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Aim: To examine the effect of maternal L-carnitine supplementation during conception and lactation in male offspring of mothers with cigarette smoke exposure (mCSE), in regards to renal oxidative stress and mitochondrial dysfunction. Background: Maternal smoking has been closely associated with underdevelopment of fetal/neonatal organs, as well as increased risk of numerous diseases such as hypertension, type 2 diabetes and chronic kidney disease in adulthood. Evidence suggests that oxidative stress and mitochondrial dysfunction might be the two underlying mechanisms. L-carnitine is a natural substance that was shown to benefit both antioxidant defense and mitochondrial performance in different disorders, thus might be able to reverse the negative impacts of mCSE on the offspring's kidney. Methods: Female Balb/c mice were exposed to cigarette smoke generated from 2 cigarettes twice daily for 6 weeks before mating, throughout gestation and lactation. A sub-group of SCE mice were administrated with L-carnitine from conception to weaning. Offspring's kidneys were harvested at birth, weaning and adulthood. Oxidative stress was evaluated by determining the levels of ROS, MnSOD, GPx-1 and mitochondrial SOD activity. Mitochondrial function was examined by the levels of TOM20 and OXPHOS complexes I–V. Body and kidney weight, glucose tolerance, TG and NEFA were also measured. Results: L-carnitine reversed low birth weight, glucose intolerance, and high level of TG in the mCSE mice offspring and this was associated with normalizations of renal MnSOD, GPx-1, TOM20, and most of the OXPHOS complexes at birth and adulthood, but not at weaning. Conclusions: L-carnitine significantly reduces renal oxidative stress and mitochondrial dysfunction in the offspring, induced by maternal smoking. This suggests a potential role for L-carnitine in preventing Chronic kidney disease.1 page(s