The majority of articles published about carnitine tend to make the assumption that plasma carnitine levels are an accurate reflection of the overall carnitine status within a species. However, plasma carnitine concentration may not accurately reflect the concentrations found in the organs (liver, heart, muscle, kidneys, etc.). Our hypothesis is that carnitine does not respond the same in all organs and as a result, the organs should be considered individually with regards to carnitine concentration. We use an animal model to test this hypothesis. Using rat and piglet data gathered by Dr. Borum, we are analyzing the effects that different parameters (such as: age, gender, carnitine supplementation, hormones, diabetes, metabolic state) have on carnitine concentrations in blood and organ samples. By using data from different animals, we can investigate the carnitine status between the organs/blood in one species, and see if similar trends appear in another species. This is to strengthen our contentions about carnitine compartmentalization and build confidence in extrapolating our data to humans. In humans, it is often significantly easier to obtain blood samples compared to organ tissue samples. Therefore, if we can understand the interrelationships between blood compartments and organs using the animal models, we may have the power to interpret the organ carnitine status of a species by simply taking a blood sample.

Carnitine has the ability to form ester bonds with various molecules, and the product of this reaction is called an acylcarnitine. The role of each acylcarnitine species is not yet fully understood. To provide further insight into the role of each acylcarnitine species, the acylcarnitine group assays the blood and organ samples that we obtain from our piglet surgeries. Using the piglet model to determine how acylcarnitines function in the piglet model, we hope to extrapolate our conclusions outward to humans. In addition to assaying piglet organs and blood, the assay group will be working with human blood samples from epileptic patients taken from a Shand's hospital CRC. By assaying the blood from epileptic patients, we hope to gain insight into how acylcarnitines function in epileptic patients and their metabolism, which in turn can cross benefit the care that the KetoGator team provides for their patients.

The HIV-Carn group consists of members from both the Carnitine team and the Gator team. The overall purpose of this group is to investigate various metabolic abnormalities prevalent in the pediatric HIV+ children with aims to improve patient care and contribute to the growing research in this field. Gator team members are responsible for collecting, organizing and auditing patient data from the patients seen at the Shands pediatric Immunology clinic each week. Thereafter, Carnitine team members transfer the patient data into an Access database, that is created for research purposes. The database is used to run queries and obtain specific data, which is analyzed by group members. HIV-Carn members have the opportunity to work on individual theses/projects concerning some aspect of the metabolic syndrome in pediatric HIV+ patients or topics related to improving and providing better patient care. Group members and Dr. Borum come together at weekly meetings to discuss relevant journal articles, give updates on the database, and to discuss the progress of each individual thesis/project. Finally, Carnitine members serve as Information Coordinators at the Gator clinic each Wednesday from about 8 a.m. to 1 p.m. The work involves ensuring accurate collection of patient growth data by the nurses and running various other errands to facilitate the Gator team and Dr. Borum.

The KetoCarn group is composed of members from the Carnitine and KetoGator teams. The purpose of this group is to further investigate the mechanisms of the Ketogenic Diet. This is accomplished through the discussion of journal articles and the building of a patient population database. This database will be used for both patient care and research purposes. It is a highly valuable tool that will aid in answering questions about patients receiving Ketogenic Therapy. Once completed, the database will house data from over 150 patients being treated at Shands. Our overall goal is to pioneer an accurate and successful database that can be used by physicians and researchers throughout the scientific community.

We work on various studies exploring the status of carnitine in humans. Some of those studies include the Orlando Study which investigates neonates on TPN with and without carnitine supplementation and the Renal Study which investigates the carnitine level of patients on hemodialysis. Our newly inputted source, the HCRV database, consists of data obtained from over 3300 patients under 35 studies as well as normal donors from Red Cross which we use to serve as control for other studies and to envisage carnitine compartmentalization in human body by comparing it to the data from other animal species such as piglets, rats, and hamsters. Through those studies, we are able to research into the variation in carnitine level under normal condition with different parameters like age, gender, and pregnancy, or abnormal physiological conditions like cancer, chronic renal disease, genetic carnitine deficiency, and myopathy. Subsequently we hope to gain an insight into assessment and functions of carnitine in human body, the knowledge that could help people in poor health as in cases of potential benefits of carnitine supplementation to people on TPN, pregnant women with carnitine deficiency, or pre-term babies and of carnitine compartmentalization that may make us able to predict the carnitine status in different organs using just blood samples.

Some examples of the questions we ask are:
1. What is the correlation between carnitine level and age?
2. What is the relationship between the mother's milk carnitine value and her baby's carnitine value?
3. How does carnitine level change before and after surgeries?
4. What is the relationship between plasma carnitine and RBC carnitine?