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Acetyl-L-carnitine in diabetic neuropathy Three Class II RCTs compared ALC versus placebo in a total of 1590 patients with diabetic peripheral neuropathy

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Abbreviations ADL: Activities of daily living ATP: Adenosine triphosphate BBB: Blood-brain barrier CAT: Catalase CBT: Cognitive behavioral therapy CDC: Centers for Disease Control and Prevention CFQ: Chalder Fatigue Questionnaire ChiCTR: Chinese Clinical Trial Register CNS: Central nervous system COMPASS: Composite Autonomic Symptom Scale CoQ 10 : Coenzyme Q 10 DCA: Sodium dichloroacetate DHTs: Digital health technologies DSQ: DePaul Symptom Questionnaire EBV: Epstein-Barr virus ETC: Electron transport chain FIS: Fatigue Impact Scale fMRI: Functional magnetic resonance imaging GET: Graded exercise therapy GPx: Glutathione peroxidase GSH: Glutathione H 2 : Molecular hydrogen HRV: Heart rate variability HSV-1: Herpes simplex virus HUTT: Head-Up Tilt Table Test IFN-: Interferon-gamma IgG: Immunoglobulin G IL-1: Interleukin-1 IL-6: Interleukin-6 iNOS: Inducible nitric oxide synthase IOM: Institute of Medicine IVIG: Intravenous immunoglobulin LDN: Low-dose naltrexone MAPK: Mitogen-activated protein kinase ME/CFS: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome MeSH: Medical Subject Headings MMSE: Mini-Mental State Examination MoCA: Montreal Cognitive Assessment NAC: N-acetylcysteine NfL: Neurofilament light chain NF-B: Nuclear factor kappa-light-chain-enhancer of activated B cells NICE: National Institute for Health and Care Excellence NK: Natural killer NO: Nitric oxide PACS: Post-acute COVID-19 syndrome PBMCs: Peripheral blood mononuclear cells PDH: Pyruvate dehydrogenase PDKs: Pyruvate dehydrogenase kinases PEM: Post-exertional malaise POTS: Postural tachycardia syndrome PSQI: Pittsburgh Sleep Quality Index RCTs: Randomized controlled trials RNA: Ribonucleic acid RNS: Reactive nitrogen species ROS: Reactive oxygen species RWD: Real-world data SANRA: The Scale for the Assessment of Narrative Review Articles SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2 SMN: Somatomotor network SOD: Superoxide dismutase TCA: Tricarboxylic acid TCM: Traditional Chinese medicine Th1: T-helper 1 Th2: T-helper 2 Th17: T-helper 17 TLR3: Toll-like receptor 3 TNF-: Tumor necrosis factor-alpha TRPM3: Transient receptor potential cation channel subfamily M member 3 tVNS: Transcutaneous vagus nerve stimulation OR: -opioid receptors References Cortes Rivera M, Mastronardi C, Silva-Aldana CT, Arcos-Burgos M, Lidbury BA

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