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Results: At one year 10 patients died (mortality 17.2%)

In anterograde regulation, proteins encoded by the nuclear genome are transferred to the mitochondria to perform functions (71), while in retrograde regulation, the signal generated from mitochondria passes into the nucleus to induce gene expression, which occurs when mitochondrial homeostasis is interrupted by hypoxia or mutation in mtDNA, or mitochondrial Ca 2+ release (72, 73)

There is another pathway by which L-carnitine assists the mitochondria to remain healthy

the method of the present invention is characterized by preparation of high-quality L-carnitine at a low production cost, through the development of a production process of alkyl (R)-4-chloro-3-hydroxybutyrate which is used as an intermediate