Determination of l- and d-carnitine in dietary food supplements using capillary electrophoresis–tandem mass spectrometry

A simple strategy for d/l-carnitine analysis in food samples using ion mobility spectrometry and theoretical calculations

This work presents a straightforward approach to the separation d/l-carnitine (d/l-Carn) using ion mobility-mass spectrometry (IM-MS) and theoretical calculations. Natamycin (Nat) was used as separation reagent to interact with the Carn, metal ions (G) were employed as ligand, the resultant ternary complexes [d/l-Carn + Nat + G]+ were observed experimentally. IM-MS results revealed that d/l-Carn could be baseline separated via complex formation using Li+, Na+, K+, Rb+, and Cs+, with a maximum peak separation resolution (Rp-p) of 2.91; Theoretical calculations were performed to determine the optimal conformations of [d/l-Carn + Nat + Li/K]+, and the predicted collisional cross section values were consistent with the experimental values. Conformational analysis was used to elucidate the enantiomeric separation of d/l-Carn at the molecular level via the formation of ternary complexes. Furthermore, quantitative analyses for the determination of the enantiomers were established with effective linearity and acceptable sensitivity. Finally, the proposed method was successfully applied in the determination of d/l-Carn in food samples.

Protective effects of L-carnitine on X irradiation-induced uterus injury via antioxidant and anti-inflammatory pathways

PURPOSE

Ionizing radiation causes oxidative stress induced tissue damage as well as a decline in reproduction incidence. The purpose of our study was to evaluate the effects of L-carnitine on radiation-induced uterine injury.

MATERIALS AND METHODS

Thirty Wistar albino rats were classified into five groups. Physiological saline was administered intraperitoneally to the control group. A single dose of 8.3 Gy whole body X-irradiation was applied to the radiation-1 and radiation-2 groups. These groups were sacrificed on the 6th hour and 4th day, respectively, after irradiation. Radiation-1 + L-carnitine and radiation-2 + L-carnitine groups received a daily dose of 200 mg/kg L-carnitine in addition to the same dose of irradiation. L-carnitine was also applied one day before and four days after irradiation.

RESULTS

L-carnitine therapy partially blocks the depletion of the deep glands and radiation-induced flattening of the glandular epithelium and endometrial surface. Proinflammatory cytokines such as IL-1β, IL-6 and TNF-α were found to be significantly expressed in the uterus tissue of irradiated mice. In the radiation groups, NFκB and PARP-1 expressions in uterine tissue was significantly increased compared to L-carnitine treated and the control groups. It was observed that the oxidative stress index increased in the radiation groups, but decreased in the L-carnitine applied groups.

CONCLUSIONS

Our findings showed that L-carnitine has a positive effect on radiation-induced uterine damage. L-carnitine may be a potential safe radio protective agent during radiotherapy for pelvic cancer provided the tumor is not protected from radiation damage to the same extent as the normal tissue is. However, prospective clinical trial studies are necessary to understand its efficacy.

Applications of Capillary Electrophoresis-Mass Spectrometry to Chiral Analysis

Capillary electrophoresis (CE) is a technique that has already proven its importance in the separation of enantiomers. The combination of CE with mass spectrometry (MS) detection further boosts the possibilities of CE in terms of achieving higher sensitivity with the possibility of an unambiguous assignment of analytes of interest. This chapter details four different examples using CE in the electrokinetic chromatography (EKC) mode coupled to MS with application to four different fields of analysis (pharmaceutical, biomedical, food, and agrochemical). The first two methods are based on the use of a single and a double chiral selector system, respectively, in which the partial filling technique (PFT) had to be used to avoid MS-source contamination. In the last two examples, PFT was not needed as they were based on the use of low concentrations of chiral selector but a derivatization step was necessary to allow proper enantiorecognition with the chiral selectors. Description of these protocols is fully explained.

Determination of L-Carnitine in Infant Powdered Milk Samples after Derivatization

Herein, a novel analytical method using a high-performance liquid chromatography-fluorescence detector (HPLC/FLD) is developed for rapidly measuring an L-carnitine ester derivative in infant powdered milk. In this study, solid-phase extraction cartridges filled with derivatized methanol and distilled water were used to effectively separate L-carnitine. Protein precipitation pretreatment was carried out to remove the protein and recover the analyte extract with a high recovery (97.16%–106.56%), following which carnitine in the formula was derivatized to its ester form. Precolumn derivation with 1-aminoanthracene (1AA) was carried out in a phosphate buffer using 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride (EDC) as the catalyst. Method validation was performed following the AOAC guidelines. The calibration curves were linear in the L-carnitine concentration range of 0.1–2.5 mg/L. The lower limit of quantitation and limit of detection of L-carnitine were 0.076 and 0.024 mg/L, respectively. The intra- and interday precision and recovery results were within the allowable limits. The results showed that our method helped reduce the sample preparation time. It also afforded higher resolution and better reproducibility than those obtained by traditional methods. Our method is suitable for detecting the quantity of L-carnitine in infant powdered milk containing a large amount of protein or starch.

The Nutraceutical Value of Carnitine and Its Use in Dietary Supplements

Carnitine can be considered a conditionally essential nutrient for its importance in human physiology. This paper provides an updated picture of the main features of carnitine outlining its interest and possible use. Particular attention has been addressed to its beneficial properties, exploiting carnitine's properties and possible use by considering the main in vitro, in animal, and human studies. Moreover, the main aspects of carnitine-based dietary supplements have been indicated and defined with reference to their possible beneficial health properties.

Functional differences between l- and d-carnitine in metabolic regulation evaluated using a low-carnitine Nile tilapia model

l-Carnitine is essential for mitochondrial β-oxidation and has been used as a lipid-lowering feed additive in humans and farmed animals. d-Carnitine is an optical isomer of l-carnitine and dl-carnitine has been widely used in animal feeds. However, the functional differences between l- and d-carnitine are difficult to study because of the endogenous l-carnitine background. In the present study, we developed a low-carnitine Nile tilapia model by treating fish with a carnitine synthesis inhibitor, and used this model to investigate the functional differences between l- and d-carnitine in nutrient metabolism in fish. l- or d-carnitine (0·4 g/kg diet) was fed to the low-carnitine tilapia for 6 weeks. l-Carnitine feeding increased the acyl-carnitine concentration from 3522 to 10 822 ng/g and alleviated the lipid deposition from 15·89 to 11·97 % in the liver of low-carnitine tilapia. However, as compared with l-carnitine group, d-carnitine feeding reduced the acyl-carnitine concentration from 10 822 to 5482 ng/g, and increased lipid deposition from 11·97 to 20·21 % and the mRNA expression of the genes involved in β-oxidation and detoxification in the liver. d-Carnitine feeding also induced hepatic inflammation, oxidative stress and apoptosis. A metabolomic investigation further showed that d-carnitine feeding increased glycolysis, protein metabolism and activity of the tricarboxylic acid cycle and oxidative phosphorylation. Thus, l-carnitine can be physiologically utilised in fish, whereas d-carnitine is metabolised as a xenobiotic and induces lipotoxicity. d-Carnitine-fed fish demonstrates increases in peroxisomal β-oxidation, glycolysis and amino acid degradation to maintain energy homeostasis. Therefore, d-carnitine is not recommended for use in farmed animals.

Chiral Capillary Electrophoresis-Mass Spectrometry

Capillary electrophoresis (CE) is a well-established and one of the most powerful separation techniques in the field of chiral separations. Its hyphenation with mass spectrometry (MS) combines both the high separation efficiency and low sample consumption of CE and the high sensitivity and structural information of MS. Thus, the outstanding chiral resolution power of CE along with the MS advantages makes CE-MS a perfect combination to achieve sensitive enantioseparations. This chapter describes three representative examples of different approaches used in the chiral analysis of amino acids in biological fluids by CE-MS. The first methodology uses the partial filling technique to avoid the entry of cyclodextrins in the MS source. The second method shows the possibility to carry out the direct coupling EKC-MS even when a relative high concentration of a native cyclodextrin is used as chiral selector. The last example illustrates an alternative strategy based on the formation of stable diastereomers between an enantiomerically pure chiral reagent and the amino acids enantiomers which can be separated in an achiral environment.

Chiral Analysis of Non-Protein Amino Acids by Capillary Electrophoresis

A high number of non-protein amino acids are chiral compounds that have demonstrated to be relevant in different fields. Their determination enables to obtain valuable information related to food quality and safety and has also a high interest from a biological point of view since many of them are key compounds in metabolic pathways or are related with different pathologies.In the development of analytical methodologies to perform chiral separations, capillary electrophoresis (CE) is well-established and one of the most powerful separation techniques as a consequence of its high efficiency, short analysis time, and versatility.This chapter shows, by means of three interesting examples, the application of different CE methodologies to the chiral analysis of non-protein amino acids. The first example describes different electrokinetic chromatography (EKC)-UV methodologies based on the use of negatively charged cyclodextrins as chiral selectors to carry out the stereoselective separation of ten different non-protein amino acids of relevance from a biological or food analysis point of view. The second method illustrates the EKC-UV analysis of L-citrulline and its enantiomeric impurity in food supplements using sulfated-γ-cyclodextrin as chiral selector. The last example shows the simultaneous enantiomeric separation of 3,4-dihydroxy-DL-phenylalanine and all the other chiral constituents involved in the phenylalanine-tyrosine metabolic pathway by using an EKC-MS methodology.

Carnitine, A New Precursor in the Formation of the Plant Growth Regulator Mepiquat

Carnitine is demonstrated as an effective methyl donor in the formation of the plant growth regulator N, N-dimethylpiperidinium (mepiquat), encompassing either N-methylation/decarboxylation of pipecolic acid, or Maillard pathways followed by transmethylation reactions. The formation of mepiquat and the intermediate compounds was monitored (180-300 °C, up to 180 min) using HPLC-MS/MS in different binary or ternary model systems composed of (i) lysine/fructose/carnitine, (ii) lysine/glucose/carnitine, or (iii) pipecolic acid (PipAc)/carnitine. The highest yield of mepiquat was 2.4% after 120 min incubation at 290 °C (PipAc/carnitine model system). The highest yield was recorded in fructose and glucose (Maillard) systems after 180 min at 230 °C. The full-scan mode was used to monitor the formation of the corresponding intermediates (piperidine and N-methylpiperidine, the demethylated intermediates of carnitine). The new pathways of mepiquat formation indicate that the occurrence of low levels of this thermally induced compound is potentially more widespread in some selected cooked foodstuffs. For the first time, mepiquat was detected in oven-cooked beef, reaching up to 82.5 μg/kg. These amounts are not expected to significantly contribute to the overall exposure via different foodstuffs, as reported in previous studies.

Chirality sensing of choline derivatives by a triple anion helicate cage through induced circular dichroism

A racemic A₂L₃ triple anion helicate cage is able to sense chiral choline derivatives by induced circular dichroism.

Enantioselective analysis of proteinogenic amino acids in cerebrospinal fluid by capillary electrophoresis-mass spectrometry

d-Amino acids (AAs) are increasingly being recognized as essential molecules in biological systems. Enantioselective analysis of proteinogenic AAs in biological samples was accomplished by CE-MS employing β-CD as chiral selector and ESI via sheath-liquid (SL) interfacing. Prior to analysis, AAs were fully derivatized with FMOC, improving AA-enantiomer separation and ESI efficiency. In order to optimize the separation and MS detection of FMOC-AAs, the effects of type and concentration of CD in the BGE, the composition of the SL, and MS-interfacing parameters were evaluated. Using a BGE of 10 mM β-CD in 50 mM ammonium bicarbonate (pH 8) containing 15% v/v isopropanol, a SL of isopropanol-water-1 M ammonium bicarbonate (50:50:1, v/v/v) at a flow rate of 3 μL/min, and a nebulizer gas pressure of 2 psi, 15 proteinogenic AAs could be detected with enantioresolutions up to 3.5 and detection limits down to 0.9 μM (equivalent to less than 3 pg AA injected). The selectivity of the method was demonstrated by the analysis of spiked cerebrospinal fluid, allowing specific detection of d-AAs. Repeatability and linearity obtained for cerebrospinal fluid were similar to standard solutions, with peak area and migration-time RSDs (n = 5) below 16.2 and 1.6%, respectively, and a linear response (R(2) ≥ 0.977) in the 3-90 μM range.

Enantiomeric separation of non-protein amino acids by electrokinetic chromatography

New analytical methodologies enabling the enantiomeric separation of a group of non-protein amino acids of interest in the pharmaceutical and food analysis fields were developed in this work using Electrokinetic Chromatography. The use of FMOC as derivatization reagent and the subsequent separation using acidic conditions (formate buffer at pH 2.0) and anionic cyclodextrins as chiral selectors allowed the chiral separation of eight from the ten non-protein amino acids studied. Pyroglutamic acid, norvaline, norleucine, 3,4-dihydroxyphenilalanine, 2-aminoadipic acid, and selenomethionine were enantiomericaly separated using sulfated-α-CD while sulfated-γ-CD enabled the enantiomeric separation of norvaline, 3,4-dihydroxyphenilalanine, 2-aminoadipic acid, selenomethionie, citrulline, and pipecolic acid. Moreover, the potential of the developed methodologies was demonstrated in the analysis of citrulline and its enantiomeric impurity in food supplements. For that purpose, experimental and instrumental variables were optimized and the analytical characteristics of the proposed method were evaluated. LODs of 2.1×10^-7 and 1.8×10^-7M for d- and l-citrulline, respectively, were obtained. d-Cit was not detectable in any of the six food supplement samples analyzed showing that the effect of storage time on the racemization of citrulline was negligible.

Derivatization in Capillary Electrophoresis

Capillary electrophoresis is a well-established separation technique in analytical research laboratories worldwide. Its interesting advantages make CE an efficient and potent alternative to other chromatographic techniques. However, it is also recognized that its main drawback is the relatively poor sensitivity when using optical detection. One way to overcome this limitation is to perform a derivatization reaction which is intended to provide the analyte more suitable analytical characteristics enabling a high sensitive detection. Based on the analytical step where the CE derivatization takes place, it can be classified as precapillary (before separation), in-capillary (during separation), or postcapillary (after separation). This chapter describes the application of four different derivatization protocols (in-capillary and precapillary modes) to carry out the achiral and chiral analysis of different compounds in food and biological samples with three different detection modes (UV, LIF, and MS).

Capillary electrophoresis determination of non-protein amino acids as quality markers in foods

Non-protein amino acids mainly exist in food as products formed during food processing, as metabolic intermediates or as additives to increase nutritional and functional properties of food. This fact makes their analysis and determination an attractive field in food science since they can give interesting information on the quality and safety of foods. This article presents a comprehensive review devoted to describe the latest advances in the development of (achiral and chiral) analytical methodologies by capillary electrophoresis and microchip capillary electrophoresis for the analysis of non-protein amino acids in a variety of food samples. Most relevant information related to sample treatment, experimental separation and detection conditions, preconcentration strategies and limits of detection will be provided.

Dereplication of known nucleobase and nucleoside compounds in natural product extracts by capillary electrophoresis-high resolution mass spectrometry

Nucleobase and nucleoside compounds exist widely in various organisms. An often occurring problem in the discovery of new bioactive compounds from natural products is reisolation of known nucleobase and nucleoside compounds. To resolve this problem, a capillary electrophoresis-high resolution mass spectrometry (CE-HR-MS) method providing both rapid separation and accurate mass full-scan MS data was developed for the first time to screen and dereplicate known nucleobase and nucleoside compounds in crude extracts of natural products. Instrumental parameters were optimized to obtain optimum conditions for CE separation and electrospray ionization-time-of-flight mass spectrometry (ESI-TOF/MS) detection. The proposed method was verified to be precise, reproducible, and sensitive. Using this method, known nucleobase and nucleoside compounds in different marine medicinal organisms including Syngnathus acus Linnaeus; Hippocampusjaponicus Kaup and Anthopleura lanthogrammica Berkly were successfully observed and identified. This work demonstrates that CE-HR-MS combined with an accurate mass database may be used as a powerful tool for dereplicating known nucleobase and nucleoside compounds in different types of natural products. Rapid dereplication of known nucleobase and nucleoside compounds allows researchers to focus on other leads with greater potential to yield new substances.

Development of chiral methodologies by capillary electrophoresis with ultraviolet and mass spectrometry detection for duloxetine analysis in pharmaceutical formulations

Two chiral methodologies were developed by capillary electrophoresis (CE) with UV and mass spectrometry (MS) detection to ensure the quality control of the drug duloxetine, commercialized as a pure enantiomer. Both methods were optimized to achieve a high baseline enantioresolution (Rs>2) and an acceptable precision (RSD values <5% for instrumental repeatability and <10% for intermediate precision). In addition to allow the unequivocal identification of duloxetine enantiomers, the CE-MS method improved the sensitivity with respect to the use of CE-UV (LOD 200 ng/mL by CE-UV and 20 ng/mL by CE-MS) enabling to detect 0.02% of duloxetine enantiomeric impurity. This is the lowest LOD value ever reported for this drug, being this work the first one enabling to accomplish with the ICH guidelines requirements. The developed methods were validated and applied for the first time to the analysis of four pharmaceutical formulations. The content of R-duloxetine in all these samples was below the detection limit and the amount of S-duloxetine was in good agreement with the labeled content, obtaining results by the two methods that did not differ significantly (p-values >0.05).

Potential of vancomycin for the enantiomeric resolution of FMOC-amino acids by capillary electrophoresis-ion-trap-mass spectrometry

The potential of the antibiotic vancomycin (VC) as chiral selector for the enantiomeric separation of amino acids by CE-ESI-MS/MS² was investigated for the first time in this work. Derivatization of amino acids with FMOC-Cl was carried out to enable their interaction with VC as well as the formation of precursor ions with larger m/z which were employed in MS² experiments. The partial filling of a coated capillary was employed to avoid the loss in MS sensitivity originated by the introduction of VC in the ionization source. Under optimized conditions, the simultaneous enantiomeric separation and unequivocal identification of 17 amino acids (two of them being nonprotein amino acids) took place in about 20 min with LODs in the micromolar range.

Chiral capillary electromigration techniques-mass spectrometry-hope and promise

Analytical methods for chiral compounds require a separation step prior to mass spectrometric detection. CE can separate enantiomers by the use of a chiral selector and can be hyphenated with MS. The chiral selector can be either embedded inside the capillary (electrochromatography) or added into the background solution (EKC). This review describes the fundamentals and highlights the recent developments (September 2009-May 2013) of chiral CEC and EKC with detection using MS. There were 20 research and more than 30 review papers during this period. The research efforts were driven by fundamental studies, such as the development of novel chiral selectors in electrochromatography and of advanced partial filling techniques in EKC in order to optimise separation. Other developments were in application studies, such as in food analytics and metabolomics.

Quantitative analysis of trigonelline in some Annona species by proton NMR spectroscopy

A quantitative ¹H NMR method (qHNMR) was used to measure the trigonelline content in the leaves of six species of the Annona genus. The methodology employed compared the intensities of the signals at δ 9.14 (H-2) and δ 0.00, the internal standard TSP-d₄. This measuring method was able to establish the concentration of trigonelline in the range from 0.67 to 10.04 mg·g⁻¹ depending on the investigated extract.

Chiral selectors in CE: recent developments and applications

This review article provides an overview of the recent advances in enantioanalysis by use of electrophoretic techniques. Due to the big number of publications in the subject mentioned above, this article is focused on chiral method developments and applications published from 2008 until 2011, and it demonstrates chiral selectors used in CE. Numerous chiral selectors have been used over the years, and these include the cyclic and the linear oligo- and polysaccharides, the branched polysaccharides, the polymeric and monomeric surfactants, the macrocyclic and other antibiotics, and the crown ethers. Different dual-selector systems are also presented in this article, and the results are compared with those obtained by use of a single chiral selector. Finally, several pharmaceutical and biomedical applications based on chiral recognition are summarized.

Enantiomeric separation of free L- and D-amino acids in hydrolyzed protein fertilizers by capillary electrophoresis tandem mass spectrometry

Two capillary electrophoresis-tandem mass spectrometry (CE-MS(2)) methods were optimized in this work using cyclodextrins (CDs) as chiral selectors in order to determine the degree of racemization of the free amino acids contained in different hydrolyzed protein fertilizers used as plant biostimulants. The methodologies developed were characterized by the specificity of MS(2) experiments enabling the identification of all protein amino acids, except for cysteine. The enantiomeric separation of up to 14 amino acids was achieved with resolutions above 1.0 and limits of detection between 0.02 and 0.8 μM. The methods were applied to the analysis of complex samples such as hydrolyzed protein fertilizers to evaluate the presence of d-amino acids after different kinds of hydrolysis treatments. The results corroborated the absence or almost negligible presence of enantiomeric conversions of the L-amino acids into D-amino acids in the case of fertilizers obtained by enzymatic hydrolysis, as well as the high racemization rate for those obtained through a chemical hydrolysis.

Chiral capillary electrophoresis-mass spectrometry

Capillary electrophoresis-mass spectrometry (CE-MS) is a powerful analytical tool, especially in the case of chiral separations, due to the fact that it combines the high efficiency, short analysis time, and versatility of the CE with the sensitivity, selectivity, and the capacity for the identification of unknown chiral compounds offered by MS detection. This chapter describes three methodologies enabling the chiral separation of cationic and anionic compounds using different strategies, illustrating the most employed approaches used in chiral CE-MS. The first methodology uses the partial filling technique for the enantioseparation of a cationic compound using a neutral cyclodextrin. Secondly, the enantioseparation of a cationic compound using low concentrations of a neutral cyclodextrin under acidic conditions is described. Finally, a methodology for the chiral separation of an anionic compound employing low concentrations of a native cyclodextrin under basic conditions is illustrated.

Recentchiral selectors for separation in HPLC and CE

Enantiomers (stereoisomers) can exhibit substantially different properties if present in chiral environments. Since chirality is a basic property of nature, the different behaviors of the individual enantiomers must be carefully studied and properly treated. Therefore, enantioselective separations are a very important part of separation science. To achieve the separation of enantiomers, an enantioselective environment must be created by the addition of a chiral selector to the separation system. Many chiral selectors have been designed and used in various fields, such as the analyses of drugs, food constituents and agrochemicals. The most popular have become the chiral selectors and/or chiral stationary phases that are of general use, i.e., are applicable in various separation systems and allow for chiral separation of structurally different compounds. This review covers the most important chiral selectors / chiral stationary phases described and applied in high performance liquid chromatography and capillary electrophoresis during the period of the last three years (2008–2011).

Thirty years of capillary electrophoresis in food analysis laboratories: potential applications

CE has generated considerable interest in the research community since instruments were introduced by different trading companies in the 1990s. Nowadays, CE is popular due to its simplicity, speed, highly efficient separations and minimal solvent and reagent consumption; it can also be included as a useful technique in the nanotechnology field and it covers a wide range of specific applications in different fields (chemical, pharmaceutical, genetic, clinical, food and environmental). CE has been very well evaluated in research laboratories for several years, and different new approaches to improve sensitivity (one of the main drawbacks of CE) and robustness have been proposed. However, this technique is still not well accepted in routine laboratories for food analysis. Researching in data bases, it is easy to find several electrophoretic methods to determine different groups of analytes and sometimes they are compared in terms of sensitivity, selectivity, precision and applicability with other separation techniques. Although these papers frequently prove the potential of this methodology in spiked samples, it is not common to find a discussion of the well-known complexity of the matrices to extract analytes from the sample and/or to study the interferences in the target analytes. Summarizing, the majority of CE scientific papers focus primarily on the effects upon the separation of the analytes while ignoring their behavior if these analytes are presented in real samples.

Sensitive determination of D-carnitine as enantiomeric impurity of levo-carnitine in pharmaceutical formulations by capillary electrophoresis-tandem mass spectrometry

In this work, capillary electrophoresis-electrospray ionization-tandem mass spectrometry was applied to the determination of l- and d-carnitine in pharmaceutical formulations. A simple sample treatment procedure consisting of the use of a dilution or an extraction step with water was employed prior to derivatization with 9-fluorenylmethoxycarbonyl (FMOC). The method was validated in terms of selectivity, linearity, accuracy, precision and sensitivity, with a LOD of 10ngmL(-1) for each enantiomer, which was enough to detect enantiomeric impurities up to 0.002% of d-carnitine with respect to the main enantiomer (l-carnitine). Eleven pharmaceutical formulations were analyzed including ampoules, oral solutions, sachets, and tablets. Results showed contents for carnitine comprised between 77 and 101% with respect to the labeled ones in the case of those formulations marketed with the racemate, and from 97 to 102% in those cases where the single enantiomer (l-carnitine) was employed as active ingredient. Percentages for the enantiomeric impurity (d-carnitine) ranging from 0.6 to 1.3% were obtained exceeding the limits established for impurities in drug products. These results corroborate the need of validated analytical methodologies enabling the quality control of pharmaceutical formulations containing carnitine.