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This combination therapy consists of meldonium (also known as Mildronate) and omega-3 polyunsaturated fatty acids (PUFAs), specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Meldonium is a cardioprotective agent that acts by inhibiting gamma-butyrobetaine dioxygenase (BBOX) and carnitine palmitoyltransferase I (CPT1), as well as the organic cation/carnitine transporter 2 (OCTN2). These actions lead to a reduction in carnitine levels, which inhibits the transport of long-chain fatty acids into the mitochondria, thereby shifting cellular energy metabolism from fatty acid oxidation to glucose oxidation. The combination with PUFAs is being investigated by Riga Stradins University to determine how the inhibition of mitochondrial fatty acid metabolism by meldonium affects the plasma concentrations and metabolic profiles (acylcarnitines) of EPA and DHA in healthy individuals.
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