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The purpose of this review is to comprehensively summarize the multidimensional biological effects of the carnitine pool beyond its traditional role in fatty acid oxidation and to summarize the systemic effects mediated by carnitine/acylcarnitine to provide new perspectives for pharmacological research and treatment innovation and new strategies for the prevention and treatment of a variety of diseases

Acetyl coenzyme A: a central metabolite and second messenger

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Propionyl-L-carnitine chloride, chloride of the ester of propanoic acid and carnitine, is the main analyte in the diagnosis propionic acidemia or methylmalonic acidemia

ALCAR and KET also activated brainstem nuclei (locus coeruleus, diagonal band, and raphe nuclei) which send aminergic projections to cortical areas and spinal dorsal horns that are involved in pain and mood control (Khan and Stroman, 2015)