RESUMEN
Pulmonary arterial hypertension (PAH) is a fatal vasculopathy that ultimately leads to elevated pulmonary pressure and death by right ventricular (RV) failure, which occurs in part due to decreased fatty acid oxidation and cytotoxic lipid accumulation. In this study, we tested the hypothesis that decreased fatty acid oxidation and increased lipid accumulation in the failing RV is driven, in part, by a relative carnitine deficiency. We then tested whether supplementation of l-carnitine can reverse lipotoxic RV failure through augmentation of fatty acid oxidation. In vivo in transgenic mice harboring a human BMPR2 mutation, l-carnitine supplementation reversed RV failure by increasing RV cardiac output, improving RV ejection fraction, and decreasing RV lipid accumulation through increased PPARγ expression and augmented fatty acid oxidation of long chain fatty acids. These findings were confirmed in a second model of pulmonary artery banding-induced RV dysfunction. In vitro, l-carnitine supplementation selectively increased fatty acid oxidation in mitochondria and decreased lipid accumulation through a Cpt1-dependent pathway. l-Carnitine supplementation improves right ventricular contractility in the stressed RV through augmentation of fatty acid oxidation and decreases lipid accumulation. Correction of carnitine deficiency through l-carnitine supplementation in PAH may reverse RV failure.
RESUMEN
The main purpose of a root canal treatment is to eliminate the bacteria and their products from the pulp space. Chemomechanical preparation (chemical-refers to irrigating solutions, i.e., either synthetic chemicals or herbal solutions and mechanical-refers to instrumentation of a root canals with endodontic files) of a root canal system plays a major role in obtaining the rationale of root canal treatment. Various synthetic chemicals known as endodontic irrigants play a major role in disinfection, but also have undesirable properties like allergic potential, toxicity, unacceptable taste, etc. Today there is a major change in trend towards the use of natural herbal medicines as a part of dental treatment due to its easy availability, less toxicity, and cost effectiveness. This article aims to provide a comprehensive review of various herbal endodontic irrigants evaluated for their effectiveness in the disinfection of a root canal system. This literature review is conducted using electronic databases "PubMed," "Google Scholar," and "Scopus," and articles were limited to those in the English language and published between 1980 and 2014.