AMIHO ACID METABOLISM IN CHRONIC VALPROATE TREATMENT AT TWO LEVELS OF CARNITINE INTAKE

While valproate (VPA) is known to cause changes of nitrogen containing metabolites, the amino acid (AA) metabolism and its alterations during carnitine (C) therapy have not been studied. Ten VPA treated C deficient children equimolar C were given over a 14 days period. Before C treatment the fasting plasma levels of ammonia, taurine, aspartate, hydroxyproline, glutamate, proline, glycine, alanine, methionine were elevated, the levels of leucine and ornithine were depressed in VPA treated children as compared to controls (p<0.05), their levels remained unchanged after C therapy. The elevated ammonia and glutamate with normal glutamine levels show impaired glutamate-glutamine cycle. After a standard meal the plasma levels of AA exhibited different elevation before and after C treatment. The urinary output of AA was lower in the VPA treated group, output of 8 individual AA increased after the C treatment, showing that the C may influence the AA metabolism, yet most changes are C independent and are caused probably by the VPA per se.