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However, TMAO insult alone was not sufficient to convert renal fibroblasts to myofibroblasts requiring synergy with a preexisting pathological state, i.e., pro-fibrotic signaling (second-hit) in the form of TGF-1 stimulation, the most prominent pro-fibrotic cytokine 46

[DOI] [PubMed] [Google Scholar] Michelini E

Augmented Fatty Acid Oxidation: The inclusion of L-carnitine directly supports the transport of fatty acids into the mitochondria, boosting the cell's capacity for energy production from fats

In addition to oral l-carnitine, metformin was administered either intraperitoneally (ip, solubilized in 0.9% NaCl) at a concentration of 100 mg/kg of rat weight twice a day for 4 weeks in the l-carnitine + Metformin group [28]