Creatine as a Therapeutic Strategy

Dear Colleagues,

After decades of relative neglect, the scientific world is again slowly turning its attention to the energetic metabolism of the cells. This field is especially important for those of us who work and do research on excitable tissues, which create and consume the largest share of energy in the entire human body. As often pointed out, the brain represents about 2% of body weight but consumes about 20% of all the oxygen consumed by the body. Muscles as a whole consume another 20%, and this requirement increases as physical activity increases. The heart consumes “only” 11% of the total energy expenditure of the body, but it is a small organ, so it has the highest energy expenditure relative to its weight. These high energy requirements are easily unbalanced at times of higher energy requirements (increased “effort”), or at times of energy shortage (hypoxia, ischemia).

As these basic notions receive renewed focus from scientists, dietary supplementation with creatine is more and more utilized to prevent or cure various conditions affecting excitable tissues. In fact, this relatively inexpensive supplement lays at the very core of the energy metabolism of the cell. By increasing its own intracellular concentration as well as that of its metabolite phosphocreatine, creatine can at least transiently balance the energy needs when either increased demand or reduced supply throws them off balance.

Moreover, creatine has a modulatory role in the differentiation of neurons and muscle cells, so its biological effects probably surpass energy balance and intervene in neuronal and muscular plasticity as well.

In view of all the above considerations and discoveries, in the past decade, creatine has been used to treat or prevent various conditions of excitable tissues. Several groups have carried out clinical trials that studied how dietary supplementation with creatine may improve health and wellbeing in several conditions. Yet mainstream research still pays insufficient attention to these studies that could herald new ways to address various conditions affecting excitable tissues. Thus, increasing the dissemination of this research is of paramount importance to those of us who are involved in research on the possible clinical uses of creatine.

The present Special Issue of Biomolecules will publish research articles, reviews, and communications reporting the state of the art of the therapeutic use of creatine supplementation in humans. It is exciting to see that after long years of creatine research being confined to experimental preclinical investigation, clinical results are more and more being reported.

Clearly, as human therapeutic use of creatine is growing, more attention must be devoted to how safe its use may be. Thus, the present Special Issue will put creatine safety into focus as well, and discuss the state of the art of safe creatine supplementation.

We look forward to receiving your contributions.

Dr. Maurizio Balestrino
Guest Editor

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