Effects of L- Carnitine Supplementation on Nitric Oxide Levels in Pemphigus Vulgaris Patients: A Randomized, Double-Blind Clinical Trial

Background and objective: Blisters on the human skin and mucous membranes are a hallmark of the extremely rare autoimmune disease known as Pemphigus vulgaris (PV). Elevated levels of reactive oxygen species (ROS) are linked to this condition. Nitric oxide (NO), produced by endothelial cells, is a key signaling molecule that contributes to vascular function and can act as an antioxidant by neutralizing reactive oxygen species in specific biological contexts. A substance that resembles a vitamin, L-carnitine, positively influences antioxidant levels. This study aimed to investigate the impact of L-carnitine supplementation on serum nitric oxide levels in patients with Pemphigus vulgaris. Method and materials: This clinical trial included a total of 46 patients with Pemphigus Vulgaris, aged between 30 and 65 years. Participants were randomly divided into two groups: one receiving L-carnitine (n = 23) and the other a placebo (n = 23). Each group took either 2000 mg of L-carnitine or placebo tablets daily. The intervention was conducted over 8 weeks, with serum L-carnitine and nitric oxide (NO) levels assessed both before and after the intervention. Results: At baseline, the intervention and control groups did not differ statistically significantly in terms of age, weight, height, and BMI (p > 0.05). By the end of the study, patients in the L-Carnitine group showed a significant increase in serum L-Carnitine levels (from 74.56±36.36 to 97.49±41.27, p<0.001) and in nitric oxide (NO) concentration (from 202.37±14.59 to 242.98±20.63, p=0.006) In contrast, the placebo group did not show any significant changes in either parameter (p>0.05). Conclusion: A daily intake of 2 g of L-carnitine for 8 weeks in patients with PV has positive effects on reducing oxidative stress and increasing serum nitric oxide levels.