Pantethine: A Review of its Biochemistry and Therapeutic Applications

Pantethine is the stable disulfate form of pantetheine, the metabolic substrate which constitutes the active part of coenzyme A (CoA) molecules and acyl carrier proteins. Because pantethine is located nearer to CoA than is pantothenic acid in the biosynthetic pathway of CoA, it has been suggested it will have clinical benefits in conditions where pantothenic acid is not effective, and clinical trials with pantethine appear to prove this argument. Oral administration of pantethine has consistently shown an ability to favorably impact a variety of lipid risk factors in persons with hypercholesterolemia, arteriosclerosis, and diabetes. Pantethine administration positively affects parameters associated with platelet lipid composition and cell membrane fluidity. In several animal models, preliminary studies have indicated pantethine can inhibit cataract formation. Pantethine is capable of lipotropic activity, and in experimental models exerts hepato-protective action and impacts adrenal cortex function. The intravenous administration of pantethine has been shown to impact several central nervous system neurotransmitters and hormones; however, oral doses of pantethine have not demonstrated a similar action, suggesting cysteamine, a metabolite of pantethine, is responsible for these actions. (Alt Med Rev 1997;2(5):365-377)