Elucidation of the mechanism by which (+)-acylcarnitines inhibit mitochondrial fatty acid transport

It is well established that medium and long chain (+)-acylcarnitines (ie. fatty acid esters of the unnatural D-isomer of carnitine) inhibit the oxidation of long chain fatty acids in mammalian tissues by interfering with some component(s) of the mitochondrial carnitine palmitoyltransferase (CPT) system. However, whether their site of action is at the level of CPT I (outer membrane), CPT II (inner membrane), carnitine-acylcarnitine translocase (CACT, inner membrane), or some combination of these elements has never been resolved. Ne chose to readdress this question using rat liver mitochondria and employing a variety of assays that distinguish between the three enzyme activities. The effect on each of (+)-acetylcarnitine, (+)-hexanoylcarnitine, (+)octanoylcarnitine, (+)-decanoylcarnitine, and (+)-palmitoylcarnitine was examined. Contrary to longstanding belief, none of these agents was found to impact significantly upon the activity of CPT I or CPT II. Whereas (+)-acetylcarnitine also failed to influence CACT, both (+) octanoylcarnitine and (+)-palmitoylcarnitine strongly inhibited this enzyme with a similar IC50 value (similar to 35 muM) under the assay conditions employed. Remarkably, (+)-decanoylcarnitine was even more potent (IC50 similar to5 muM), whereas (+)-hexanoylcarnitine was far less potent (IC50 >200 muM). These findings resolve a 35-year-old puzzle by establishing unambiguously that medium and long chain (+)-acylcarnitines suppress mitochondrial fatty acid transport solely through the inhibition of the CACT component. They also reveal a surprising rank order of potency among the various (+)-acylcarnitines in this respect and should prove useful in the design of future experiments in which selective blockade of CACT is desired.