Acetyl-l-Carnitine in the Treatment of Peripheral Neuropathies: A Narrative Review

Acetyl-l-carnitine is an ester of l-carnitine, both endogenous molecules, with a vital role in lipid metabolism. Exogenously delivered acetyl-l-carnitine is endowed with neuroprotective and neurotrophic actions due to its antioxidant and metabolic properties. Moreover, acetyl-l-carnitine is an epigenetic regulator of genes involved in analgesia such as the metabotropic glutamate 2 receptor in the presynaptic neurons and of neurotrophic factors including nerve growth factor. Accordingly, its long-term neurotrophic and analgesic activity has been confirmed in animal models of chronic inflammatory and neuropathic pain and in clinical studies in patients with peripheral neuropathies. The aim of this narrative review was to summarise the available evidence on the usefulness of acetyl-l-carnitine in the treatment of peripheral neuropathies.