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Divković A, Karasalihović Z, Rumora Samarin I, Sabitović D, Radić K, Golub N, Vujić L, Rajković MG, Vitali Čepo D. Effect of Alpha Lipoic Acid Supplementation on Oxidative Stress and Lipid Parameters in Women Diagnosed with Low-Grade Squamous Intraepithelial Lesions (LSILs): A Double-Blind, Randomized, Placebo-Controlled Trial. Antioxidants (Basel) 2023; 12:1670. [PMID: 37759972 PMCID: PMC10525309 DOI: 10.3390/antiox12091670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Limited scientific evidence shows that alpha lipoic acid (ALA) can induce regression rates of low-grade squamous intraepithelial lesions (LSILs), but the mechanisms of these effects have not been elucidated. To gain a broader insight into its therapeutic potential and mechanisms of action, the effects of 3 months of supplementation with 600 mg of ALA on antioxidant and lipid status parameters in 100 patients with LSILs were investigated in a randomized, placebo-controlled study. The obtained results are discussed in terms of patients' initial metabolic status and diet quality (particularly nutritional intake of antioxidants). The obtained results showed that oxidative status biomarkers were not significantly affected by ALA supplementation. However, serum superoxide dismutase (SOD) activity was positively affected in the subgroup of patients with higher dietary antioxidant intake. Surprisingly, ALA supplementation resulted in a small but statistically significant increase in serum low density lipoprotein (LDL), and the observed effect was significantly affected by the initial lipid status of the participants. Larger studies are necessary to gain additional insights on the clinical significance of ALA as an antioxidant and hypolipemic agent and to optimize its potential application in LSIL treatment.
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Affiliation(s)
- Anja Divković
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Zinaida Karasalihović
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Ivana Rumora Samarin
- University of Zagreb, Faculty of Food Technology and Biotechnology, 10000 Zagreb, Croatia;
| | - Damir Sabitović
- University Clinical Centre Tuzla, 75000 Tuzla, Bosnia and Herzegovina; (A.D.); (Z.K.)
| | - Kristina Radić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Nikolina Golub
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Lovorka Vujić
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Marija Grdić Rajković
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
| | - Dubravka Vitali Čepo
- University of Zagreb, Faculty of Pharmacy and Biochemistry, 10000 Zagreb, Croatia; (K.R.); (N.G.); (L.V.); (M.G.R.)
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Jeffrey S, Isaac Samraj P, Sundara Raj B. Therapeutic Benefits of Alpha-Lipoic Acid Supplementation in Diabetes Mellitus: A Narrative Review. J Diet Suppl 2021; 19:566-586. [PMID: 34939534 DOI: 10.1080/19390211.2021.2020387] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Elevated oxidative stress is a common denominator between pathways implicated in the pathogenesis of diabetes mellitus and diabetes complications, prompting the use of antioxidant compounds in diabetes therapy. Alpha-lipoic acid (ALA), has been investigated for its role as a potent antioxidant in diabetes treatment and the results from clinical trials indicate improved glucose metabolism, reduced oxidative stress, improved endothelial dysfunction, a decline in platelet reactivity and moderate improvements to weight loss yet conflicting data regarding insulin metabolism. ALA inhibits nuclear factor kappa B (NFkB), chelates divalent transient metal ions and induces the expression of adenosine monophosphate-activated protein kinase (AMPK). This narrative review explores the results from clinical trials investigating the role of ALA in the treatment of diabetes mellitus.
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Affiliation(s)
- Sarah Jeffrey
- Endeavour College of Natural Health, Perth, WA, Australia
| | | | - Behin Sundara Raj
- School of Pharmacy and Biomedical Sciences, Curtin University, Perth, WA, Australia
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Rezaei Zonooz S, Hasani M, Morvaridzadeh M, Beatriz Pizarro A, Heydari H, Yosaee S, Rezamand G, Heshmati J. Effect of alpha-lipoic acid on oxidative stress parameters: A systematic review and meta-analysis. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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Barteková M, Adameová A, Görbe A, Ferenczyová K, Pecháňová O, Lazou A, Dhalla NS, Ferdinandy P, Giricz Z. Natural and synthetic antioxidants targeting cardiac oxidative stress and redox signaling in cardiometabolic diseases. Free Radic Biol Med 2021; 169:446-477. [PMID: 33905865 DOI: 10.1016/j.freeradbiomed.2021.03.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Abstract
Cardiometabolic diseases (CMDs) are metabolic diseases (e.g., obesity, diabetes, atherosclerosis, rare genetic metabolic diseases, etc.) associated with cardiac pathologies. Pathophysiology of most CMDs involves increased production of reactive oxygen species and impaired antioxidant defense systems, resulting in cardiac oxidative stress (OxS). To alleviate OxS, various antioxidants have been investigated in several diseases with conflicting results. Here we review the effect of CMDs on cardiac redox homeostasis, the role of OxS in cardiac pathologies, as well as experimental and clinical data on the therapeutic potential of natural antioxidants (including resveratrol, quercetin, curcumin, vitamins A, C, and E, coenzyme Q10, etc.), synthetic antioxidants (including N-acetylcysteine, SOD mimetics, mitoTEMPO, SkQ1, etc.), and promoters of antioxidant enzymes in CMDs. As no antioxidant indicated for the prevention and/or treatment of CMDs has reached the market despite the large number of preclinical and clinical studies, a sizeable translational gap is evident in this field. Thus, we also highlight potential underlying factors that may contribute to the failure of translation of antioxidant therapies in CMDs.
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Affiliation(s)
- Monika Barteková
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia.
| | - Adriana Adameová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, 83232 Bratislava, Slovakia
| | - Anikó Görbe
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Kristína Ferenczyová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia
| | - Oľga Pecháňová
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, 81371 Bratislava, Slovakia
| | - Antigone Lazou
- Laboratory of Animal Physiology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, And Department of Physiology & Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Zoltán Giricz
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
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Banik S, Halder S, Sato H, Onoue S. Self-emulsifying drug delivery system of (R)-α-lipoic acid to improve its stability and oral absorption. Biopharm Drug Dispos 2021; 42:226-233. [PMID: 33843079 DOI: 10.1002/bdd.2277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 02/03/2023]
Abstract
The present study was designed to develop a self-emulsifying drug delivery system (SEDDS) of (R)-α-lipoic acid (RLA) to improve the physicochemical and nutraceutical properties of RLA. RLA/SEDDS was prepared using medium-chain triglycerides, Tween 80, and polyethylene glycol 400 as oil, surfactant, and co-surfactant, respectively. The preferable composition of SEDDS was selected according to a pseudo-ternary phase diagram for improved emulsification properties, and its physicochemical and pharmacokinetic properties were evaluated. RLA/SEDDS showed the immediate formation of fine micelles with a mean droplet size of approximately 260 nm when introduced into aqueous media. In simulated gastric fluid, this system could significantly improve the dissolution behavior of RLA and prevent the degradation of RLA, possibly due to the encapsulation of RLA into the emulsion structure. Following the oral administration of RLA/SEDDS (10 mg RLA/kg) in rats, systemic exposure to RLA and dihydrolipoic acid (DHLA), a reduced form of RLA, increased by 7- and 3-fold, respectively. The improved dissolution and gastric stability of RLA could contribute to enhancing systemic exposure to RLA and DHLA after oral administration. From these findings, RLA/SEDDS might be an efficacious dosage option for improving the oral bioavailability as well as nutraceutical properties of RLA.
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Affiliation(s)
- Sujan Banik
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Shimul Halder
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Hideyuki Sato
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Satomi Onoue
- Laboratory of Biopharmacy, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
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Safety Evaluation of α-Lipoic Acid Supplementation: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Clinical Studies. Antioxidants (Basel) 2020; 9:antiox9101011. [PMID: 33086555 PMCID: PMC7603186 DOI: 10.3390/antiox9101011] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/10/2020] [Accepted: 10/15/2020] [Indexed: 12/21/2022] Open
Abstract
Alpha-lipoic acid (ALA) is a natural short-chain fatty acid that has attracted great attention in recent years as an antioxidant molecule. However, some concerns have been recently raised regarding its safety profile. To address the issue, we aimed to assess ALA safety profile through a systematic review of the literature and a meta-analysis of the available randomized placebo-controlled clinical studies. The literature search included EMBASE, PubMed Medline, SCOPUS, Google Scholar, and ISI Web of Science by Clarivate databases up to 15th August 2020. Data were pooled from 71 clinical studies, comprising 155 treatment arms, which included 4749 subjects with 2558 subjects treated with ALA and 2294 assigned to placebo. A meta-analysis of extracted data suggested that supplementation with ALA was not associated with an increased risk of any treatment-emergent adverse event (all p > 0.05). ALA supplementation was safe, even in subsets of studies categorized according to smoking habit, cardiovascular disease, presence of diabetes, pregnancy status, neurological disorders, rheumatic affections, severe renal impairment, and status of children/adolescents at baseline.
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Kallinikou D, Soldatou A, Tsentidis C, Louraki M, Kanaka-Gantenbein C, Kanavakis E, Karavanaki K. Diabetic neuropathy in children and adolescents with type 1 diabetes mellitus: Diagnosis, pathogenesis, and associated genetic markers. Diabetes Metab Res Rev 2019; 35:e3178. [PMID: 31083769 DOI: 10.1002/dmrr.3178] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/10/2019] [Accepted: 05/07/2019] [Indexed: 01/09/2023]
Abstract
Diabetic neuropathy (DN) is a common long-term complication of type 1 (T1D) and type 2 (T2D) diabetes mellitus, with significant morbidity and mortality. DN is defined as impaired function of the autonomic and/or peripheral nervous system, often subclinical, particularly in children and adolescents with T1D. Nerve conduction studies (NCS) and skin biopsies are considered gold-standard methods in the assessment of DN. Multiple environmental and genetic factors are involved in the pathogenesis of DN. Specifically, the role of metabolic control and glycemic variability is of paramount importance. A number of recently identified genes, including the AKR1B1, VEGF, MTHFR, APOE, and ACE genes, contribute significantly in the pathogenesis of DN. These genes may serve as biomarkers to predict future DN development or treatment response. In addition, they may serve as the basis for the development of new medications or gene therapy. In this review, the diagnostic evaluation, pathogenesis, and associated genetic markers of DN in children and adolescents with T1D are presented and discussed.
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Affiliation(s)
- Dimitra Kallinikou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Charalambos Tsentidis
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Maria Louraki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- Diabetes Center, Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Emmanouil Kanavakis
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
- Department of Medical Genetics, Choremeio Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, 2nd Department of Pediatrics, National and Kapodistrian University of Athens-Faculty of Medicine, "P.&A. Kyriakou" Children's Hospital, Athens, Greece
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Rahimlou M, Asadi M, Banaei Jahromi N, Mansoori A. Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A Systematic Review and meta- analysis. Clin Nutr ESPEN 2019; 32:16-28. [PMID: 31221283 DOI: 10.1016/j.clnesp.2019.03.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/08/2019] [Accepted: 03/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Several randomized clinical trials (RCTs) have investigated the effect of Alpha - Lipoic Acid (ALA) supplementation on metabolic parameters, with conflicting results. Therefore, the present study assessed the effect of ALA on some glycemic and inflammatory parameters. METHODS A comprehensive literature search was conducted up from inception to July 2018 on PubMed, Scopus, Cochrane databases, Google Scholar, ProQuest, Web of Science, and Embase. From among eligible trials, 41 articles were selected for the meta-analysis. Two reviewers independently assessed the risk of bias and extracted data from the included studies. Meta-analyses using the random-effects model were performed to analyze the data. RESULTS Based on the Cochrane risk of bias tool, 19 articles had a good quality, 16 trials had a poor quality and 6 trials had a fair quality. The results demonstrated the significant effect of ALA on Fasting Blood Sugar (FBS) (weighted mean difference (WMD)) = -6.57, 95% confidence interval (CI: -11.91 to -1.23, P = 0.016), Hemoglobin A1c (HbA1c) (WMD = -0.35, 95% CI: -0.55 to -0.15, P = 0.004), Tumor Necrosis Factor Alpha (TNF-α) (WMD = -1.57, 95% CI: -2.29 to -0.85, P < 0.05), Interleukin 6 levels (IL-6) (WMD = -1.15, 95% CI: -1.58 to -0.72, P < 0.001), and C-reactive protein (CRP) (WMD = -0.31, 95% CI: -0.47 to -0.16, P > 0.001). No effect was detected for ALA on insulin and the homeostatic model assessment of insulin resistance (HOMA-IR). CONCLUSIONS These findings suggest that ALA is a viable supplement to improve some of the glycemic and inflammatory biomarkers.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, School of Para-Medical Sciences, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
| | - Maryam Asadi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Nasrin Banaei Jahromi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Anahita Mansoori
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Etchegoyen M, Nobile MH, Baez F, Posesorski B, González J, Lago N, Milei J, Otero-Losada M. Metabolic Syndrome and Neuroprotection. Front Neurosci 2018; 12:196. [PMID: 29731703 PMCID: PMC5919958 DOI: 10.3389/fnins.2018.00196] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/12/2018] [Indexed: 12/17/2022] Open
Abstract
Introduction: Over the years the prevalence of metabolic syndrome (MetS) has drastically increased in developing countries as a major byproduct of industrialization. Many factors, such as the consumption of high-calorie diets and a sedentary lifestyle, bolster the spread of this disorder. Undoubtedly, the massive and still increasing incidence of MetS places this epidemic as an important public health issue. Hereon we revisit another outlook of MetS beyond its classical association with cardiovascular disease (CVD) and Diabetes Mellitus Type 2 (DM2), for MetS also poses a risk factor for the nervous tissue and threatens neuronal function. First, we revise a few essential concepts of MetS pathophysiology. Second, we explore some neuroprotective approaches in MetS pertaining brain hypoxia. The articles chosen for this review range from the years 1989 until 2017; the selection criteria was based on those providing data and exploratory information on MetS as well as those that studied innovative therapeutic approaches. Pathophysiology: The characteristically impaired metabolic pathways of MetS lead to hyperglycemia, insulin resistance (IR), inflammation, and hypoxia, all closely associated with an overall pro-oxidative status. Oxidative stress is well-known to cause the wreckage of cellular structures and tissue architecture. Alteration of the redox homeostasis and oxidative stress alter the macromolecular array of DNA, lipids, and proteins, in turn disrupting the biochemical pathways necessary for normal cell function. Neuroprotection: Different neuroprotective strategies are discussed involving lifestyle changes, medication aimed to mitigate MetS cardinal symptoms, and treatments targeted toward reducing oxidative stress. It is well-known that the routine practice of physical exercise, aerobic activity in particular, and a complete and well-balanced nutrition are key factors to prevent MetS. Nevertheless, pharmacological control of MetS as a whole and pertaining hypertension, dyslipidemia, and endothelial injury contribute to neuronal health improvement. Conclusion: The development of MetS has risen as a risk factor for neurological disorders. The therapeutic strategies include multidisciplinary approaches directed to address different pathological pathways all in concert.
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Affiliation(s)
- Melisa Etchegoyen
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Mariana H Nobile
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Francisco Baez
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Barbara Posesorski
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Julian González
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Néstor Lago
- Institute of Cardiovascular Pathophysiology, School of Medicine, University of Buenos Aires, UBA-CONICET, Buenos Aires, Argentina
| | - José Milei
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Matilde Otero-Losada
- Institute of Cardiological Research, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
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Affiliation(s)
- Scott V. Wiener
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Thomas Chi
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
| | - Marshall L Stoller
- Department of Urology, University of California San Francisco, San Francisco, CA, USA
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Ikuta N, Okamoto H, Furune T, Uekaji Y, Terao K, Uchida R, Iwamoto K, Miyajima A, Hirota T, Sakamoto N. Bioavailability of an R-α-Lipoic Acid/γ-Cyclodextrin Complex in Healthy Volunteers. Int J Mol Sci 2016; 17:ijms17060949. [PMID: 27314343 PMCID: PMC4926482 DOI: 10.3390/ijms17060949] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 06/08/2016] [Accepted: 06/09/2016] [Indexed: 11/16/2022] Open
Abstract
R-α-lipoic acid (R-LA) is a cofactor of mitochondrial enzymes and a very strong antioxidant. R-LA is available as a functional food ingredient but is unstable against heat or acid. Stabilized R-LA was prepared through complexation with γ-cyclodextrin (CD), yielding R-LA/CD. R-LA/CD was orally administered to six healthy volunteers and showed higher plasma levels with an area under the plasma concentration-time curve that was 2.5 times higher than that after oral administration of non-complexed R-LA, although the time to reach the maximum plasma concentration and half-life did not differ. Furthermore, the plasma glucose level after a single oral administration of R-LA/CD or R-LA was not affected and no side effects were observed. These results indicate that R-LA/CD could be easily absorbed in the intestine. In conclusion, γ-CD complexation is a promising technology for delivering functional but unstable ingredients like R-LA.
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Affiliation(s)
- Naoko Ikuta
- Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan.
| | - Hinako Okamoto
- Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan.
- CycloChem Bio Co., Ltd., Kobe 650-0047, Japan.
| | | | | | - Keiji Terao
- Graduate School of Medicine, Kobe University, Kobe 650-0017, Japan.
- CycloChem Bio Co., Ltd., Kobe 650-0047, Japan.
| | - Ryota Uchida
- Department of Biopharmaceutics, Faculty of Pharmaceutical Science, Tokyo University of Science, Chiba 278-8510, Japan.
| | - Kosuke Iwamoto
- Department of Biopharmaceutics, Faculty of Pharmaceutical Science, Tokyo University of Science, Chiba 278-8510, Japan.
| | - Atsushi Miyajima
- Department of Biopharmaceutics, Faculty of Pharmaceutical Science, Tokyo University of Science, Chiba 278-8510, Japan.
| | - Takashi Hirota
- Department of Biopharmaceutics, Faculty of Pharmaceutical Science, Tokyo University of Science, Chiba 278-8510, Japan.
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Oyenihi AB, Ayeleso AO, Mukwevho E, Masola B. Antioxidant strategies in the management of diabetic neuropathy. BIOMED RESEARCH INTERNATIONAL 2015; 2015:515042. [PMID: 25821809 PMCID: PMC4363503 DOI: 10.1155/2015/515042] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 09/10/2014] [Indexed: 02/07/2023]
Abstract
Chronic hyperglycaemia (an abnormally high glucose concentration in the blood) resulting from defects in insulin secretion/action, or both, is the major hallmark of diabetes in which it is known to be involved in the progression of the condition to different complications that include diabetic neuropathy. Diabetic neuropathy (diabetes-induced nerve damage) is the most common diabetic complication and can be devastating because it can lead to disability. There is an increasing body of evidence associating diabetic neuropathy with oxidative stress. Oxidative stress results from the production of oxygen free radicals in the body in excess of its ability to eliminate them by antioxidant activity. Antioxidants have different mechanisms and sites of actions by which they exert their biochemical effects and ameliorate nerve dysfunction in diabetes by acting directly against oxidative damage. This review will examine different strategies for managing diabetic neuropathy which rely on exogenous antioxidants.
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Affiliation(s)
- Ayodeji Babatunde Oyenihi
- Discipline of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, University Road, Durban 4000, South Africa
| | - Ademola Olabode Ayeleso
- Department of Biochemistry, University of Johannesburg, P.O. Box 524, Auckland Park 2002, South Africa
| | - Emmanuel Mukwevho
- Department of Biochemistry, University of Johannesburg, P.O. Box 524, Auckland Park 2002, South Africa
| | - Bubuya Masola
- Discipline of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, University Road, Durban 4000, South Africa
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Pagano G, Aiello Talamanca A, Castello G, Cordero MD, d'Ischia M, Gadaleta MN, Pallardó FV, Petrović S, Tiano L, Zatterale A. Current experience in testing mitochondrial nutrients in disorders featuring oxidative stress and mitochondrial dysfunction: rational design of chemoprevention trials. Int J Mol Sci 2014; 15:20169-208. [PMID: 25380523 PMCID: PMC4264162 DOI: 10.3390/ijms151120169] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 02/07/2023] Open
Abstract
An extensive number of pathologies are associated with mitochondrial dysfunction (MDF) and oxidative stress (OS). Thus, mitochondrial cofactors termed "mitochondrial nutrients" (MN), such as α-lipoic acid (ALA), Coenzyme Q10 (CoQ10), and l-carnitine (CARN) (or its derivatives) have been tested in a number of clinical trials, and this review is focused on the use of MN-based clinical trials. The papers reporting on MN-based clinical trials were retrieved in MedLine up to July 2014, and evaluated for the following endpoints: (a) treated diseases; (b) dosages, number of enrolled patients and duration of treatment; (c) trial success for each MN or MN combinations as reported by authors. The reports satisfying the above endpoints included total numbers of trials and frequencies of randomized, controlled studies, i.e., 81 trials testing ALA, 107 reports testing CoQ10, and 74 reports testing CARN, while only 7 reports were retrieved testing double MN associations, while no report was found testing a triple MN combination. A total of 28 reports tested MN associations with "classical" antioxidants, such as antioxidant nutrients or drugs. Combinations of MN showed better outcomes than individual MN, suggesting forthcoming clinical studies. The criteria in study design and monitoring MN-based clinical trials are discussed.
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Affiliation(s)
- Giovanni Pagano
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Annarita Aiello Talamanca
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Giuseppe Castello
- Istituto Nazionale Tumori Fondazione G. Pascale-Cancer Research Center at Mercogliano (CROM)-IRCCS, Naples I-80131, Italy.
| | - Mario D Cordero
- Research Laboratory, Dental School, Universidad de Sevilla, Sevilla 41009, Spain.
| | - Marco d'Ischia
- Department of Chemical Sciences, University of Naples "Federico II", Naples I-80126, Italy.
| | - Maria Nicola Gadaleta
- National Research Council, Institute of Biomembranes and Bioenergetics, Bari I-70126, Italy.
| | - Federico V Pallardó
- CIBERER (Centro de Investigación Biomédica en Red de Enfermedades Raras), University of Valencia-INCLIVA, Valencia 46010, Spain.
| | - Sandra Petrović
- Vinca" Institute of Nuclear Sciences, University of Belgrade, Belgrade 11001, Serbia.
| | - Luca Tiano
- Biochemistry Unit, Department of Clinical and Dental Sciences, Polytechnical University of Marche, Ancona I-60131, Italy.
| | - Adriana Zatterale
- Genetics Unit, Azienda Sanitaria Locale (ASL) Napoli 1 Centro, Naples I-80136, Italy.
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Pop-Busui R, Stevens MJ, Raffel DM, White EA, Mehta M, Plunkett CD, Brown MB, Feldman EL. Effects of triple antioxidant therapy on measures of cardiovascular autonomic neuropathy and on myocardial blood flow in type 1 diabetes: a randomised controlled trial. Diabetologia 2013; 56:1835-44. [PMID: 23740194 PMCID: PMC3730828 DOI: 10.1007/s00125-013-2942-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 05/02/2013] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS We evaluated the effects of a combination triple antioxidant therapy on measures of cardiovascular autonomic neuropathy (CAN) and myocardial blood flow (MBF) in patients with type 1 diabetes. METHODS This was a randomised, parallel, placebo-controlled trial. Participants were allocated to interventions by sequentially numbered, opaque, sealed envelopes provided to the research pharmacist. All participants and examiners were masked to treatment allocation. Participants were evaluated by cardiovascular autonomic reflex testing, positron emission tomography with [(11)C]meta-hydroxyephedrine ([(11)C]HED) and [(13)N]ammonia, and adenosine stress testing. Markers of oxidative stress included 24 h urinary F2-isoprostanes. Diabetic peripheral neuropathy (DPN) was evaluated by symptoms, signs, electrophysiology and intra-epidermal nerve fibre density. Randomised participants included 44 eligible adults with type 1 diabetes and mild-to-moderate CAN, who were aged 46 ± 11 years and had HbA1c 58 ± 5 mmol/mol (7.5 ± 1.0%), with no evidence of ischaemic heart disease. Participants underwent a 24-month intervention, consisting of antioxidant treatment with allopurinol, α-lipoic acid and nicotinamide, or placebo. The main outcome was change in the global [(11)C]HED retention index (RI) at 24 months in participants on the active drug compared with those on placebo. RESULTS We analysed data from 44 participants (22 per group). After adjusting for age, sex and in-trial HbA1c, the antioxidant regimen was associated with a slight, but significant worsening of the global [(11)C]HED left ventricle RI (-0.010 [95% CI -0.020, -0.001] p = 0.045) compared with placebo. There were no significant differences at follow-up between antioxidant treatment and placebo in the global MBF, coronary flow reserve, or in measures of DPN and markers of oxidative stress. The majority of adverse events were of mild-to-moderate severity and did not differ between groups CONCLUSIONS/INTERPRETATION In this cohort of type 1 diabetes patients with mild-to-moderate CAN, a combination antioxidant treatment regimen did not prevent progression of CAN, had no beneficial effects on myocardial perfusion or DPN, and may have been detrimental. However, a larger study is necessary to assess the underlying causes of these findings.
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Affiliation(s)
- R Pop-Busui
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
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Park CH, Lee J. pH-dependent sustained release characteristics of disulfide polymers prepared by simple thermal polymerization. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2013; 24:1848-57. [PMID: 23768254 DOI: 10.1080/09205063.2013.807458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Biocompatible polymers have played an integral role in the advancement of drug delivery systems. The discovery of a novel polymer with innovative properties can provide great opportunities to enhance drug efficacy as well as reduce side effects. In this study, a novel disulfide polymer was synthesized and characterized. Its monomer is alpha-lipoic acid (ALA), which is synthesized in all cells in the human body. The disulfide polymer was obtained by the simple thermal polymerization of crystalline particles at a temperature higher than its melting point, followed by precipitation purification. It had rubbery and sticky characteristics. In vitro release tests demonstrated that the disulfide polymer had both pH-dependent degradation and related sustained release profiles, with a degraded form of ALA. Therefore, this novel class of responsive polymers that can be prepared by simple thermal polymerization has pronounced potential to contribute to future drug delivery systems.
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Affiliation(s)
- Chul Ho Park
- a Jeju Global Research Center , Korea Institute of Energy Research , 200, Haemajihaean-ro , Gujwa-eup , Jeju Specific Self-Governing Province , 695-971 , South Korea
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Xie R, Li X, Ling Y, Shen C, Wu X, Xu W, Gao X. Alpha-lipoic acid pre- and post-treatments provide protection against in vitro ischemia-reperfusion injury in cerebral endothelial cells via Akt/mTOR signaling. Brain Res 2012; 1482:81-90. [DOI: 10.1016/j.brainres.2012.09.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 01/03/2023]
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Fayh APT, Krause M, Rodrigues-Krause J, Ribeiro JL, Ribeiro JP, Friedman R, Moreira JCF, Reischak-Oliveira A. Effects of L-arginine supplementation on blood flow, oxidative stress status and exercise responses in young adults with uncomplicated type I diabetes. Eur J Nutr 2012; 52:975-83. [PMID: 22763798 DOI: 10.1007/s00394-012-0404-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 06/12/2012] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Vascular disease is the principal cause of death and disability in patients with diabetes, and endothelial dysfunction seems to be the major cause in its pathogenesis. Since L-arginine levels are diminished in conditions such as type 1 and type 2 diabetes, in this work we aimed to verify the effects of L-arginine supplementation (7 g/day) over the endothelial function and oxidative stress markers in young male adults with uncomplicated type 1 diabetes. We also investigated the influences of L-arginine administration on vascular/oxidative stress responses to an acute bout of exercise. METHODS Ten young adult male subjects with uncomplicated type 1 diabetes and twenty matched controls volunteered for this study. We analysed the influence of L-arginine supplementation (7 g/day during 1 week) over lower limb blood flow (using a venous occlusion plethysmography technique), oxidative stress marker (TBARS, Carbonyls), anti-oxidant parameters (uric acid and TRAP) and total tNOx in rest conditions and after a single bout of submaximal exercise (VO₂ at 10 % below the second ventilatory threshold). Data described as mean ± standard error (SE). Alpha level was P < 0.05. RESULTS Glycaemic control parameters were altered in type 1 diabetic subjects, such as HbA1c (5.5 ± 0.03 vs. 8.3 ± 0.4 %) and fasted glycaemia (94.8 ± 1.4 vs. 183 ± 19 mg/dL). Oxidative stress/damage markers (carbonyls and TBARS) were increased in the diabetic group, while uric acid was decreased. Rest lower limb blood flow was lower in type 1 diabetic subjects than in healthy controls (3.53 ± 0.35 vs. 2.66 ± 0.3 ml 100 ml⁻¹ min⁻¹). L-Arginine supplementation completely recovered basal blood flow to normal levels in type 1 diabetics' subjects (2.66 ± 0.3 to 4.74 ± 0.86 ml 100 ml⁻¹ min⁻¹) but did not interfere in any parameter of redox state or exercise. CONCLUSION Our findings highlight the importance of L-arginine for the improvement of vascular function in subjects with diabetes, indicating that L-arginine supplementation could be an essential tool for the treatment for the disease complications, at least in non-complicated diabetes. However, based on our data, it is not possible to draw conclusions regarding the mechanisms by which L-arginine therapy is inducing improvements on cardiovascular function, but this important issue requires further investigations.
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Affiliation(s)
- Ana Paula Trussardi Fayh
- Laboratório de Pesquisa do Exercício, Escola de Educação Física, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Golbidi S, Badran M, Laher I. Diabetes and alpha lipoic Acid. Front Pharmacol 2011; 2:69. [PMID: 22125537 PMCID: PMC3221300 DOI: 10.3389/fphar.2011.00069] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Accepted: 10/18/2011] [Indexed: 12/25/2022] Open
Abstract
Diabetes mellitus is a multi-faceted metabolic disorder where there is increased oxidative stress that contributes to the pathogenesis of this debilitating disease. This has prompted several investigations into the use of antioxidants as a complementary therapeutic approach. Alpha lipoic acid, a naturally occurring dithiol compound which plays an essential role in mitochondrial bioenergetic reactions, has gained considerable attention as an antioxidant for use in managing diabetic complications. Lipoic acid quenches reactive oxygen species, chelates metal ions, and reduces the oxidized forms of other antioxidants such as vitamin C, vitamin E, and glutathione. It also boosts antioxidant defense system through Nrf-2-mediated antioxidant gene expression and by modulation of peroxisome proliferator activated receptors-regulated genes. ALA inhibits nuclear factor kappa B and activates AMPK in skeletal muscles, which in turn have a plethora of metabolic consequences. These diverse actions suggest that lipoic acid acts by multiple mechanisms, many of which have only been uncovered recently. In this review we briefly summarize the known biochemical properties of lipoic acid and then discussed the oxidative mechanisms implicated in diabetic complications and the mechanisms by which lipoic acid may ameliorate these reactions. The findings of some of the clinical trials in which lipoic acid administration has been tested in diabetic patients during the last 10 years are summarized. It appears that the clearest benefit of lipoic acid supplementation is in patients with diabetic neuropathy.
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Affiliation(s)
- Saeid Golbidi
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia Vancouver, BC, Canada
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Taliyan R, Sharma P. Diabetic Neuropathic Pain: An Update and Novel Pharmacological Strategies for Relief of Pain. JOURNAL OF MEDICAL SCIENCES 2010. [DOI: 10.3923/jms.2010.93.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Tavakoli M, Asghar O, Alam U, Petropoulos IN, Fadavi H, Malik RA. Novel insights on diagnosis, cause and treatment of diabetic neuropathy: focus on painful diabetic neuropathy. Ther Adv Endocrinol Metab 2010; 1:69-88. [PMID: 23148152 PMCID: PMC3475285 DOI: 10.1177/2042018810370954] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Diabetic neuropathy is common, under or misdiagnosed, and causes substantial morbidity with increased mortality. Defining and developing sensitive diagnostic tests for diabetic neuropathy is not only key to implementing earlier interventions but also to ensure that the most appropriate endpoints are employed in clinical intervention trials. This is critical as many potentially effective therapies may never progress to the clinic, not due to a lack of therapeutic effect, but because the endpoints were not sufficiently sensitive or robust to identify benefit. Apart from improving glycaemic control, there is no licensed treatment for diabetic neuropathy, however, a number of pathogenetic pathways remain under active study. Painful diabetic neuropathy is a cause of considerable morbidity and whilst many pharmacological and nonpharmacological interventions are currently used, only two are approved by the US Food and Drug Administration. We address the important issue of the 'placebo effect' and also consider potential new pharmacological therapies as well as nonpharmacological interventions in the treatment of painful diabetic neuropathy.
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Affiliation(s)
- Mitra Tavakoli
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Omar Asghar
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Uazman Alam
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Ioannis N. Petropoulos
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Hassan Fadavi
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Rayaz A. Malik
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
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Shapiro S, Rapaport R. The role of complementary and alternative therapies in pediatric diabetes. Endocrinol Metab Clin North Am 2009; 38:791-810. [PMID: 19944293 DOI: 10.1016/j.ecl.2009.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Complementary and alternative medicine (CAM), also referred to as holistic, or integrative, medicine, are terms that describe a heterogeneous collection of nontraditional therapies, from chemical substances, to biofeedback, to prayer. This review focuses on CAM in pediatric patients with type 1 and type 2 diabetes. CAM prevalence in this population and the specific modalities that have been studied in children are described. Randomized, placebo-controlled, prospective studies in young adults are evaluated for their applicability to pediatric patients. CAM's "complementary" role is emphasized, as there is evidence of significant morbidity when CAM replaces standard-of-care therapy.
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Affiliation(s)
- Sofia Shapiro
- Mount Sinai School of Medicine, New York, NY 10029, USA.
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