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Generation of hydroxytrimethyllysine from trimethyllysine limits the carnitine biosynthesis in premature infants

B Melegh1, R Hermann, I Bock

  • 1Department of Paediatrics, University Medical School of Pécs, Hungary.

Insights

Oral administration of epsilon-N-Trimethyl-L-lysine (TML) to premature infants showed increased TML levels. The conversion of TML to hydroxy-TML appears to be a regulatory step in neonatal carnitine biosynthesis.

Area of Science:

  • Biochemistry
  • Neonatal Metabolism
  • Nutritional Science

Background:

  • Carnitine is essential for fatty acid metabolism in neonates.
  • The biosynthesis pathway of carnitine in premature infants is not fully elucidated.
  • epsilon-N-Trimethyl-L-lysine (TML) is a precursor in carnitine biosynthesis.

Purpose of the Study:

  • To investigate the metabolic fate of orally administered TML in premature infants.
  • To identify regulatory steps in neonatal carnitine biosynthesis.
  • To assess the impact of TML dosage on carnitine levels.

Main Methods:

  • Oral administration of TML to two groups of premature infants at different dosages.
  • Analysis of plasma and urinary carnitine and TML levels.
  • 1H NMR and Fast Atom Bombardment Mass Spectrometry (FAB-MS) for metabolite identification.

Main Results:

  • Low-dose TML (100 μmol/day) increased urinary TML 17-fold with no change in carnitine.
  • High-dose TML (1 mmol) increased plasma and urinary carnitine, and urinary TML 62-fold.
  • NMR and FAB-MS confirmed increased TML and no changes in other precursors.

Conclusions:

  • The conversion of TML to hydroxy-TML is likely a regulatory step in neonatal carnitine biosynthesis.
  • A limitation in the conversion of hydroxy-TML to carnitine is unlikely.
  • These findings provide insights into carnitine metabolism in premature infants.

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