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Sampaio OGM, Santos SAAR, Damasceno MDBMV, Joventino LB, Schneider A, Masternak MM, Campos AR, Cavalcante MB. Impact of repeated ovarian hyperstimulation on the reproductive function. J Reprod Immunol 2024; 164:104277. [PMID: 38889661 DOI: 10.1016/j.jri.2024.104277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 05/31/2024] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
One of six couples (17.5 % of the adult population) worldwide is affected by infertility during their lifetime. This number represents a substantial increase in the prevalence of this gynecological condition over the last decade. Ovulatory dysfunction and anovulation are the main causes of female infertility. Timed intercourse, intrauterine insemination, and assisted reproductive technology (ART), such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), are the most common interventions for infertile couples. Ovulation induction protocols for IVF/ICSI routinely use supraphysiological doses of gonadotropins to stimulate many preovulatory follicles. Animal and human studies suggested that ovarian hyperstimulation, alone or repeatedly, for ART cycles can induce changes in the immune response and increase the oxidative stress (OS) in the ovarian microenvironment. The consequences of repeated ovarian hyperstimulation on the human ovary remain poorly understood, particularly in relation to the effects of ovarian stimulation on the immune system and the potential for ovarian stimulation to cause OS. Animal studies have observed that repeated cycles of ovarian hyperstimulation can accelerate ovarian aging. Changes in ovarian hormone levels, accelerated loss of ovarian reserve, disorders in ovarian ultrastructure, ovarian senescence, and decreased reproductive performance represent possible long-term effects of repeated ovarian hyperstimulation. The short and long-term impact of the combination of antioxidant agents in ovarian hyperstimulation protocols in women undergoing ART must urgently be better understood. The recent increase in the number of ART and fertility preservation cycles may accelerate ovarian aging in these women, promoting consequences beyond the reproductive function and including health deterioration.
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Affiliation(s)
| | | | | | | | - Augusto Schneider
- Nutrition College, Federal University of Pelotas (UFPel), Pelotas, RS 96010-610, Brazil
| | - Michal M Masternak
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA; Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland
| | - Adriana Rolim Campos
- Graduate Program in Medical Sciences, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil
| | - Marcelo Borges Cavalcante
- Graduate Program in Medical Sciences, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil; Medical School, Universidade de Fortaleza (UNIFOR), Fortaleza, CE 60.811-905, Brazil; CONCEPTUS - Reproductive Medicine, Fortaleza, CE 60.170-240, Brazil.
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Jovičić-Bata J, Todorović N, Krstonošić V, Ristić I, Kovačević Z, Vuković M, Lalić-Popović M. Liquid- and Semisolid-Filled Hard Gelatin Capsules Containing Alpha-Lipoic Acid as a Suitable Dosage Form for Compounding Medicines and Dietary Supplements. Pharmaceutics 2024; 16:892. [PMID: 39065589 PMCID: PMC11279521 DOI: 10.3390/pharmaceutics16070892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 06/29/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Liquid-filled hard gelatin capsules may have pertinent advantages both for therapeutic effect and extemporaneous preparations of medicines. Alpha lipoic acid is a substance used in medicines and dietary supplements and there is a need for creating an appropriate formulation which would be suitable for each individual patient or consumer. Based on its biopharmaceutical and physical chemical characteristics, eight different capsule formulations were designed and characterized. Silicon dioxide was added to form a semisolid content and prevent leakage. The formulation filled with alpha lipoic acid solution in polyethylene glycol 400 showed the best performance. Although the addition of silicon dioxide to the formulation with polyethylene glycol 400 led to a change in both flow character and viscosity, the release rate did not show a statistically significant decrease (more than 85% of content was released after 5 min testing). Applied technique is a simple and an appropriate approach for compounding and could be used for other substances with similar properties.
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Affiliation(s)
- Jelena Jovičić-Bata
- Department of Pharmacy, Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (J.J.-B.); (V.K.); (M.V.); (M.L.-P.)
| | - Nemanja Todorović
- Department of Pharmacy, Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (J.J.-B.); (V.K.); (M.V.); (M.L.-P.)
| | - Veljko Krstonošić
- Department of Pharmacy, Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (J.J.-B.); (V.K.); (M.V.); (M.L.-P.)
| | - Ivan Ristić
- Faculty of Technology Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Zorana Kovačević
- Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Milana Vuković
- Department of Pharmacy, Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (J.J.-B.); (V.K.); (M.V.); (M.L.-P.)
| | - Mladena Lalić-Popović
- Department of Pharmacy, Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia; (J.J.-B.); (V.K.); (M.V.); (M.L.-P.)
- Centre for Medical and Pharmaceutical Investigations and Quality Control (CEMPhIC), Faculty of Medicine Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia
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Atmaca A, Ketenci A, Sahin I, Sengun IS, Oner RI, Erdem Tilki H, Adas M, Soyleli H, Demir T. Expert opinion on screening, diagnosis and management of diabetic peripheral neuropathy: a multidisciplinary approach. Front Endocrinol (Lausanne) 2024; 15:1380929. [PMID: 38952393 PMCID: PMC11215140 DOI: 10.3389/fendo.2024.1380929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/15/2024] [Indexed: 07/03/2024] Open
Abstract
The proposed expert opinion aimed to address the current knowledge on conceptual, clinical, and therapeutic aspects of diabetic peripheral neuropathy (DPN) and to provide a guidance document to assist clinicians for the best practice in DPN care. The participating experts consider the suspicion of the disease by clinicians as a key factor in early recognition and diagnosis, emphasizing an improved awareness of the disease by the first-admission or referring physicians. The proposed "screening and diagnostic" algorithm involves the consideration of DPN in a patient with prediabetes or diabetes who presents with neuropathic symptoms and/or signs of neuropathy in the presence of DPN risk factors, with careful consideration of laboratory testing to rule out other causes of distal symmetric peripheral neuropathy and referral for a detailed neurological work-up for a confirmative test of either small or large nerve fiber dysfunction in atypical cases. Although, the first-line interventions for DPN are currently represented by optimized glycemic control (mainly for type 1 diabetes) and multifactorial intervention (mainly for type 2 diabetes), there is a need for individualized pathogenesis-directed treatment approaches for DPN. Alpha-lipoic acid (ALA) seems to be an important first-line pathogenesis-directed agent, given that it is a direct and indirect antioxidant that works with a strategy targeted directly against reactive oxygen species and indirectly in favor of endogenous antioxidant capacity for improving DPN conditions. There is still a gap in existing research in the field, necessitating well-designed, robust, multicenter clinical trials with sensitive endpoints and standardized protocols to facilitate the diagnosis of DPN via a simple and effective algorithm and to track progression of disease and treatment response. Identification of biomarkers/predictors that would allow an individualized approach from a potentially disease-modifying perspective may provide opportunities for novel treatments that would be efficacious in early stages of DPN, and may modify the natural course of the disease. This expert opinion document is expected to increase awareness among physicians about conceptual, clinical, and therapeutic aspects of DPN and to assist them in timely recognition of DPN and translating this information into their clinical practice for best practice in the management of patients with DPN.
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Affiliation(s)
- Aysegul Atmaca
- Department of Endocrinology and Metabolism, Ondokuz Mayis University Faculty of Medicine, Samsun, Türkiye
| | - Aysegul Ketenci
- Department of Physical Medicine and Rehabilitation, Koc University Faculty of Medicine, Istanbul, Türkiye
| | - Ibrahim Sahin
- Department of Endocrinology and Metabolism, Inonu University Faculty of Medicine, Malatya, Türkiye
| | - Ihsan Sukru Sengun
- Department of Neurology, Dokuz Eylul University Faculty of Medicine, Izmir, Türkiye
| | - Ramazan Ilyas Oner
- Department of Internal Medicine, Adiyaman University Faculty of Medicine, Adiyaman, Türkiye
| | - Hacer Erdem Tilki
- Department of Neurology, Ondokuz Mayis University Faculty of Medicine, Samsun, Türkiye
| | - Mine Adas
- Department of Endocrinology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Türkiye
| | - Hatice Soyleli
- Department of Medical Affairs, Abdi Ibrahim Pharmaceuticals, Istanbul, Türkiye
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Izmir, Türkiye
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Bellini C, Mancin F, Papini E, Tavano R. Nanotechnological Approaches to Enhance the Potential of α-Lipoic Acid for Application in the Clinic. Antioxidants (Basel) 2024; 13:706. [PMID: 38929145 PMCID: PMC11201002 DOI: 10.3390/antiox13060706] [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: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
α-lipoic acid is a naturally occurring compound with potent antioxidant properties that helps protect cells and tissues from oxidative stress. Its incorporation into nanoplatforms can affect factors like bioavailability, stability, reactivity, and targeted delivery. Nanoformulations of α-lipoic acid can significantly enhance its solubility and absorption, making it more bioavailable. While α-lipoic acid can be prone to degradation in its free form, encapsulation within nanoparticles ensures its stability over time, and its release in a controlled and sustained manner to the targeted tissues and cells. In addition, α-lipoic acid can be combined with other compounds, such as other antioxidants, drugs, or nanomaterials, to create synergistic effects that enhance their overall therapeutic benefits or hinder their potential cytotoxicity. This review outlines the advantages and drawbacks associated with the use of α-lipoic acid, as well as various nanotechnological approaches employed to enhance its therapeutic effectiveness, whether alone or in combination with other bioactive agents. Furthermore, it describes the engineering of α-lipoic acid to produce poly(α-lipoic acid) nanoparticles, which hold promise as an effective drug delivery system.
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Affiliation(s)
- Chiara Bellini
- Department of Biomedical Sciences, University of Padova, Via U. Bassi 58/b, 35121 Padova, Italy; (C.B.); (E.P.)
| | - Fabrizio Mancin
- Department of Chemical Sciences, University of Padova, Via F. Marzolo 1, 35121 Padova, Italy;
| | - Emanuele Papini
- Department of Biomedical Sciences, University of Padova, Via U. Bassi 58/b, 35121 Padova, Italy; (C.B.); (E.P.)
| | - Regina Tavano
- Department of Biomedical Sciences, University of Padova, Via U. Bassi 58/b, 35121 Padova, Italy; (C.B.); (E.P.)
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Mian NH, Azeem M, Ali Q, Mahmood S, Akram MS. Alpha lipoic acid mitigates adverse impacts of drought stress on growth and yield of mungbean: photosynthetic pigments, and antioxidative defense mechanism. PeerJ 2024; 12:e17191. [PMID: 38699184 PMCID: PMC11064871 DOI: 10.7717/peerj.17191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
Context Exogenous use of potential organic compounds through different modes is a promising strategy for the induction of water stress tolerance in crop plants for better yield. Aims The present study aimed to explore the potential role of alpha-lipoic acid (ALA) in inducing water stress tolerance in mungbean lines when applied exogenously through various modes. Methods The experiment was conducted in a field with a split-plot arrangement, having three replicates for each treatment. Two irrigation regimes, including normal and reduced irrigation, were applied. The plants allocated to reduced irrigation were watered only at the reproductive stage. Three levels of ALA (0, 0.1, 0.15 mM) were applied through different modes (seed priming, foliar or priming+foliar). Key results ALA treatment through different modes manifested higher growth under reduced irrigation (water stress) and normal irrigation. Compared to the other two modes, the application of ALA as seed priming was found more effective in ameliorating the adverse impacts of water stress on growth and yield associated with their better content of leaf photosynthetic pigments, maintenance of plant water relations, levels of non-enzymatic antioxidants, improved activities of enzymatic antioxidants, and decreased lipid peroxidation and H2O2 levels. The maximum increase in shoot fresh weight (29% and 28%), shoot dry weight (27% and 24%), 100-grain weight (24% and 23%) and total grain yield (20% and 21%) in water-stressed mungbean plants of line 16003 and 16004, respectively, was recorded due to ALA seed priming than other modes of applications. Conclusions Conclusively, 0.1 and 0.15 mM levels of ALA as seed priming were found to reduce the adverse impact of water stress on mungbean yield that was associated with improved physio-biochemical mechanisms. Implications The findings of the study will be helpful for the agriculturalists working in arid and semi-arid regions to obtain a better yield of mungbean that will be helpful to fulfill the food demand in those areas to some extent.
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Affiliation(s)
| | - Muhammad Azeem
- Government College University, Faisalabad, Faisalabad, Pakistan
| | - Qasim Ali
- Government College University, Faisalabad, Faisalabad, Pakistan
| | - Saqib Mahmood
- Government College University, Faisalabad, Faisalabad, Pakistan
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Andeen NK, Kung VL, Avasare RS. NELL1 membranous nephropathy: clinical associations provide mechanistic clues. FRONTIERS IN NEPHROLOGY 2024; 4:1323432. [PMID: 38596642 PMCID: PMC11002321 DOI: 10.3389/fneph.2024.1323432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/04/2024] [Indexed: 04/11/2024]
Abstract
Neural epidermal growth factor-like 1 (NELL1) membranous nephropathy (MN) is notable for its segmental deposit distribution, IgG1 dominant deposits, and comparatively high rate of spontaneous remission. It has been associated with a variety of exposures and secondary conditions, specifically use of thiol-containing medications - including lipoic acid, bucillamine, and tiopronin - as well as traditional indigenous medications (TIM) particularly those with high mercury content, and non-steroid anti-inflammatory drugs (NSAIDs). Malignancies, graft vs. host disease (GVHD), infection, and autoimmune conditions have also been associated with NELL1 MN. Herein, we provide a detailed summary of the clinicopathologic features of NELL1 and associations with underlying conditions, with a focus on treatment and outcomes. Rare cases of dual NELL1 and phospholipase A2 receptor (PLA2R) positive MN are reviewed. Genome-wide association study of NELL1, role of NELL1 in other physiologic and pathologic processes, and connection between NELL1 MN and malignancy with relevance of NELL1 tumor staining are examined. Finally, relationships and potential disease mechanisms of thiol- and mercury- associated NELL1 MN are discussed.
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Affiliation(s)
- Nicole K. Andeen
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Vanderlene L. Kung
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Rupali S. Avasare
- Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, OR, United States
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Mahmoud LM, Killiny N, Dutt M. Melatonin supplementation enhances browning suppression and improves transformation efficiency and regeneration of transgenic rough lemon plants (Citrus × jambhiri). PLoS One 2024; 19:e0294318. [PMID: 38446779 PMCID: PMC10917246 DOI: 10.1371/journal.pone.0294318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/31/2023] [Indexed: 03/08/2024] Open
Abstract
Enzymatic browning poses a significant challenge that limits in vitro propagation and genetic transformation of plant tissues. This research focuses on investigating how adding antioxidant substances can suppress browning, leading to improved efficiency in transforming plant tissues using Agrobacterium and subsequent plant regeneration from rough lemon (Citrus × jambhiri). When epicotyl segments of rough lemon were exposed to Agrobacterium, they displayed excessive browning and tissue decay. This was notably different from the 'Hamlin' explants, which did not exhibit the same issue. The regeneration process failed completely in rough lemon explants, and they accumulated high levels of total phenolic compounds (TPC) and polyphenol oxidase (PPO), which contribute to browning. To overcome these challenges, several antioxidant and osmoprotectant compounds, including lipoic acid, melatonin, glycine betaine, and proline were added to the tissue culture medium to reduce the oxidation of phenolic compounds and mitigate browning. Treating epicotyl segments with 100 or 200 μM melatonin led to a significant reduction in browning and phenolic compound accumulation. This resulted in enhanced shoot regeneration, increased transformation efficiency, and reduced tissue decay. Importantly, melatonin supplementation effectively lowered the levels of TPC and PPO in the cultured explants. Molecular and physiological analyses also confirmed the successful overexpression of the CcNHX1 transcription factor, which plays a key role in imparting tolerance to salinity stress. This study emphasizes the noteworthy impact of supplementing antioxidants in achieving successful genetic transformation and plant regeneration in rough lemon. These findings provide valuable insights for developing strategies to address enzymatic browning and enhance the effectiveness of plant tissue culture and genetic engineering methods with potential applications across diverse plant species.
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Affiliation(s)
- Lamiaa M. Mahmoud
- Department of Horticultural Science, Citrus Research and Education Center, University of Florida, Lake Alfred, Florida, United States of America
| | - Nabil Killiny
- Department of Plant Pathology, Citrus Research and Education Center, IFAS, University of Florida, Lake Alfred, Florida, United States of America
| | - Manjul Dutt
- Department of Horticultural Science, Citrus Research and Education Center, University of Florida, Lake Alfred, Florida, United States of America
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Efe O, So PNH, Anandh U, Lerma EV, Wiegley N. An Updated Review of Membranous Nephropathy. Indian J Nephrol 2024; 34:105-118. [PMID: 38681023 PMCID: PMC11044666 DOI: 10.25259/ijn_317_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 05/01/2024] Open
Abstract
Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults. The discovery of phospholipase A2 receptor (PLA2R) as a target antigen has led to a paradigm shift in the understanding and management of MN. At present, serum PLA2R antibodies are used for diagnosis, prognostication, and guiding treatment. Now, with the discovery of more than 20 novel target antigens, antigen mapping is almost complete. The clinical association of certain antigens provides clues for clinicians, such as the association of nerve epidermal growth factor-like 1 with malignancies and indigenous medicines. Serum antibodies are detected for most target antigens, except exostosin 1 and 2 and transforming growth factor-beta receptor 3, but their clinical utility is yet to be defined. Genome-wide association studies and studies investigating environmental factors, such as air pollution, shed more light on the underpinnings of MN. The standard therapy of MN diversified from cyclical cyclophosphamide and steroids to include rituximab and calcineurin inhibitors over the past decades. Here, we provide a cutting-edge review of MN, focusing on genetics, immune system and environmental factors, novel target antigens and their clinical characteristics, and currently available and emerging novel therapies in MN.
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Affiliation(s)
- Orhan Efe
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital; Harvard Medical School, Boston, USA
| | | | - Urmila Anandh
- Department of Nephrology, Amrita Hospitals, Faridabad, Delhi, NCR, India
| | - Edgar V. Lerma
- Department of Medicine, University of Illinois at Chicago; Advocate Christ Medical Center, Oak Lawn, Illinois, USA
| | - Nasim Wiegley
- Division of Nephrology, Department of Medicine, University of California Davis School of Medicine, Sacramento, CA, USA
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Abu-Zaid A, Baradwan S, Bukhari IA, Alyousef A, Abuzaid M, Saleh SAK, Adly HM, Alomar O, Al-Badawi IA. The effect of alpha-lipoic acid supplementation on anthropometric, glycemic, lipid, oxidative stress, and hormonal parameters in individuals with polycystic ovary syndrome: a systematic review and meta-analysis of randomized clinical trials. Obstet Gynecol Sci 2024; 67:17-29. [PMID: 38044616 DOI: 10.5468/ogs.23206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
This systematic review and meta-analysis aimed to examine the effect of the antioxidant alpha-lipoic acid (ALA) on various cardiometabolic risk factors and hormonal parameters in patients with polycystic ovary syndrome (PCOS). We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Web of Science databases without language restrictions until May 2023 to find randomized controlled trials (RCTs) that assessed the impact of ALA supplementation on anthropometric, glycemic, lipid, oxidative stress, and hormonal parameters in women with PCOS. Outcomes were summarized using the standardized mean difference (SMD) and 95% confidence interval (CI) in a random-effects model. An I2 statistic of >60% established significant between-study heterogeneity. The overall certainty of the evidence for each outcome was determined using the grading of recommendations, assessment, development, and evaluations system. Seven RCTs met the inclusion criteria. The ALA group had significant reductions in fasting blood sugar (fasting blood sugar (FBS), n=7 RCTs, SMD, -0.60; 95% CI, -1.10 to -0.10; I2=63.54%, moderate certainty of evidence) and homeostatic model assessment for insulin resistance (homeostatic model assessment of insulin resistance (HOMA-IR), n=4 RCTs, SMD, -2.03; 95% CI, -3.85 to -0.20; I2=96.32%, low certainty of evidence) compared with the control group. However, significant differences were observed between the groups in body mass index, insulin, estrogen, follicle-stimulating hormone, luteinizing hormone, testosterone, low-density lipoprotein, highdensity lipoprotein, triglyceride, total cholesterol, malondialdehyde, or total antioxidant capacity profiles. ALA supplementation improves FBS and HOMA-IR levels in women with PCOS. ALA consumption is an effective complementary therapy for the management of women with PCOS.
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Affiliation(s)
- Ahmed Abu-Zaid
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ibtihal Abdulaziz Bukhari
- Department of Obstetrics and Gynecology, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdullah Alyousef
- Department of Obstetrics and Gynecology, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Abuzaid
- Department of Obstetrics and Gynecology, Muhayil General Hospital, Muhayil, Saudi Arabia
| | - Saleh A K Saleh
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M Adly
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Osama Alomar
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ismail Abdulrahman Al-Badawi
- Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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Ziegler D. Pathogenetic treatments for diabetic peripheral neuropathy. Diabetes Res Clin Pract 2023; 206 Suppl 1:110764. [PMID: 38245327 DOI: 10.1016/j.diabres.2023.110764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/30/2023] [Indexed: 01/22/2024]
Abstract
Diabetic peripheral neuropathy (DPN) is found in around one third of people with diabetes, but remains inadequately diagnosed and treated. Its management includes three cornerstones: 1) causal treatment with lifestyle modification, intensive diabetes therapy aimed at near-normoglycemia, and multifactorial cardiovascular risk intervention, 2) pathogenesis-oriented pharmacotherapy, and 3) symptomatic pain relief. Since symptomatic analgesic monotherapy only relieves the pain without targeting the underlying neuropathy and both has limited efficacy and is associated with adverse events, there is an unmet need for additional approaches derived from the pathogenetic concepts of DPN. Preclinical studies have suggested that diabetic neuropathy can be prevented or improved through the use of various agents that interfere with the pathophysiology of the underlying condition. Some of these encouraging findings could be translated successfully into the clinical setting. Efficacy and excellent safety were demonstrated in several meta-analyses (α-lipoic acid) and randomized clinical trials (benfotiamine, actovegin, epalrestat) in the treatment of symptomatic DPN. The NATHAN 1 trial demonstrated an improvement of neuropathic signs (deficits, impairments) after four years in asymptomatic DPN. These compounds are currently authorized for treatment of DPN in several countries. Long-term pivotal clinical trials should further establish their value as mono- and combination therapies in DPN.
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Affiliation(s)
- Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
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11
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Didarataee S, Joshi N, Scaiano JC. A laser flash photolysis study of the free radical chemistry of lipoic acid and dihydrolipoic acid. Photochem Photobiol Sci 2023; 22:2579-2585. [PMID: 37740885 DOI: 10.1007/s43630-023-00473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/28/2023] [Indexed: 09/25/2023]
Abstract
The free radical chemistry of lipoic acid (LA) and dihydrolipoic acid (DHLA) intersect at the point where DHLA loses hydrogen to a good hydrogen abstracting radical, while LA reacts with strongly reducing ketyl radicals capable of donating a hydrogen atom. While aliphatic thiyl radicals have an absorbance at ~ 330 nm, the resulting radical, formally also a thiyl radical has distinct spectroscopic properties with a maximum at 385 nm, suggesting that the two sulphur centres interact strongly with each other as part of the chromophore. The reactions that form these radicals were studied by laser flash photolysis that revealed DHLA as an excellent hydrogen donor, while LA is an excellent hydrogen acceptor. The results support earlier evidence that the real antioxidant is DHLA, while LA is not; yet, the reported facile interconversion of the two molecules suggests that LA may be a better supplement, given its shelf stability, compared with a far more difficult-to-handle DHLA.
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Affiliation(s)
- Saba Didarataee
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Neeraj Joshi
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Juan C Scaiano
- Department of Chemistry and Biomolecular Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
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Batóg G, Dołoto A, Bąk E, Piątkowska-Chmiel I, Krawiec P, Pac-Kożuchowska E, Herbet M. The interplay of oxidative stress and immune dysfunction in Hashimoto's thyroiditis and polycystic ovary syndrome: a comprehensive review. Front Immunol 2023; 14:1211231. [PMID: 37588599 PMCID: PMC10426741 DOI: 10.3389/fimmu.2023.1211231] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
In recent years, there has been a significant increase in the concomitant incidence of Hashimoto's thyroiditis (HT) and polycystic ovary syndrome (PCOS), both in terms of incidence, etiology, and clinical consequences. PCOS patients suffering from autoimmune thyroid diseases show insulin resistance, impaired glucose tolerance, weight gain, and metabolic and reproductive complications. Studies have shown that chronic stress and its consequence, i.e. oxidative stress, play an important role in the pathomechanism of both disorders. It has also been shown that long-term exposure to stress triggers biological mechanisms, in particular related to the regulation of the inflammatory cascade, which plays a key role in autoimmune diseases. The paper is a review of the literature on the role of chronic stress, oxidative stress, and immune processes in the pathogenesis of HT and PCOS. In addition, the review is a source of knowledge about the treatment of these diseases, and in particular the use of antioxidants in therapeutic management.
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Affiliation(s)
- Gabriela Batóg
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Anna Dołoto
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Ewelina Bąk
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Iwona Piątkowska-Chmiel
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
| | - Paulina Krawiec
- Department of Paediatrics and Gastroenterology, Medical University of Lublin, Lublin, Poland
| | | | - Mariola Herbet
- Chair and Department of Toxicology, Faculty of Pharmacy, Medical University of Lublin, Lublin, Poland
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Jermendy G, Rokszin G, Fábián I, Kempler P, Wittmann I. Morbidity and mortality of patients with diabetic neuropathy treated with pathogenetically oriented alpha-lipoic acid versus symptomatic pharmacotherapies - a nationwide database analysis from Hungary. Diabetes Res Clin Pract 2023:110734. [PMID: 37257759 DOI: 10.1016/j.diabres.2023.110734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/14/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
AIMS Diabetic neuropathy is associated with increased risk of morbidity and all-cause mortality. It is unclear whether these outcomes differ in patients with diabetic neuropathy treated with pathogenetically oriented vs symptomatic pharmacotherapies. METHODS We performed a retrospective (2009-2019) database analysis of patients treated with pathogenetically oriented alpha-lipoic acid (ALA) or symptomatic pharmacotherapies for diabetic neuropathy. We investigated clinical outcomes in propensity score matched patients in Hungary. Changes in hazard ratios and annualized event rates were assessed and sensitivity analyses performed. RESULTS Hazard ratios favored treatment with ALA vs symptomatic pharmacotherapies regarding acute myocardial infarction (HR 0.73, 95%CI: 0.60-0.89, p = 0.0016), stroke (HR 0.71, 95%CI: 0.62-0.82, p<0.0001), hospitalization for heart failure (HR 0.72, 95%CI: 0.66-0.78, p<0.0001), cancer events (HR 0.83, 95% CI: 0.76-0.92, p = 0.0002) and all-cause mortality (HR 0.55, 95% CI: 0.49-0.61, p<0.0001), but not for lower limb amputation (HR 1.05, 95%CI: 0.89-1.25, p = 0.5455). This association was supported by results of evaluating annual event rates and sensitivity analyses. CONCLUSIONS This retrospective database analysis revealed a lower occurrence of cardio- and cerebrovascular morbidity, cancer events and all-cause mortality in patients with diabetic neuropathy treated with pathogenetically oriented ALA vs symptomatic pharmacotherapies. This hypothesis-generating result requires further investigations.
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Affiliation(s)
- György Jermendy
- Bajcsy-Zsilinszky Hospital, 3(rd) Department of Medicine, Maglódi út 89-91, 1106, Budapest, Hungary.
| | - György Rokszin
- RxTarget Ltd., Bacsó Nándor út 10, 5000 Szolnok, Hungary.
| | - Ibolya Fábián
- RxTarget Ltd., Bacsó Nándor út 10, 5000 Szolnok, Hungary.
| | - Péter Kempler
- Semmelweis University, Faculty of Medicine, Department of Medicine and Oncology, Korányi Sándor út 2, 1083 Budapest, Hungary.
| | - István Wittmann
- University of Pécs, Medical School, 2(nd) Department of Medicine, Nephrology-Diabetes Center, Pacsirta út 1, 7624 Pécs, Hungary.
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14
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Differential Effects of Oligosaccharides, Antioxidants, Amino Acids and PUFAs on Heat/Hypoxia-Induced Epithelial Injury in a Caco-2/HT-29 Co-Culture Model. Int J Mol Sci 2023; 24:ijms24021111. [PMID: 36674626 PMCID: PMC9861987 DOI: 10.3390/ijms24021111] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023] Open
Abstract
(1) Exposure of intestinal epithelial cells to heat and hypoxia causes a (heat) stress response, resulting in the breakdown of epithelial integrity. There are indications that several categories of nutritional components have beneficial effects on maintaining the intestinal epithelial integrity under stress conditions. This study evaluated the effect of nine nutritional components, including non-digestible oligosaccharides (galacto-oligosaccharides (GOS), fructo-oligosaccharides (FOS), chitosan oligosaccharides (COS)), antioxidants (α-lipoic acid (ALA), resveratrol (RES)), amino acids (l-glutamine (Glu), l-arginine (Arg)) and polyunsaturated fatty acids (PUFAs) (docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)), on heat/hypoxia-induced epithelial injury. (2) Two human colonic cell lines, Caco-2 and HT-29, were co-cultured and pre-treated with the nutritional components for 48 h. After pre-treatment, the cells were exposed to heat/hypoxia (42 °C, 5% O2) for 2 h. Epithelial integrity was evaluated by measuring trans-epithelial electrical resistance (TEER), paracellular Lucifer Yellow (LY) permeability, and tight junction (TJ) protein expression. Heat stress and oxidative stress levels were evaluated by determining heat-shock protein-70 (HSP-70) expression and the concentration of the lipid peroxidation product malondialdehyde (MDA). (3) GOS, FOS, COS, ALA, RES, Arg, and EPA presented protective effects on epithelial damage in heat/hypoxia-exposed Caco-2/HT-29 cells by preventing the decrease in TEER, the increase in LY permeability, and/or decrease in TJ proteins zonula occludens-1 (ZO-1) and claudin-3 expression. COS, RES, and EPA demonstrated anti-oxidative stress effects by suppressing the heat/hypoxia-induced MDA production, while Arg further elevated the heat/hypoxia-induced increase in HSP-70 expression. (4) This study indicates that various nutritional components have the potential to counteract heat/hypoxia-induced intestinal injury and might be interesting candidates for future in vivo studies and clinical trials in gastrointestinal disorders related to heat stress and hypoxia.
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Fernández-Araque A, Verde Z, Torres-Ortega C, Sainz-Gil M, Velasco-Gonzalez V, González-Bernal JJ, Mielgo-Ayuso J. Effects of Antioxidants on Pain Perception in Patients with Fibromyalgia-A Systematic Review. J Clin Med 2022; 11:2462. [PMID: 35566585 PMCID: PMC9099826 DOI: 10.3390/jcm11092462] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/04/2022] [Accepted: 04/26/2022] [Indexed: 01/17/2023] Open
Abstract
In recent years, antioxidant supplements have become popular to counteract the effects of oxidative stress in fibromyalgia and one of its most distressing symptoms, pain. The aim of this systematic review was to summarize the effects of antioxidant supplementation on pain levels perceived by patients diagnosed with fibromyalgia. The words used respected the medical search terms related to our objective including antioxidants, fibromyalgia, pain, and supplementation. Seventeen relevant articles were identified within Medline (PubMed), Scopus, Web of Science (WOS), the Cochrane Database of Systematic Review, and the Cochrane Central Register of Controlled Trials. This review found that antioxidant supplementation is efficient in reducing pain in nine of the studies reviewed. Studies with a duration of supplementation of at least 6 weeks showed a benefit on pain perception in 80% of the patients included in these studies. The benefits shown by vitamins and coenzyme Q10 are remarkable. Further research is needed to identify the effects of other types of antioxidants, such as extra virgin olive oil and turmeric. More homogeneous interventions in terms of antioxidant doses administered and duration would allow the effects on pain to be addressed more comprehensively.
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Affiliation(s)
- Ana Fernández-Araque
- Research Group Pharmacogenetics, Cancer Genetics, Genetic Polymorphisms and Pharmacoepidemiology, Department of Nursing, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42003 Soria, Spain; (Z.V.); (V.V.-G.)
| | - Zoraida Verde
- Research Group Pharmacogenetics, Cancer Genetics, Genetic Polymorphisms and Pharmacoepidemiology, Department of Nursing, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42003 Soria, Spain; (Z.V.); (V.V.-G.)
| | - Clara Torres-Ortega
- Department of Nursing, Faculty of Health Sciences, University of Valladolid, 42005 Soria, Spain;
- Emergency Service of the Hospital Santa Bárbara, Soria Healthcare Management, 42005 Soria, Spain
| | - Maria Sainz-Gil
- Recognized Research Group “Pharmacogenetics, Cancer Genetics, Genetic Polymorphisms and Pharmacoepidemiology”, Department of Cell Biology, Histology and Pharmacology, Faculty of Medicine, University of Valladolid, Center for Drug Safety Studies, 47005 Valladolid, Spain;
| | - Veronica Velasco-Gonzalez
- Research Group Pharmacogenetics, Cancer Genetics, Genetic Polymorphisms and Pharmacoepidemiology, Department of Nursing, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42003 Soria, Spain; (Z.V.); (V.V.-G.)
| | - Jerónimo Javier González-Bernal
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.J.G.-B.); (J.M.-A.)
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain; (J.J.G.-B.); (J.M.-A.)
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Ramadan KMA, Alharbi MM, Alenzi AM, El-Beltagi HS, Darwish DBE, Aldaej MI, Shalaby TA, Mansour AT, El-Gabry YAEG, Ibrahim MFM. Alpha Lipoic Acid as a Protective Mediator for Regulating the Defensive Responses of Wheat Plants against Sodic Alkaline Stress: Physiological, Biochemical and Molecular Aspects. PLANTS (BASEL, SWITZERLAND) 2022; 11:plants11060787. [PMID: 35336669 PMCID: PMC8949438 DOI: 10.3390/plants11060787] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 05/13/2023]
Abstract
Recently, exogenous α-Lipoic acid (ALA) has been suggested to improve the tolerance of plants to a wide array of abiotic stresses. However, there is currently no definitive data on the role of ALA in wheat plants exposed to sodic alkaline stress. Therefore, this study was designed to evaluate the effects of foliar application by ALA at 0 (distilled water as control) and 20 µM on wheat seedlings grown under sodic alkaline stress (50 mM 1:1 NaHCO3 & Na2CO3; pH 9.7. Under sodic alkaline stress, exogenous ALA significantly (p ≤ 0.05) improved growth (shoot fresh and dry weight), chlorophyll (Chl) a, b and Chl a + b, while Chl a/b ratio was not affected. Moreover, leaf relative water content (RWC), total soluble sugars, carotenoids, total soluble phenols, ascorbic acid, K and Ca were significantly increased in the ALA-treated plants compared to the ALA-untreated plants. This improvement was concomitant with reducing the rate of lipid peroxidation (malondialdehyde, MDA) and H2O2. Superoxide dismutase (SOD) and ascorbate peroxidase (APX) demonstrated greater activity in the ALA-treated plants compared to the non-treated ones. Conversely, proline, catalase (CAT), guaiacol peroxidase (G-POX), Na and Na/K ratio were significantly decreased in the ALA-treated plants. Under sodic alkaline stress, the relative expression of photosystem II (D2 protein; PsbD) was significantly up-regulated in the ALA treatment (67% increase over the ALA-untreated plants); while Δ pyrroline-5-carboxylate synthase (P5CS), plasma membrane Na+/H+ antiporter protein of salt overly sensitive gene (SOS1) and tonoplast-localized Na+/H+ antiporter protein (NHX1) were down-regulated by 21, 37 and 53%, respectively, lower than the ALA-untreated plants. These results reveal that ALA may be involved in several possible mechanisms of alkalinity tolerance in wheat plants.
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Affiliation(s)
- Khaled M. A. Ramadan
- Central Laboratories, Department of Chemistry, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
- Biochemistry Department, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt
| | - Maha Mohammed Alharbi
- Biology Department, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia; (M.M.A.); (A.M.A.); or (D.B.E.D.)
| | - Asma Massad Alenzi
- Biology Department, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia; (M.M.A.); (A.M.A.); or (D.B.E.D.)
| | - Hossam S. El-Beltagi
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
- Biochemistry Department, Faculty of Agriculture, Cairo University, Gamma St, Giza 12613, Egypt
- Correspondence: (H.S.E.-B.); (M.F.M.I.); Tel.: +20-1123403173 (M.F.M.I.)
| | - Doaa Bahaa Eldin Darwish
- Biology Department, Faculty of Science, University of Tabuk, Tabuk 71491, Saudi Arabia; (M.M.A.); (A.M.A.); or (D.B.E.D.)
- Botany Department, Faculty of Science, Mansoura University, Mansoura 35511, Egypt
| | - Mohammed I. Aldaej
- Agricultural Biotechnology Department, College of Agriculture and Food Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Tarek A. Shalaby
- Department of Arid Land Agriculture, College of Agricultural and Food Science, King Faisal University, P.O. Box 400, Al-Ahsa 31982, Saudi Arabia;
- Horticulture Department, Faculty of Agriculture, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt
| | - Abdallah Tageldein Mansour
- Animal and Fish Production Department, College of Agricultural and Food Sciences, King Faisal University, P.O. Box 420, Al-Ahsa 31982, Saudi Arabia;
- Fish and Animal Production Department, Faculty of Agriculture (Saba Basha), Alexandria University, Alexandria 21531, Egypt
| | | | - Mohamed F. M. Ibrahim
- Department of Agricultural Botany, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt
- Correspondence: (H.S.E.-B.); (M.F.M.I.); Tel.: +20-1123403173 (M.F.M.I.)
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Kermeoğlu F, Sayıner S, Şehirli AÖ, Savtekin G, Aksoy U. Does α-lipoic acid therapeutically effective against experimentally induced-acute pulpitis in rats? AUST ENDOD J 2022; 49:87-91. [PMID: 35290687 DOI: 10.1111/aej.12618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022]
Abstract
The purpose of the study was to investigate the therapeutic effects of α-lipoic acid (ALA) on an induced-acute pulpitis model in rats. Twenty-four Wistar albino rats were randomly divided into three groups: control, induced-acute pulpitis (PULP) and PULP + ALA groups. In the PULP and PULP + ALA groups, the crowns of the maxillary left incisors were removed horizontally. All exposed pulp tissues were treated with 5 µL LPS solution. In the PULP + ALA group, the rats were treated intraperitoneally with a single dose of ALA (100 mg/kg). The rats were sacrificed 24 h after pulp injury, and the trunk blood and pulp samples were collected and then determined using ELISA assay kits. TNF-α, IL-1β, MMP-1 and MMP-2 levels in the serum and pulp tissues were considerably higher in the PULP group than the control group (p < 0.01-0.001). In the PULP + ALA group, TNF-α, IL-1β, MMP-1 and MMP-2 levels in the serum and pulp tissues decreased significantly compared to the PULP group (p < 0.05-0.001). ALA decreases pro-inflammatory mediators and proteolytic enzymes, which might relieve acute inflammation.
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Affiliation(s)
- Fatma Kermeoğlu
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, North Cyprus, Turkey
| | - Serkan Sayıner
- Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Nicosia, North Cyprus, Turkey
| | - Ahmet Özer Şehirli
- Departments of Pharmacology, Faculty of Dentistry, Near East University, Nicosia, North Cyprus, Turkey
| | - Gökçe Savtekin
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Ada Kent University, Morphou, Cyprus
| | - Umut Aksoy
- Department of Endodontics, Faculty of Dentistry, Near East University, Nicosia, North Cyprus, Turkey
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Useinovic N, Maksimovic S, Near M, Quillinan N, Jevtovic-Todorovic V. Do We Have Viable Protective Strategies against Anesthesia-Induced Developmental Neurotoxicity? Int J Mol Sci 2022; 23:ijms23031128. [PMID: 35163060 PMCID: PMC8834847 DOI: 10.3390/ijms23031128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Since its invention, general anesthesia has been an indispensable component of modern surgery. While traditionally considered safe and beneficial in many pathological settings, hundreds of preclinical studies in various animal species have raised concerns about the detrimental and long-lasting consequences that general anesthetics may cause to the developing brain. Clinical evidence of anesthetic neurotoxicity in humans continues to mount as we continue to contemplate how to move forward. Notwithstanding the alarming evidence, millions of children are being anesthetized each year, setting the stage for substantial healthcare burdens in the future. Hence, furthering our knowledge of the molecular underpinnings of anesthesia-induced developmental neurotoxicity is crucially important and should enable us to develop protective strategies so that currently available general anesthetics could be safely used during critical stages of brain development. In this mini-review, we provide a summary of select strategies with primary focus on the mechanisms of neuroprotection and potential for clinical applicability. First, we summarize a diverse group of chemicals with the emphasis on intracellular targets and signal-transduction pathways. We then discuss epigenetic and transgenerational effects of general anesthetics and potential remedies, and also anesthesia-sparing or anesthesia-delaying approaches. Finally, we present evidence of a novel class of anesthetics with a distinct mechanism of action and a promising safety profile.
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Affiliation(s)
- Nemanja Useinovic
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.); (M.N.); (N.Q.); (V.J.-T.)
- Correspondence:
| | - Stefan Maksimovic
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.); (M.N.); (N.Q.); (V.J.-T.)
| | - Michelle Near
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.); (M.N.); (N.Q.); (V.J.-T.)
| | - Nidia Quillinan
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.); (M.N.); (N.Q.); (V.J.-T.)
- Neuronal Injury and Plasticity Program, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Vesna Jevtovic-Todorovic
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; (S.M.); (M.N.); (N.Q.); (V.J.-T.)
- Department of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
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Evaluation of the analgesic effect of ɑ-lipoic acid in treating pain disorders: A systematic review and meta-analysis of randomized controlled trials. Pharmacol Res 2022; 177:106075. [PMID: 35026405 DOI: 10.1016/j.phrs.2022.106075] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/22/2022]
Abstract
Neuropathic pain is the most prevalent form of chronic pain caused by a disease of the nervous system, such as diabetic polyneuropathy. ɑ-Lipoic acid (ALA) is an antioxidant that has been widely studied for the treatment of pain symptoms in diverse conditions. Therefore, this study aimed to investigate the efficacy of ALA in the treatment of different types of pain through a systematic review and meta-analysis of randomized clinical trials. The study protocol was registered in the International Prospective Registry of Systematic Reviews (CRD42021261971). A search of the databases resulted in 1154 articles, 16 of which were included in the review (9 studies with diabetic polyneuropathy and 7 studies with other painful conditions). Most of the included studies had a low risk of bias. ALA showed efficacy for the treatment of headache, carpal tunnel syndrome and burning mouth syndrome. Meta-analysis was conducted only with the studies using diabetic polyneuropathy. Compared to placebo, ALA treatment decreased the total symptom score (TSS). The subgroup meta-analysis indicated a decrease of stabbing pain, burning, paraesthesia, and numbness in ALA-treated patients compared to placebo. In addition, both routes of administration, intravenous and oral, demonstrated the efficacy to reduce TSS. Therefore, ALA should be used to treat diabetic polyneuropathy pain symptoms. However, the standardization of treatment time and the dose may advance for the approval of ALA for clinical use in diabetic polyneuroneuropathy.
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Kelishadi MR, Naeini AA, Khorvash F, Askari G, Heidari Z. The beneficial effect of Alpha-lipoic acid supplementation as a potential adjunct treatment in episodic migraines. Sci Rep 2022; 12:271. [PMID: 34997178 PMCID: PMC8742085 DOI: 10.1038/s41598-021-04397-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 12/20/2021] [Indexed: 01/10/2023] Open
Abstract
The current study was performed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on lactate, nitric oxide (NO), vascular cell adhesion molecule-1 (VCAM-1) levels, and clinical symptoms in women with episodic migraines. Considering the inclusion and exclusion criteria, ninety-two women with episodic migraines participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The participants were randomly assigned to receive either 300 mg/day ALA or placebo, twice per day for 12 weeks. The primary outcomes included headache severity, headache frequency per month, and duration of attacks and the secondary outcomes included lactate (a marker of mitochondrial function), NO, and VCAM-1 serum levels were measured at baseline and the end of the intervention. At the end of the study, there was a significant decrease in lactate serum levels (- 6.45 ± 0.82 mg/dl vs - 2.27 ± 1.17 mg/dl; P = 0.039) and VCAM-1 (- 2.02 ± 0.30 ng/ml vs - 1.21 ± 0.36 ng/ml; P = 0.025) in the ALA as compared to the placebo group. In addition, the severity (P < 0.001), frequency (P = 0.001), headache impact test (HIT-6) (P < 0.001), headache dairy results (HDR) (P = 0.003), and migraine headache index score (MHIS) (P < 0.001) had significantly decreased in the intervention as compared to the control group. No significant changes were observed for NO levels and duration of migraine pains. ALA supplementation can be considered a potential adjunct treatment in patients with migraine due to its improving mitochondrial and endothelial functions and clinical symptoms.
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Affiliation(s)
- Mahnaz Rezaei Kelishadi
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirmansour Alavi Naeini
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Fariborz Khorvash
- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Xie H, Yang X, Cao Y, Long X, Shang H, Jia Z. Role of lipoic acid in multiple sclerosis. CNS Neurosci Ther 2021; 28:319-331. [PMID: 34964271 PMCID: PMC8841304 DOI: 10.1111/cns.13793] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 02/05/2023] Open
Abstract
Lipoic acid (LA) is an endogenous antioxidant that exists widely in nature. Supplementation with LA is a promising approach to improve the outcomes of patients with multiple sclerosis (MS). This systematic review aimed to provide a comprehensive overview of both in vitro and in vivo studies describing the pharmacokinetics, efficacy, safety, and mechanism of LA in MS‐related experiments and clinical trials. A total of 516 records were identified by searching five databases, including PubMed, Web of Science, Embase, Scopus, and Cochrane Library. Overall, we included 20 studies reporting LA effects in cell and mouse models of MS and 12 studies reporting LA effects in patients with MS. Briefly, cell experiments revealed that LA protected neurons by inhibiting the expression of inflammatory mediators and activities of immune cells. Experimental autoimmune encephalomyelitis mouse experiments demonstrated that LA consistently reduced the number of infiltrating immune cells in the central nervous system and decreased the clinical disability scores. Patients with MS showed relatively stable Expanded Disability Status Scale scores and better walking performance with few adverse events after the oral administration of LA. Notably, heterogeneity of this evidence existed among modeling methods, LA usage, MS stage, and trial duration. In conclusion, this review provides evidence for the anti‐inflammatory and antioxidative effects of LA in both in vitro and in vivo experiments; therefore, patients with MS may benefit from LA administration. Whether LA can be a routine supplementary therapy warrants further study.
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Affiliation(s)
- Hongsheng Xie
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xiufang Yang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Cao
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Huifang Shang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.,Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
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Ramos CSCB, Silva VAPD, Corrêa LBNS, Abboud RDS, Boaventura GT, Chagas MA. Long-Term Alpha-Lipoic Acid (ALA) Antioxidant Therapy Reduces Damage in the Cardiovascular System of Streptozotocin-Induced Diabetic Rats. J Diet Suppl 2021; 20:444-458. [PMID: 34806528 DOI: 10.1080/19390211.2021.2004290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cellular damage, lipid oxidation and the action of inflammatory cytokines are implicated in the evolution of vascular complications associated with diabetes mellitus (DM) hyperglycemia. In contrast, alpha-lipoic acid (ALA) is a supplement with antioxidant and anti-inflammatory effects. This study aims to evaluate the overall effects of ALA supplementation by assessing its long-term systemic action on the vascular morphology of rats with induced diabetes. A total of 28 male rats were divided into 4 groups with seven animals each. For diabetes induction, two groups received streptozotocin. The animals in the lipoic and diabetic lipoic groups received ALA supplement. After 8 weeks the animals were anesthetized and blood collected was for hematological, biochemical and serological analyses. The thoracic aorta was removed, processed for paraffin and histological sections were stained for morphometric analysis. In diabetic groups, an improvement in hematological profile was observed, with platelet reduction in the diabetic lipoic group. ALA addition to the diet attenuated the negative effects in lipid profile; moreover, renal, hepatic and inflammatory parameters reduced or displayed values close to the values of the normal control. The anti-inflammatory effect of ALA was observed in diabetic animals, with a reduction of inflammatory citokines, accompanied by the improvement of morphological parameters in the aorta. In conclusion, long-term supplementation with ALA promoted systemic improvement, thus reducing the risk of vascular diseases. The changes in the renal and hepatic parameters without any negative impact in the hematological profile also show that ALA can be indicated as a low-risk prophylaxis or complementary therapy.
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Affiliation(s)
- Cristiane Simões Coelho Britto Ramos
- Department of Morphology, Laboratory of Cellular and Extracellular Biomorphology. Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
| | - Vivian Alves Pereira da Silva
- Department of Morphology, Laboratory of Cellular and Extracellular Biomorphology. Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
| | - Lanna Beatriz Neves Silva Corrêa
- Department of Morphology, Laboratory of Cellular and Extracellular Biomorphology. Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
| | - Renato de Souza Abboud
- Department of Morphology, Laboratory of Cellular and Extracellular Biomorphology. Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
| | - Gilson Teles Boaventura
- Laboratory of Experimental Nutrition. Department of Nutrition and Dietetics, Federal Fluminense University, Rio de Janeiro, Brazil
| | - Mauricio Alves Chagas
- Department of Morphology, Laboratory of Cellular and Extracellular Biomorphology. Biomedical Institute, Federal Fluminense University, Niteroi, Brazil
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Elkelish A, El-Mogy MM, Niedbała G, Piekutowska M, Atia MAM, Hamada MMA, Shahin M, Mukherjee S, El-Yazied AA, Shebl M, Jahan MS, Osman A, El-Gawad HGA, Ashour H, Farag R, Selim S, Ibrahim MFM. Roles of Exogenous α-Lipoic Acid and Cysteine in Mitigation of Drought Stress and Restoration of Grain Quality in Wheat. PLANTS (BASEL, SWITZERLAND) 2021; 10:plants10112318. [PMID: 34834681 PMCID: PMC8619972 DOI: 10.3390/plants10112318] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 05/13/2023]
Abstract
Cysteine (Cys) and α-lipoic acid (ALA) are naturally occurring antioxidants (sulfur-containing compounds) that can protect plants against a wide spectrum of environmental stresses. However, up to now, there are no conclusive data on their integrative roles in mitigation of drought stress in wheat plants. Here, we studied the influence of ALA at 0.02 mM (grain dipping pre-cultivation treatment) and Cys (25 and 50 ppm as a foliar application) under well watered and deficit irrigation (100% and 70% of recommended dose). The results showed that deficit irrigation markedly caused obvious cellular oxidative damage as indicated by elevating the malondialdehyde (MDA) and hydrogen peroxide content (H2O2). Moreover, water stressed plants exhibited multiple changes in physiological metabolism, which affected the quantitative and qualitative variables of grain yield. The enzymatic antioxidants, including superoxide dismutase (SOD), ascorbate peroxidase (APX), catalase (CAT) and peroxidase (POX) were improved by Cys application. SOD and APX had the same response when treated with ALA, but CAT and POX did not. Moreover, both studied molecules stimulated chlorophyll (Chl) and osmolytes' biosynthesis. In contrast, the Chl a/b ratio was decreased, while flavonoids were not affected by either of the examined molecules. Interestingly, all above-mentioned changes were associated with an improvement in the scavenging capacity of reactive oxygen species (ROS), leaf relative water content (RWC), grain number, total grain yield, weight of 1000 kernels, gluten index, falling number, and alveographic parameters (P, W, and P/L values). Furthermore, heatmap plot analysis revealed several significant correlations between different studied parameters, which may explore the importance of applied Cys and ALA as effective compounds in wheat cultivation under water deficit conditions.
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Affiliation(s)
- Amr Elkelish
- Botany Department, Faculty of Science, Suez Canal University Ismailia, Ismailia 41522, Egypt;
| | - Mohamed M. El-Mogy
- Vegetable Crops Department, Faculty of Agriculture, Cairo University, Giza 12613, Egypt
- Correspondence: (M.M.E.-M); (M.F.M.I.); Tel.: +20-1068027607 (M.M.E.-M); +20-1123403173 (M.F.M.I.)
| | - Gniewko Niedbała
- Department of Biosystems Engineering, Faculty of Environmental and Mechanical Engineering, Poznań University of Life Sciences, Wojska Polskiego 50, 60-627 Poznań, Poland;
| | - Magdalena Piekutowska
- Department of Geoecology and Geoinformation, Institute of Biology and Earth Sciences, Pomeranian University in Słupsk, Partyzantów 27, 76-200 Słupsk, Poland;
| | - Mohamed A. M. Atia
- Molecular Genetics and Genome Mapping Laboratory, Genome Mapping Department, Agricultural Genetic Engineering Research Institute (AGERI), Agricultural Research Center (ARC), Giza 12619, Egypt;
| | - Maha M. A. Hamada
- Department of Agronomy, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (M.M.A.H.); (M.S.)
| | - Mostafa Shahin
- Department of Agronomy, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (M.M.A.H.); (M.S.)
| | - Soumya Mukherjee
- Department of Botany, Jangipur College, University of Kalyani, Kalyani 742213, India;
| | - Ahmed Abou El-Yazied
- Department of Horticulture, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (A.A.E.-Y.); (H.G.A.E.-G.)
| | - Mohamed Shebl
- Food Science Department, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt;
| | - Mohammad Shah Jahan
- College of Horticulture, Nanjing Agricultural University, Nanjing 210095, China;
- Department of Horticulture, Sher-e-Bangla Agricultural University, Dhaka 1207, Bangladesh
| | - Ali Osman
- Biochemistry Department, Faculty of Agriculture, Zagazig University, Zagazig 44511, Egypt;
| | - Hany G. Abd El-Gawad
- Department of Horticulture, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (A.A.E.-Y.); (H.G.A.E.-G.)
| | - Hatem Ashour
- Department of Agricultural Botany, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (H.A.); (R.F.)
| | - Reham Farag
- Department of Agricultural Botany, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (H.A.); (R.F.)
| | - Samy Selim
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Mohamed F. M. Ibrahim
- Department of Agricultural Botany, Faculty of Agriculture, Ain Shams University, Cairo 11566, Egypt; (H.A.); (R.F.)
- Correspondence: (M.M.E.-M); (M.F.M.I.); Tel.: +20-1068027607 (M.M.E.-M); +20-1123403173 (M.F.M.I.)
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Spain RI, Andeen NK, Gibson PC, Samuels MH, Morris CD, Solomon AJ, Solomon R, Waslo C, Avasare RS. Lipoic acid supplementation associated with neural epidermal growth factor-like 1 (NELL1)-associated membranous nephropathy. Kidney Int 2021; 100:1208-1213. [PMID: 34662650 DOI: 10.1016/j.kint.2021.10.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/21/2021] [Accepted: 10/10/2021] [Indexed: 12/13/2022]
Abstract
Lipoic acid (alpha lipoic acid, thioctic acid) is a popular over-the-counter antioxidant and insulin-mimetic supplement under investigation in a variety of conditions including multiple sclerosis, diabetes, and schizophrenia. Unfortunately, high-grade proteinuria was an unexpected adverse event specific to the treatment arm of our clinical trial investigating lipoic acid supplementation in patients with multiple sclerosis. This observation led to detection of similar patients in our nephrology practice. Here, we describe four biopsy-proven cases of neural epidermal growth factor-like 1 (NELL1)-associated membranous nephropathy following lipoic acid supplementation and a fifth suspected case. Discontinuation of lipoic acid and supportive therapy resulted in remission.
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Affiliation(s)
- Rebecca I Spain
- Neurology Division, Portland VA Medical Center, Portland, Oregon, USA.
| | - Nicole K Andeen
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Pamela C Gibson
- Department of Pathology and Larboratory Medicine, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Mary H Samuels
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Cynthia D Morris
- Oregon Clinical and Translational Research Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Andrew J Solomon
- Department of Neurological Sciences, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Richard Solomon
- Division of Nephrology and Hypertension, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Carin Waslo
- Research Division, Portland VA Medical Center, Portland, Oregon, USA
| | - Rupali S Avasare
- Department of Medicine, Division of Nephrology and Hypertension, Oregon Health & Science University, Portland, Oregon, USA
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Nutraceuticals for Peripheral Vestibular Pathology: Properties, Usefulness, Future Perspectives and Medico-Legal Aspects. Nutrients 2021; 13:nu13103646. [PMID: 34684646 PMCID: PMC8538675 DOI: 10.3390/nu13103646] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/09/2021] [Accepted: 10/13/2021] [Indexed: 02/07/2023] Open
Abstract
Vestibular disorders may generate complex signs and symptoms, which may alter patients' balance and the quality of life. Dizziness and vertigo can strongly affect daily activities and relations. Despite the presence of conventional drugs, maneuvers, and surgery, another interesting therapeutic opportunity is offered by nutraceuticals. These molecules are often used in the treatment of dizziness and vertigo, but the rationale of their application is not always solidly demonstrated by the scientific evidence. Several substances have shown a variable level of efficacy/usefulness in this field, but there is lack of important evidence for most of them. From a medico-legal point of view, specific information must be provided to the patient regarding the efficacy and possibilities that the use of these preparations can allow. Administering the right nutraceutical to the proper patient is a fundamental clinical skill. Integrating conventional drug treatment with nutraceutical administration seems to be easy, but it may be difficult considering the (in part unexplored) pharmacodynamics and pharmacokinetics of nutraceuticals. The aim of the scientific community should be to elevate nutraceuticals to the same law and technical dignity of conventional drugs.
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Esposito C, Ugo Garzarella E, Santarcangelo C, Di Minno A, Dacrema M, Sacchi R, Piccinocchi G, Piccinocchi R, Daglia M. Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: A monocentric, randomized, double-blind, placebo-controlled clinical trial. Biomed Pharmacother 2021; 144:112308. [PMID: 34649217 DOI: 10.1016/j.biopha.2021.112308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Extensive evidence suggests that alpha-lipoic acid (ALA) is effective in diabetic neuropathy pain management. However, little is known on its safety and efficacy in reducing idiopathic pain in normoglycemic subjects. The aim of this study was to evaluate ALA food supplement safety and efficacy in the reduction of different forms of idiopathic pain. METHODS Two-hundred and ten normoglycemic adults suffering from idiopathic pain (i.e. 57 subjects with primitive neuropathic pain, 141 subjects with arthralgia with unknown etiology, and 12 subjects with idiopathic myalgia) were randomized to receive placebo, 400 mg/day, or 800 mg/day of ALA. Participants underwent two visits (at baseline = t0, and after 2 months = t1) in which two validated questionaries for pain (numerical rating scale [NRS] and visual analogue scale [VAS]) were collected; fasting blood glucose assessment, adverse effects, and renal and hepatic toxicity were also monitored. RESULTS At t1, none of subjects treated with ALA reported a decreased glycemia or adverse effects. The treated subjects showed a significant reduction in NRS (p < 0.001) while the placebo group did not show any NRS reduction (p = 0.86). Similar results were also obtained for VAS. Statistical analysis aimed at detecting possible differences in NRS and VAS scores among treatment groups based on the source of pain did not reveal any significant effect. CONCLUSIONS Since the management of idiopathic pain is challenging for physicians, the use of ALA food supplements could be a feasible option, based on its safety and efficacy compared to commonly-used analgesic drugs.
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Affiliation(s)
- Cristina Esposito
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Emanuele Ugo Garzarella
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Cristina Santarcangelo
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Alessandro Di Minno
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy; CEINGE-Biotecnologie Avanzate, Via Gaetano Salvatore 486, 80145 Naples, Italy
| | - Marco Dacrema
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Roberto Sacchi
- Applied Statistic Unit, Department of Earth and Environmental Sciences, University of Pavia, viale Taramelli 24, 27100 Pavia, Italy
| | - Gaetano Piccinocchi
- Comegen S.c.S., Società Cooperativa Sociale di Medici di Medicina Generale, Viale Maria Bakunin, 41, 80125 Naples, Italy
| | - Roberto Piccinocchi
- Level 1 Medical Director Anaesthesia and Resuscitation A. U. O. Luigi Vanvitelli, Via Santa Maria di Costantinopoli, 80138 Naples, Italy
| | - Maria Daglia
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, 212013 Zhenjiang, China.
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An X, Liu L, Schaefer M, Yan B, Scholz C, Hillmer S, Wang K, Luo Y, Ji H, Gladkich J, Herr I. Alpha-Lipoic Acid Prevents Side Effects of Therapeutic Nanosilver without Compromising Cytotoxicity in Experimental Pancreatic Cancer. Cancers (Basel) 2021; 13:4770. [PMID: 34638256 PMCID: PMC8507678 DOI: 10.3390/cancers13194770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 01/14/2023] Open
Abstract
Silver nanoparticles (AgNPs) have attracted attention in cancer therapy and might support the treatment of pancreatic ductal adenocarcinoma (PDAC). Silver is in clinical use in wound dressings, catheters, stents and implants. However, the side effects of systemic AgNP treatment due to silver accumulation limit its therapeutic application. We evaluated whether the antioxidant and natural agent α-lipoic acid might prevent these side effects. We synthesized AgNPs using an Ionic-Pulser® Pro silver generator and determined the concentration by inductively coupled plasma-optical emission spectrometry. The effect of α-lipoic acid was examined in four PDAC and two nonmalignant cell lines by MTT, FACS analysis, TEM, xenotransplantation and immunohistochemistry. The viability of PDAC cells was nearly totally abolished by AgNP treatment, whereas nonmalignant cells largely resisted. α-Lipoic acid prevented AgNP-induced cytotoxicity in nonmalignant cells but not in PDAC cells, which might be due to the higher sensitivity of malignant cells to silver-induced cytotoxicity. α-Lipoic acid protected mitochondria from AgNP-induced damage and led to precipitation of AgNPs. AgNPs reduced the growth of tumor xenografts, and cotreatment with α-lipoic acid protected chick embryos from AgNP-induced liver damage. Together, α-lipoic acid strongly reduced AgNP-induced side effects without weakening the therapeutic efficacy.
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Affiliation(s)
- Xuefeng An
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Li Liu
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Michael Schaefer
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Bin Yan
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Christian Scholz
- Institute of Earth Sciences, University of Heidelberg, 69120 Heidelberg, Germany;
| | - Stefan Hillmer
- Electron Microscopy Core Facility, University of Heidelberg, 69120 Heidelberg, Germany;
| | - Kangtao Wang
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Yiqiao Luo
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Huihui Ji
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Jury Gladkich
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
| | - Ingrid Herr
- Department of General, Visceral & Transplant Surgery, Molecular OncoSurgery, Section Surgical Research, University of Heidelberg, 69120 Heidelberg, Germany; (X.A.); (L.L.); (M.S.); (B.Y.); (K.W.); (Y.L.); (H.J.); (J.G.)
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Myoinositol Reduces Inflammation and Oxidative Stress in Human Endothelial Cells Exposed In Vivo to Chronic Hyperglycemia. Nutrients 2021; 13:nu13072210. [PMID: 34199095 PMCID: PMC8308270 DOI: 10.3390/nu13072210] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Myo-inositol (Myo) improves insulin resistance, glucose metabolism, and helps gestational diabetes (GDM) management. GDM is associated with a pro-inflammatory state and increased oxidative stress, which are both involved in vascular damage in diabetes. Our aim was to study Myo anti-inflammatory/antioxidant potential effects on an in vitro model of human umbilical vein endothelial cells (HUVECs). To this end, monocyte cell adhesion to HUVECs, adhesion molecule membrane exposure, and oxidative stress levels were determined in cells from control (C-) and GDM women treated during pregnancy either with diet only (GD-) or with diet plus Myo (GD+Myo). To deeply study the vascular effects of Myo, the same evaluations were performed in C- and GD-HUVECs following 48 h in vitro stimulation with Myo. Notably, we first observed that GD-HUVECs obtained from women assuming Myo supplementation exhibited a significantly decreased number of monocytes that adhered to endothelial cells, less adhesion molecule exposure, and lower intracellular reactive oxygen species (ROS) levels in the basal state as compared to GD-HUVECs obtained from women treated by diet only. This Myo anti-inflammatory/antioxidant effect was confirmed by 48 h in vitro stimulation of GD-HUVECs as compared to controls. Altogether, these results strongly suggest that Myo may exert protective actions against chronic inflammation induced by endothelial dysfunction in diabetes.
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Martinelli I, Tomassoni D, Roy P, Di Cesare Mannelli L, Amenta F, Tayebati SK. Antioxidant Properties of Alpha-Lipoic (Thioctic) Acid Treatment on Renal and Heart Parenchyma in a Rat Model of Hypertension. Antioxidants (Basel) 2021; 10:antiox10071006. [PMID: 34201726 PMCID: PMC8300705 DOI: 10.3390/antiox10071006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 01/01/2023] Open
Abstract
Renal and cardiac impairments are frequent events in the presence of hypertension. Organ damage is mainly linked to oxidative stress due to high blood pressure and may be reduced by antioxidant supplementation. Alpha-lipoic acid (ALA) is one of most effective antioxidants. It is widely used as a nutritional supplement in a racemic mixture (+/–), even though the (+)-enantiomer is biologically active. This study was designed to investigate the effect of treatment with (+/–)-ALA and its enantiomers on renal and heart parenchyma in spontaneously hypertensive rats (SHR), using immunochemical and immunohistochemical techniques. The results confirmed that the oxidative mechanisms of organ alterations, due to hypertension, and characterized by glomerular and tubular lesions, left ventricular hypertrophy, and fibrosis but not by apoptosis were accompanied by proteins’ and nucleic acids’ oxidation. We found greater effectiveness of (+)-ALA compared to (+/−)-ALA in reducing oxidative stress, cardiac and renal damages in SHR. To conclude, these data propose (+)-ALA as one of the more appropriate antioxidant molecules to prevent renal and cardiac alterations associated with hypertension.
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Affiliation(s)
- Ilenia Martinelli
- School of Pharmacy, University of Camerino, 62032 Camerino, Italy; (I.M.); (F.A.)
| | - Daniele Tomassoni
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy; (D.T.); (P.R.)
| | - Proshanta Roy
- School of Biosciences and Veterinary Medicine, University of Camerino, 62032 Camerino, Italy; (D.T.); (P.R.)
| | - Lorenzo Di Cesare Mannelli
- Department of Neuroscience, Pharmaceutical and Child Health Area (NEUROFARBA), University of Florence, 50139 Florence, Italy;
| | - Francesco Amenta
- School of Pharmacy, University of Camerino, 62032 Camerino, Italy; (I.M.); (F.A.)
| | - Seyed Khosrow Tayebati
- School of Pharmacy, University of Camerino, 62032 Camerino, Italy; (I.M.); (F.A.)
- Correspondence:
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Li Z, Su Y, Yi D, Wu C, Fang W, Wang C. Analysis of the clinical characteristics of insulin autoimmune syndrome induced by alpha-lipoic acid. J Clin Pharm Ther 2021; 46:1295-1300. [PMID: 33821530 DOI: 10.1111/jcpt.13427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/21/2021] [Accepted: 03/26/2021] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Alpha-lipoic acid (ALA) is widely used as a dietary supplement and antiageing agent. Insulin autoimmune syndrome (IAS) is the most serious adverse reaction reported with the use of ALA. The purpose of this study was to explore the clinical characteristics of ALA-induced IAS and provide a scientific reference for clinical diagnosis, treatment and prevention. METHODS We collected literature on IAS cases induced by ALA for retrospective analysis in Chinese and English. RESULTS AND DISCUSSION The median age of 37 patients (28 females and 9 males) was 61 years (range 32-82). The symptoms occurred at night and in the early morning (60.7%), in the late postprandial period (50.0%) or after fasting (35.7%), within hours in some patients and up to 2 months in others after stopping ALA or during medication treatment. Autonomic nervous system symptoms (81.1%) and neurological hypoglycaemia (64.9%) are the main clinical manifestations of hypoglycaemia. The blood glucose concentration at the onset of hypoglycaemia was 2.19 mmol/L (median, range 1.09-3.52), the insulin concentration was ≥100 μIU/ml (94.6%), and the C-peptide concentration was ≤20 ng/ml (83.3%). Testing for IgG insulin autoantibodies (IAAs) was positive in 37 patients. Pancreatic imaging was unremarkable on computed tomography (CT), magnetic resonance imaging (MRI) and abdominal sonography. Hypoglycaemia disappeared within 5 days to 8 months after withdrawing ALA alone or using corticosteroid treatment. IAA turned negative in 7 months (median; range 2-36). Follow-up showed no recurrent hypoglycaemic episodes at 7.25 months (median; range 1-36). WHAT IS NEW AND CONCLUSION ALA-induced IAS is a clinically rare autoimmune disease with hypoglycaemia that occurs during medication treatment or after drug withdrawal that should be treated promptly.
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Affiliation(s)
- Zuojun Li
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yanhong Su
- Department of Pharmacy, Yinan County People's Hospital, Linyi, China
| | - Dan Yi
- Drug clinical trial center, Zhuzhou central hospital, Zhuzhou, China
| | - Cuifang Wu
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Weijin Fang
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Chunjiang Wang
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
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Cicero AFG, Kennedy C, Knežević T, Bove M, Georges CMG, Šatrauskienė A, Toth PP, Fogacci F. Efficacy and Safety of Armolipid Plus ®: An Updated PRISMA Compliant Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials. Nutrients 2021; 13:nu13020638. [PMID: 33669333 PMCID: PMC7920267 DOI: 10.3390/nu13020638] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022] Open
Abstract
Armolipid Plus® is a multi-constituent nutraceutical that claims to improve lipid profiles. The aim of this PRISMA compliant systematic review and meta-analysis was to globally evaluate the efficacy and safety of Armolipid Plus® on the basis of the available randomized, blinded, controlled clinical trials (RCTs). A systematic literature search in several databases was conducted in order to identify RCTs assessing the efficacy and safety of dietary supplementation with Armolipid Plus®. Two review authors independently identified 12 eligible studies (1050 included subjects overall) and extracted data on study characteristics, methods, and outcomes. Meta-analysis of the data suggested that dietary supplementation with Armolipid Plus® exerted a significant effect on body mass index (mean difference (MD) = -0.25 kg/m2, p = 0.008) and serum levels of total cholesterol (MD = -25.07 mg/dL, p < 0.001), triglycerides (MD = -11.47 mg/dL, p < 0.001), high-density lipoprotein cholesterol (MD = 1.84 mg/dL, p < 0.001), low-density lipoprotein cholesterol (MD = -26.67 mg/dL, p < 0.001), high sensitivity C reactive protein (hs-CRP, MD = -0.61 mg/L, p = 0.022), and fasting glucose (MD = -3.52 mg/dL, p < 0.001). Armolipid Plus® was well tolerated. This meta-analysis demonstrates that dietary supplementation with Armolipid Plus® is associated with clinically meaningful improvements in serum lipids, glucose, and hs-CRP. These changes are consistent with improved cardiometabolic health.
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Affiliation(s)
- Arrigo F. G. Cicero
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (M.B.); (F.F.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Italian Nutraceutical Society (SINut), 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-512142224; Fax: +39-51390646
| | - Cormac Kennedy
- Department of Pharmacology and Therapeutics, Trinity College Dublin and St James Hospital, Dublin 8, Ireland;
| | - Tamara Knežević
- Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, 10000 Zagreb, Croatia;
| | - Marilisa Bove
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (M.B.); (F.F.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Coralie M. G. Georges
- Department of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium;
| | - Agnė Šatrauskienė
- Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania;
- Vilnius University Hospital Santariškiu Klinikos, LT-08661 Vilnius, Lithuania
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL 61081, USA;
- Cicarrone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Federica Fogacci
- Hypertension and Atherosclerosis Research Group, Medical and Surgical Sciences Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy; (M.B.); (F.F.)
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Italian Nutraceutical Society (SINut), 40138 Bologna, Italy
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Interpreting data on alpha-lipoic acid safety considering the number of subjects exposed. Clin Nutr 2020; 40:654. [PMID: 33349483 DOI: 10.1016/j.clnu.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023]
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