Carnitine palmitoyltransferase-I CPT

Long-chain acyl-CoA esters are then converted to acylcamitine esters by readily reversible reactions with L-camitine catalyzed by carnitine palmitoyltransferase I (CPT I). 

Figure 9-1- Role of carnitine in fatty acid oxidation. Long-chain fatty acids are activated as the thioester of CoA on the cytoplasmic side of the mitochondrial membrane. The fatty acyl group is then transferred to form the corresponding carnitine ester in a reaction catalyzed by carnitine palmitoyltransferase I (CPT ]) The acylcarnitine then enters the mitochondrial matrix in exchange for carnitine via the carnitine-acylcarnitine translocase. The acyl group is transferred back to CoA in the matrix by carnitine palmitoyltransferase II (CPT II). The intramitochondrial acyl-CoA can then undergo P-oxidation.

Figure 9-2. Carnitine palmitoyltransferase reaction. Palmitoyl-CoA is shown as a proto-typic substrate. Carnitine palmitoyltransferase I (CPT I) and carnitine palmitoyltransferase II (CPT II) are shown illustrating the direction of the reaction catalyzed by each enzyme during physiological fatty acid oxidation.

Clinical problems related to fatty acid metabolism. Deficiencies in carnitine lead to an inability to transport fatty acids into the mitochondria for oxidation. This can occur in newborns and particularly in pre-term infants. Treatment is by oral carnitine administration. Carnitine palmitoyltransferase I (CPT I) deficiency primarily affects the liver and leads to reduced fatty acid oxidation and ketogenesis. CPT II deficiency results in recurrent muscle pain, fatigue and myoglobinuria following strenuous exercise. 

---