Carnitine and/or Acetylcarnitine Deficiency as a Cause of Higher Levels of Ammonia
Blood carnitine and/or acetylcarnitine deficiencies are postulated in the literature as possible causes of higher ammonia levels. The aim of this study was to investigate if the use of valproic acid, the age of the patients, or certain central nervous system pathologies can cause carnitine and/or ac...
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| creator | Fagiolino, Pietro González, Raquel Queijo, Cecilia Guevara, Natalia Maldonado, Cecilia Vázquez, Marta |
| description | Blood carnitine and/or acetylcarnitine deficiencies are postulated in the literature as possible causes of higher ammonia levels. The aim of this study was to investigate if the use of valproic acid, the age of the patients, or certain central nervous system pathologies can cause carnitine and/or acetylcarnitine deficiency leading to increased ammonia levels. Three groups of patients were studied: (A) epileptic under phenytoin monotherapy (n=31); (B) with bipolar disorder under valproic acid treatment (n=28); (C) elderly (n=41). Plasma valproic acid and blood carnitine and acyl carnitine profiles were determined using a validated HPLC and LC-MS/MS method, respectively. Blood ammonia concentration was determined using an enzymatic automated assay. Higher ammonia levels were encountered in patients under valproic acid treatment and in the elderly. This may be due to the lower carnitine and/or acetylcarnitine found in these patients. Patients with controlled seizures had normal carnitine and acetylcarnitine levels. Further studies are necessary in order to conclude if the uncontrolled bipolar disorder could be the cause of higher carnitine and/or acetylcarnitine levels. |
| doi_str_mv | 10.1155/2016/2920108 |
| format | Article |
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The aim of this study was to investigate if the use of valproic acid, the age of the patients, or certain central nervous system pathologies can cause carnitine and/or acetylcarnitine deficiency leading to increased ammonia levels. Three groups of patients were studied: (A) epileptic under phenytoin monotherapy (n=31); (B) with bipolar disorder under valproic acid treatment (n=28); (C) elderly (n=41). Plasma valproic acid and blood carnitine and acyl carnitine profiles were determined using a validated HPLC and LC-MS/MS method, respectively. Blood ammonia concentration was determined using an enzymatic automated assay. Higher ammonia levels were encountered in patients under valproic acid treatment and in the elderly. This may be due to the lower carnitine and/or acetylcarnitine found in these patients. Patients with controlled seizures had normal carnitine and acetylcarnitine levels. Further studies are necessary in order to conclude if the uncontrolled bipolar disorder could be the cause of higher carnitine and/or acetylcarnitine levels.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2016/2920108</identifier><identifier>PMID: 26998483</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Acetylcarnitine - blood ; Acetylcarnitine - deficiency ; Adolescent ; Adult ; Age ; Aged ; Aged, 80 and over ; Ammonia ; Ammonia - blood ; Biosynthesis ; Bipolar disorder ; Bipolar Disorder - blood ; Bipolar Disorder - drug therapy ; Carnitine ; Carnitine - blood ; Carnitine - deficiency ; Divalproex ; Enzymes ; Epilepsy - blood ; Epilepsy - drug therapy ; Female ; High performance liquid chromatography ; Humans ; Male ; Medical research ; Medicine, Experimental ; Metabolism ; Metabolites ; Middle Aged ; Older people ; Phenytoin - administration & dosage ; Valproic acid ; Valproic Acid - administration & dosage</subject><ispartof>BioMed research international, 2016-01, Vol.2016 (2016), p.1-8</ispartof><rights>Copyright © 2016 Cecilia Maldonado et al.</rights><rights>COPYRIGHT 2016 John Wiley & Sons, Inc.</rights><rights>Copyright © 2016 Cecilia Maldonado et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2016 Cecilia Maldonado et al. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c598t-f756f1ccb72287ad0dbcfee35af62d672738db4fbbee67397e6552fcf58fbb8e3</citedby><cites>FETCH-LOGICAL-c598t-f756f1ccb72287ad0dbcfee35af62d672738db4fbbee67397e6552fcf58fbb8e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779505/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779505/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26998483$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Jaeschke, Hartmut</contributor><creatorcontrib>Fagiolino, Pietro</creatorcontrib><creatorcontrib>González, Raquel</creatorcontrib><creatorcontrib>Queijo, Cecilia</creatorcontrib><creatorcontrib>Guevara, Natalia</creatorcontrib><creatorcontrib>Maldonado, Cecilia</creatorcontrib><creatorcontrib>Vázquez, Marta</creatorcontrib><title>Carnitine and/or Acetylcarnitine Deficiency as a Cause of Higher Levels of Ammonia</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Blood carnitine and/or acetylcarnitine deficiencies are postulated in the literature as possible causes of higher ammonia levels. The aim of this study was to investigate if the use of valproic acid, the age of the patients, or certain central nervous system pathologies can cause carnitine and/or acetylcarnitine deficiency leading to increased ammonia levels. Three groups of patients were studied: (A) epileptic under phenytoin monotherapy (n=31); (B) with bipolar disorder under valproic acid treatment (n=28); (C) elderly (n=41). Plasma valproic acid and blood carnitine and acyl carnitine profiles were determined using a validated HPLC and LC-MS/MS method, respectively. Blood ammonia concentration was determined using an enzymatic automated assay. Higher ammonia levels were encountered in patients under valproic acid treatment and in the elderly. This may be due to the lower carnitine and/or acetylcarnitine found in these patients. Patients with controlled seizures had normal carnitine and acetylcarnitine levels. Further studies are necessary in order to conclude if the uncontrolled bipolar disorder could be the cause of higher carnitine and/or acetylcarnitine levels.</description><subject>Acetylcarnitine - blood</subject><subject>Acetylcarnitine - deficiency</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ammonia</subject><subject>Ammonia - blood</subject><subject>Biosynthesis</subject><subject>Bipolar disorder</subject><subject>Bipolar Disorder - blood</subject><subject>Bipolar Disorder - drug therapy</subject><subject>Carnitine</subject><subject>Carnitine - blood</subject><subject>Carnitine - deficiency</subject><subject>Divalproex</subject><subject>Enzymes</subject><subject>Epilepsy - blood</subject><subject>Epilepsy - drug therapy</subject><subject>Female</subject><subject>High performance liquid chromatography</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Metabolism</subject><subject>Metabolites</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Phenytoin - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fagiolino, Pietro</au><au>González, Raquel</au><au>Queijo, Cecilia</au><au>Guevara, Natalia</au><au>Maldonado, Cecilia</au><au>Vázquez, Marta</au><au>Jaeschke, Hartmut</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Carnitine and/or Acetylcarnitine Deficiency as a Cause of Higher Levels of Ammonia</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>2016</volume><issue>2016</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Blood carnitine and/or acetylcarnitine deficiencies are postulated in the literature as possible causes of higher ammonia levels. The aim of this study was to investigate if the use of valproic acid, the age of the patients, or certain central nervous system pathologies can cause carnitine and/or acetylcarnitine deficiency leading to increased ammonia levels. Three groups of patients were studied: (A) epileptic under phenytoin monotherapy (n=31); (B) with bipolar disorder under valproic acid treatment (n=28); (C) elderly (n=41). Plasma valproic acid and blood carnitine and acyl carnitine profiles were determined using a validated HPLC and LC-MS/MS method, respectively. Blood ammonia concentration was determined using an enzymatic automated assay. Higher ammonia levels were encountered in patients under valproic acid treatment and in the elderly. This may be due to the lower carnitine and/or acetylcarnitine found in these patients. Patients with controlled seizures had normal carnitine and acetylcarnitine levels. Further studies are necessary in order to conclude if the uncontrolled bipolar disorder could be the cause of higher carnitine and/or acetylcarnitine levels.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>26998483</pmid><doi>10.1155/2016/2920108</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acetylcarnitine - blood Acetylcarnitine - deficiency Adolescent Adult Age Aged Aged, 80 and over Ammonia Ammonia - blood Biosynthesis Bipolar disorder Bipolar Disorder - blood Bipolar Disorder - drug therapy Carnitine Carnitine - blood Carnitine - deficiency Divalproex Enzymes Epilepsy - blood Epilepsy - drug therapy Female High performance liquid chromatography Humans Male Medical research Medicine, Experimental Metabolism Metabolites Middle Aged Older people Phenytoin - administration & dosage Valproic acid Valproic Acid - administration & dosage |
| title | Carnitine and/or Acetylcarnitine Deficiency as a Cause of Higher Levels of Ammonia |
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