Role of α-Lipoic Acid in Diabetic Polyneuropathy Treatment

Abstract

Diabetic neuropathy represents late diabetes complications, and diabetes duration and long-term hyperglycemia are the main reasons for polyneuropathy. The goal was to estimate the effects of alpha-lipoic acid on symptoms of diabetic neuropathy after 600 mg i.v. for 3 weeks and 3 months of 300-600 mg of alpha-lipoic acid per os. This study has been designed as a multicentric, in 5-centers in B&H, carried out by 5 physicians with 20 diabetic patients each. Following parameters were monitored in 100 diabetics suffering from Type 1 and Type 2 diabetes, both men and women: diabetes duration, diabetes therapy, duration of polyneuropathy symptoms, height, weight, BMI (body mass index), subjective assessment of patients, objective examinations of physicians and subjective assessment of physicians. 100 diabetics, average age 61,36; oldest 79, youngest 40, suffered from diabetes in average 11,9 years. There were 35 men and 65 women, 16 with Type 1 and 80 with Type 2 diabetes, while 4 patients were not classified. 69 were having insulin therapy and 31 oral hypoglicemics. Shortest diabetic status was less than a year, and longest was 28 years. Average duration of polyneuropathic symptoms was 3,02 years, shortest was less than a year, and the longest was 15 years. Average height was 1,70 m, average weight 76,13 kg, and average BMI 26,51 kg/m2. Significant statistic differences in improvement were recorded (P>0,05) according to Fridman's test for repeated measurements compared to initial findings in assessments: sensory symptoms of polyneuropathy, pain sensations as polyneuropathy symptoms, total score of polyneuropathy symptoms, subjective assessment of patients, subjective findings of physicians, and significant differences were not find (P>0,05) in autonomous and motoric neuropathy. Based on the conducted study, we have concluded that the application of alpha-lipoic acid during 3 months has helped to decrease the symptoms of diabetic neuropathy and in only one case out of 100 included patients there was no subjective improvement after drug application.

Effects of Alpha Lipoic Acid Treatment on Laminin Alteration of the Sciatic Nerve in Streptozotocin Induced Diabetic Rats

“…Glycation of laminin in ECM leads to impaired regenerative activity in diabetic neuropathy (21). Previous studies have suggested that the level of laminin mRNA increased in kidney or retina after diabetes induction (4,(22)(23)(24)(25). Our immunohistochemial results indicated that diabetes in rats resulted in significantly increased laminin expression in the perineurium, endoneurium, epineurial and endoneurial blood vessels.…”

“…These discrepancies are probably due to differences in experimental methods, in Serafin et al study (26), mice was made diabetic with a low dose of streptozotocin with a short study time period and in Hill et al study (6), duration of diabetes in diabetic patients was different. Diabetes duration and long-term hyperglycemia are the most important reasons for polyneuropathy (22). Beneficial effect of ALA on the neuropathic symptoms due to diabetic neuropathy had been reported (10,11,13).…”

Role of Drp1, a Key Mitochondrial Fission Protein, in Neuropathic Pain

“…The mechanical hyperalgesia associated with these forms of painful peripheral neuropathy isantagonized by inhibitors of mitochondrial functions including all five mitochondrial electron transport chain complexes (Joseph and Levine, 2006), oxidative stress (Green et al, 2004; Osio et al, 2006; Vanotti et al, 2007) and generation of reactive oxygen species (ROS) (Joseph and Levine, 2010), and apoptotic signaling (Joseph and Levine, 2009). In patients, while antioxidants have been shown to have efficacy against symptoms of peripheral neuropathy associated with diabetes (Ziegler et al, 2004; Argyriou et al, 2006; Foster, 2007; Sima, 2007), complex regional pain syndrome type I and chemotherapy-induced painful neuropathy (Burekovic et al, 2008; Besse et al, 2009; Mijnhout et al, 2010; Pace et al, 2010), these effects have been relatively modest. It has been suggested that this limited efficacy is due to a failure to achieve sufficient anti-oxidant levels within the mitochondrion (Murphy and Smith, 2007), the major site of ROS generation (Inoue et al, 2003; Brand, 2010).…”

Comparison of insulin and alpha lipoic acid treatment on laminin expression in sciatic nerve of diabetic rats

“…These discrepancies are probably due to differences in experimental methods, in Serafin et al (2010) study, mice was made diabetic with a low dose of STZ with a short-term study and in Hill (2009) study, duration of diabetes in diabetic patients were different. Duration of diabetes and long-term hyperglycemia are the most important reasons for polyneuropathy (Bureković et al, 2008). Beneficial effects of ALA on the neuropathic symptoms due to diabetic neuropathy had been reported (Vallianou et al, 2009;Han et al, 2012;Ziegler, 2004).…”