)(C)C[C@H](O)CC([O-])=O PHIQHXFUZVPYII-ZCFIWIBFSA-N 0.000 title description 6
- 125000001589 carboacyl group Chemical group 0.000 claims description 12
- -1 isovaleryl Chemical group 0.000 claims description 10
- 125000002777 acetyl group Chemical group [H]C([H])([H])C(*)=O 0.000 claims description 4
- UFAHZIUFPNSHSL-MRVPVSSYSA-N O-propanoyl-L-carnitine Chemical compound CCC(=O)O[C@H](CC([O-])=O)C[N+](C)(C)C UFAHZIUFPNSHSL-MRVPVSSYSA-N 0.000 claims description 3
- 238000007911 parenteral administration Methods 0.000 claims description 3
- 125000004432 carbon atom Chemical group C* 0.000 claims description 2
- 239000002552 dosage form Substances 0.000 claims description 2
- 239000000203 mixture Substances 0.000 claims description 2
- 239000008194 pharmaceutical composition Substances 0.000 claims description 2
- 239000000546 pharmaceutical excipient Substances 0.000 claims description 2
- 125000004063 butyryl group Chemical group O=C([*])C([H])([H])C([H])([H])C([H])([H])[H] 0.000 claims 2
- VSNFQQXVMPSASB-SNVBAGLBSA-N O-valeroyl-L-carnitine Chemical compound CCCCC(=O)O[C@H](CC([O-])=O)C[N+](C)(C)C VSNFQQXVMPSASB-SNVBAGLBSA-N 0.000 claims 1
- 230000037396 body weight Effects 0.000 claims 1
- 239000003814 drug Substances 0.000 claims 1
- 229940079593 drug Drugs 0.000 claims 1
- 230000003053 immunization Effects 0.000 claims 1
- 238000002649 immunization Methods 0.000 claims 1
- 125000001501 propionyl group Chemical group O=C([*])C([H])([H])C([H])([H])[H] 0.000 claims 1
- 230000004936 stimulating effect Effects 0.000 claims 1
- 125000003774 valeryl group Chemical group O=C([*])C([H])([H])C([H])([H])C([H])([H])C([H])([H])[H] 0.000 claims 1
- 230000001225 therapeutic effect Effects 0.000 description 6
- 229960004203 carnitine Drugs 0.000 description 5
- 208000021642 Muscular disease Diseases 0.000 description 4
- 201000009623 Myopathy Diseases 0.000 description 4
- 230000007812 deficiency Effects 0.000 description 4
- 238000009825 accumulation Methods 0.000 description 3
- 230000007170 pathology Effects 0.000 description 3
- 230000009885 systemic effect Effects 0.000 description 3
- 206010058892 Carnitine deficiency Diseases 0.000 description 2
- 206010019280 Heart failures Diseases 0.000 description 2
- 230000001684 chronic effect Effects 0.000 description 2
- 210000003414 extremity Anatomy 0.000 description 2
- 210000004185 liver Anatomy 0.000 description 2
- 201000006938 muscular dystrophy Diseases 0.000 description 2
- 208000029372 muscular lipidosis Diseases 0.000 description 2
- 210000002027 skeletal muscle Anatomy 0.000 description 2
- 208000011580 syndromic disease Diseases 0.000 description 2
- 208000016505 systemic primary carnitine deficiency disease Diseases 0.000 description 2
- 210000001519 tissue Anatomy 0.000 description 2
- 150000003626 triacylglycerols Chemical class 0.000 description 2
- 208000024827 Alzheimer disease Diseases 0.000 description 1
- 206010002383 Angina Pectoris Diseases 0.000 description 1
- 206010007559 Cardiac failure congestive Diseases 0.000 description 1
- 208000032131 Diabetic Neuropathies Diseases 0.000 description 1
- 206010061599 Lower limb fracture Diseases 0.000 description 1
- 208000007101 Muscle Cramp Diseases 0.000 description 1
- 208000010428 Muscle Weakness Diseases 0.000 description 1
- 206010028372 Muscular weakness Diseases 0.000 description 1
- 208000018262 Peripheral vascular disease Diseases 0.000 description 1
- 206010049514 Traumatic fracture Diseases 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 125000002252 acyl group Chemical group 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
- 230000006793 arrhythmia Effects 0.000 description 1
- 210000003169 central nervous system Anatomy 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000001631 haemodialysis Methods 0.000 description 1
- 230000000322 hemodialysis Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- IGQBPDJNUXPEMT-SNVBAGLBSA-N isovaleryl-L-carnitine Chemical compound CC(C)CC(=O)O[C@H](CC([O-])=O)C[N+](C)(C)C IGQBPDJNUXPEMT-SNVBAGLBSA-N 0.000 description 1
- 150000002632 lipids Chemical class 0.000 description 1
- 238000012423 maintenance Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 208000031225 myocardial ischemia Diseases 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 210000001087 myotubule Anatomy 0.000 description 1
- 230000000926 neurological effect Effects 0.000 description 1
- 238000010606 normalization Methods 0.000 description 1
- 150000003839 salts Chemical class 0.000 description 1
- 235000021476 total parenteral nutrition Nutrition 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Landscapes
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
Description
La presente invenzione riguarda un nuovo uso terapeutico delle alcanoil L-camitine inferiori e dei loro sali farmacologicamente accettabili per il ricupero del tono muscolare in soggetti costretti a lunghi periodi di immobilizzazione. The present invention relates to a new therapeutic use of the lower alkanoyl L-camitins and their pharmacologically acceptable salts for the recovery of muscle tone in subjects forced to long periods of immobilization.
Per “alcanoil L-carnitine inferiori” si intendono. nell’ambito della presente invenzione, le alcanoil L-camitine in cui il gruppo alcanoile ha da 1 a 5 atomi di carbonio. By “lower alkanoyl L-carnitines” we mean. in the context of the present invention, the alkanoyl L-camitine in which the alkanoyl group has from 1 to 5 carbon atoms.
Esempi di tali alcanoil L-carnitine sono la acetil-, propionil-, butirrìl-, valerli- e isovaleril L-camitina. Quest’ultimo composto è particolarmente preferito. Examples of such alkanoyl L-carnitines are acetyl-, propionyl-, butyril-, valerl- and isovaleryl L-camitine. The latter compound is particularly preferred.
Sono già noti precedenti usi terapeutici sia della L-camitina che delle alcanoil L-camitine inferiori, quali in particolare la acetil L-camitina e la propionil L-carnitina. Ad esempio, la L-camitina viene usata in campo cardiovascolare per il trattamento dell’ischemia miocardica acuta e cronica, dell’angina pectoris, dell’insufficienza e delle aritmie cardiache. In campo neurologico, la L-camitina viene somministrata a pazienti uremici cronici sottoposti a regolare trattamento emodialitico per combattere l’astenia muscolare e l'insorgenza di crampi muscolari. Altri usi terapeutici riguardano la normalizzazione del rapporto HDL/LDL VLDL e l’alimentazione parenterale totale. Non vi è tuttavia alcuna correlazione fra i noti impieghi terapeutici della L-camitina precedentemente menzionati e quello che costituisce l’oggetto della presente invenzione. Previous therapeutic uses are already known of both L-Hamitine and lower alkanoyl L-Hamitine, such as in particular acetyl L-Hamitine and propionyl L-carnitine. For example, L-camitine is used in the cardiovascular field for the treatment of acute and chronic myocardial ischemia, angina pectoris, heart failure and arrhythmias. In the neurological field, L-camitina is administered to chronic uremic patients undergoing regular hemodialysis treatment to combat muscle weakness and the onset of muscle cramps. Other therapeutic uses concern the normalization of the HDL / LDL VLDL ratio and total parenteral nutrition. However, there is no correlation between the known therapeutic uses of L-camitine previously mentioned and that which constitutes the object of the present invention.
E’ altresì noto l'impiego della L-camitina nel trattamento di certe miopatie e distrofie muscolari. Tuttavia, la causa eziologica di queste patologie è stata identificata con certezza nel deficit tessutale di L-camitina che provoca un eccessivo accumulo di lipidi nelle fibre muscolari. The use of L-camitina in the treatment of certain myopathies and muscular dystrophies is also known. However, the etiological cause of these pathologies has been identified with certainty in the tissue deficiency of L-camitina which causes an excessive accumulation of lipids in the muscle fibers.
Infatti, già nel 1973 Engel e Angelini (Science, 173. 899-902, 1973) descrissero il primo caso di miopatia da carenza di carnitina muscolare caratterizzata da accumulo di trigliceridi nel muscolo con livelli normali di carnitina nel plasma e nel fegato, sindrome che gli Autori definirono “type 1 lipid Storage myopathy”. In fact, already in 1973 Engel and Angelini (Science, 173. 899-902, 1973) described the first case of muscle carnitine deficiency myopathy characterized by the accumulation of triglycerides in the muscle with normal levels of carnitine in the plasma and liver, a syndrome that the Authors defined “type 1 lipid Storage myopathy”.
Successivamente, nel 1975 Karpati (Neurology 2£, 16-24, 1975) descrissero un caso di miopatia da accumulo di trigliceridi nel tessuto muscolare con livelli di carnitina inferiori alla norma sia nel plasma che nel fegato, cuore e muscolo scheletrico, sindrome definita carenza sistemica di carnitina. Subsequently, in 1975 Karpati (Neurology 2 £, 16-24, 1975) described a case of myopathy due to the accumulation of triglycerides in muscle tissue with lower than normal carnitine levels both in plasma and in the liver, heart and skeletal muscle, a syndrome defined as deficiency. systemic carnitine.
Nel decennio trascorso dallo studio di Engel e Angelini sono già state individuate diverse decine di casi dì miopatie e distrofie muscolari ascrivibili o a carenza di carnitina nel muscolo scheletrico (type 1 lipid Storage myopathy) o a carenza sistemica di carnitina. In the decade that has passed since Engel and Angelini's study, several dozen cases of myopathies and muscular dystrophies have already been identified, attributable to either a lack of carnitine in skeletal muscle (type 1 lipid Storage myopathy) or systemic carnitine deficiency.
Dall'esame dei casi clinici riportati in letteratura, risulta che la mancanza di trattamento ha comportato la morte del soggetto, mentre, nei casi trattati, la somministrazione di carnitina ha nella maggior parte dei casi risolto drammaticamente la patologia. From the examination of the clinical cases reported in the literature, it appears that the lack of treatment led to the death of the subject, while, in the cases treated, the administration of carnitine in most cases dramatically resolved the pathology.
E' altresì noto l’uso della acetil L-camitina per il trattamento di patologie del sistema nervoso centrale, in particolare nella demenza di Alzheimer, e per il trattamento della neuropatia diabetica, mentre la propionil L-carnitina è stata proposta per il trattamento di vasculopatie periferiche e dell insuffìcienza cardiaca congestizia. Non vi è alcuna relazione fra tali usi noti delle alcanoil L-camitine inferiori e quello che costituisce l’oggetto della presente invenzione. The use of acetyl L-camitine is also known for the treatment of diseases of the central nervous system, in particular in Alzheimer's dementia, and for the treatment of diabetic neuropathy, while propionyl L-carnitine has been proposed for the treatment of peripheral vascular disease and congestive heart failure. There is no relationship between these known uses of the lower alkanoyl L-camitine and the one that constitutes the object of the present invention.
Risulta ora inattesa e sorprendente l’efficacia terapeutica delle alcanoil L-carnitine precedentemente menzionate in pazienti la cui patologia muscolare non è provocata da deficit tissutale e/o sistemico di L-camitina, nè primario nè secondario all’evehto che ha provocato il periodo di immobilizzazione. It is now unexpected and surprising the therapeutic efficacy of the previously mentioned alkanoyl L-carnitines in patients whose muscle pathology is not caused by tissue and / or systemic L-Hamitine deficiency, neither primary nor secondary to the evehto that caused the period of immobilization.
Vennero studiati 2 gruppi di 15 pazienti ciascuno che presentavano fratture degli arti inferiori trattandone uno con isovaleril L-camitina. Prima e dopo un periodo di immobilizzazione pressoché simile (30-40 giorni) venne misurata la circonferenza dell’arto in tutti i 30 pazienti e si notò che nei 12 trattati la differenza tra le due misurazioni era significativamente inferiore rispetto agli altri. In tali soggetti la riduzione del tono e del volume muscolare conseguenti all’immobilizzazione venne pertanto notevolmente inibita dalla isovaleril L-carnitina. Venne quindi misurata in sei soggetti per grupppo la camitina muscolare allo scopo di verificare se l’immobilizzazione potesse aver determinato una perdita di L-camitina. In tutti i soggetti il livello era normale e addirittura superiore nei trattati, ciò che consente di escludere un deficit secondario di camitina conseguente aH'immobilizzazione. Two groups of 15 patients each who presented with lower limb fractures were studied by treating one with isovaleryl L-camitine. Before and after an almost similar period of immobilization (30-40 days) the circumference of the limb was measured in all 30 patients and it was noted that in the 12 treated the difference between the two measurements was significantly lower than in the others. In these subjects, the reduction in muscle tone and volume resulting from immobilization was therefore significantly inhibited by isovaleryl L-carnitine. Muscle hamstring was then measured in six subjects per group in order to verify whether the immobilization could have led to a loss of L-hamitin. In all subjects the level was normal and even higher in the treated, which allows to exclude a secondary deficiency of Hamitine consequent to immobilization.
Anche la ripresa della normale attività fu più rapida nei soggettti trattati. Si può pertanto dedurre che la isovaleril L-camitina somministrata a soggettti con fratture traumatiche degli arti inibisce la perdita di massa musc lare determinata dall , favorisce il mantenimento del tono muscolare e permette un più rapido ripristino delle condizioni precedenti il trauma accelerando il ricupero funzionale dei pazienti. The resumption of normal activity was also faster in the subjects treated. It can therefore be deduced that isovaleryl L-camitine administered to subjects with traumatic fractures of the limbs inhibits the loss of muscle mass caused by, favors the maintenance of muscle tone and allows a more rapid restoration of the conditions preceding the trauma by accelerating the functional recovery of the patients.
Sebbene la dose giornaliera da somministrare dipenda, a seconda del giudizio del medico curante, dal peso, età e condizioni generali del soggetto, si è trovato che è generalmente opportuno somministrare da circa 10 a circa 30 mg di alcanoil L-camitina/kg di peso corporeo/gio o. Although the daily dose to be administered depends, depending on the judgment of the treating physician, on the weight, age and general condition of the subject, it has been found that it is generally advisable to administer from about 10 to about 30 mg of alkanoyl L-Hamitin / kg of weight. body / day or.
Le alcanoil Lcamitine vengono formulate con gli usuali eccipienti impiegati per la preparazione di composizioni atte alla somministrazione orale o parenterale. The alkanoyl Lcamitins are formulated with the usual excipients used for the preparation of compositions suitable for oral or parenteral administration.
Si è altresì trovato che una composizione farmaceutica particolarmente adatta agli usi terapeutici sopramenzionati, comprende, quando in forma di dosaggio unitario, da circa 500 a circa 1.000 mg di alcanoil L-camitina. It has also been found that a pharmaceutical composition particularly suitable for the aforementioned therapeutic uses comprises, when in unit dosage form, from about 500 to about 1,000 mg of alkanoyl L-camitine.
Claims (5)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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IT97RM000143A IT1290976B1 (en) | 1997-03-13 | 1997-03-13 | USE OF ALCANOIL L-CARNITINE FOR THE RECOVERY OF THE MUSCLE TONE IN IMMOBILIZED SUBJECTS |
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IT97RM000143A IT1290976B1 (en) | 1997-03-13 | 1997-03-13 | USE OF ALCANOIL L-CARNITINE FOR THE RECOVERY OF THE MUSCLE TONE IN IMMOBILIZED SUBJECTS |
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Publication Number | Publication Date |
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ITRM970143A1 true ITRM970143A1 (en) | 1998-09-13 |
IT1290976B1 IT1290976B1 (en) | 1998-12-14 |
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IT97RM000143A IT1290976B1 (en) | 1997-03-13 | 1997-03-13 | USE OF ALCANOIL L-CARNITINE FOR THE RECOVERY OF THE MUSCLE TONE IN IMMOBILIZED SUBJECTS |
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- 1997-03-13 IT IT97RM000143A patent/IT1290976B1/en active IP Right Grant
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