Alpha-Linolenic Acid: Is It Essential to Cardiovascular Health? The effect of alpha-lipoic acid (ALA) supplementation on cardiovascular risk factors in men with chronic spinal cord injury: a clinical trial Burning mouth syndrome (BMS): controlled open trial of the efficacy of alpha-lipoic acid (thioctic acid) on symptomatology. Burning mouth syndrome (BMS): an open trial of comparative efficacy of alpha-lipoic acid (thioctic acid) with other therapies. Effect of alpha-lipoic acid on asymmetric dimethylarginine and disability in multiple sclerosis patients: A randomized clinical trial Randomized, triple-blind, placebo-controlled clinical trial examining the effects of alpha-lipoic acid supplement on the spermatogram and seminal oxidative stress in infertile men. Effects of alpha lipoic acid supplementation on serum levels of IL-8 and TNF-α in patient with ESRD undergoing hemodialysis Effects of Alpha Lipoic Acid on Multiple Cytokines and Biomarkers and Recurrence of Atrial Fibrillation Within 1 Year of Catheter Ablation. Effect of alpha-lipoic acid and vitamin E supplementation on oxidative stress, inflammation, and malnutrition in hemodialysis patients. Usefulness of omega-3 fatty acids and the prevention of coronary heart disease. Evaluation of laser therapy and alpha-lipoic acid for the treatment of burning mouth syndrome: a randomized clinical trial Creation of a database to assess effects of omega-3, omega-6 and total polyunsaturated fats on health: methodology for a set of systematic reviews Combination of alpha lipoic acid and gabapentin, its efficacy in the treatment of Burning Mouth Syndrome: a randomized, double-blind, placebo controlled trial. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Alpha lipoic acid in burning mouth syndrome--a randomized double-blind placebo-controlled trial. Effects of α-lipoic acid therapy on sympathetic heart innervation in patients with previous experience of transient takotsubo cardiomyopathy. Background diet influences the anti-inflammatory effect of alpha-linolenic acid in dyslipidaemic subjects. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Impact of combined therapy with alpha-lipoic and ursodeoxycolic acid on nonalcoholic fatty liver disease: double-blind, randomized clinical trial of efficacy and safety Effects of combination tocopherols and alpha lipoic acid therapy on oxidative stress and inflammatory biomarkers in chronic kidney disease. Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients. The comparison of antioxidant and hematological properties of N-acetylcysteine and alpha-lipoic acid in physically active males. The Effects of Maternal Supplementation of Polyunsaturated Fatty Acids on Visual, Neurobehavioural, and Developmental Outcomes of the Child: A Systematic Review of the Randomized Trials
There is a large body of scientific evidence that has been confirmed in r and omized controlled trials indicating a cardioprotective effect for omega-3 fatty acids from fish . For alpha-linolenic acid ( ALA ) , which is the omega-3 fatty acid from plants , the relation to cardiovascular health is less clear . We review ed the recent literature on dietary ALA intake , ALA tissue concentrations , and cardiovascular health in humans . Short-term trials ( 6–12 weeks ) in generally healthy participants mostly showed no or inconsistent effects of ALA intake ( 1.2–3.6 g/d ) on blood lipids , low-density lipoprotein oxidation , lipoprotein(a ) , and apolipoproteins A-I and B. Studies of ALA in relation to inflammatory markers and glucose metabolism yielded conflicting results . With regard to clinical cardiovascular outcomes , there is observational evidence for a protective effect against nonfatal myocardial infa rct ion . However , no protective associations were observed between  ALA status and risk of heart failure , atrial fibrillation , and sudden death . Findings from long-term trials of ALA supplementation are awaited to answer the question whether food-based or higher doses of ALA could be important for cardiovascular health in cardiac patients and the general population Study design : A r and omized , double-blind , placebo-controlled clinical trial . Objective : To assess the effect of alpha-lipoic acid ( ALA ) supplementation on IL-6 , hs-CRP , FBS , anthropometric indices , food intake and blood pressure in male patients with chronic spinal cord injury ( SCI ) . Setting : Imam Khomeini Hospital , Tehran University of Medical Sciences , Tehran , Iran . Methods : Fifty-eight men with chronic SCI participated in the study . Participants were divided in two groups : one group received 600 mg of supplemental ALA ( n=28 ) and the other group received placebo ( n=30 ) for 12 weeks . At the beginning and end of the study , biochemical parameters , anthropometric indices , blood pressure and dietary intakes were measured . Dietary intake was measured using N4 software , and statistical analyses were carried out using SPSS16 . Results : No significant reduction was found in IL-6 ( P=0.97 ) and hs-CRP levels ( P=0.23 ) . There was significant reduction in fasting blood sugar ( P=0.001 ) , body weight ( P=0.001 ) , BMI ( P=0.001 ) , waist circumference ( P=0.001 ) and blood pressure ( P=0.001 ) . Dietary intake was significantly reduced , including fat ( P=0.001 ) , carbohydrate ( P=0.001 ) , protein ( P=0.002 ) and energy intakes ( P=0.001 ) . Conclusion : Lipoic acid supplementation had no significant effect on the measured inflammatory markers but it reduces fasting blood sugar , anthropometric parameters , food intake and blood pressure in men with chronic SCI BACKGROUND Alpha-lipoic acid ( ALA ) , is a potent antioxidant mitochondrial coenzyme , the trometamol salt of thioctic acid that has been shown in clinical studies to be neuroprotective . This study examined the effect of ALA on the symptomatology of Burning mouth syndrome ( BMS ) .  SUBJECTS AND METHODS Forty-two patients with BMS and no clinical or laboratory evidence of organic oral disease were divided into two groups ( Test and Control ) each of 21 subjects , matched for age and sex . The Test group were given ALA ( thioctic acid ; Tiobec ) for 30 days , as 600 mg per day orally for 20 days followed by 200 mg per day for 10 days . The Control group were given cellulose starch 100 mg per day as placebo for 30 days . All BMS patients were review ed at 10-day intervals and scored for changes in symptomatology . RESULTS Significant improvements were shown in the symptomatology of BMS in up to two-thirds of patients with BMS receiving alpha-lipoic acid , in about 15 % of those using placebo and also in up to two-thirds of those who , having tried placebo , were switched to ALA BACKGROUND Alpha-lipoic acid ( ALA ) is a potent antioxidant mitochondrial coenzyme , trometamol salt of thioctic acid , shown in clinical studies to be neuroprotective and in a preliminary study to have an effect on the symptomatology of  Burning Mouth Syndrome ( BMS ) .  METHODS We were interested in extending our studies as to whether alpha-lipoic acid might improve the symptomatology in BMS and therefore carried out a larger open controlled clinical study on the effects of alpha-lipoic acid on BMS symptomatology . RESULTS We have examined the effects on 4 groups of 20 patients with BMS of ALA  , compared with bethanecol , Biotene and placebo , and found ALA of remarkable benefit with minimal adverse effects . CONCLUSIONS These results suggest that double-blind r and omized controlled multicenter studies of ALA are indicated Background Multiple Sclerosis ( MS ) is an inflammatory and demyelinating disease of the central nervous system . Oxidative stress plays a major role in the onset and progression of MS . Asymmetric dimethylarginine ( ADMA ) formation is dependent on oxidative stress status . Objective We examined whether alpha-lipoic acid ( ALA ) as a potent antioxidant could improve the Exp and ed Disability Status Scale ( EDSS ) and decrease plasma level of ADMA in multiple sclerosis patients . Methods In a r and omized , double-blinded clinical trial conducted at Sina Hospital in Tehran , Iran , from September 2009 to July 2011 , 24 patients with relapsing-remitting MS were divided into a treatment group receiving ALA ( 1200mg/day ) for 12 weeks and a control group receiving placebo . Then patients ’ EDSS and Plasma levels of ADMA were measured at baseline and 12 weeks later . Statistical analysis was done by SPSS software version 16 using the K-S test , Chi square , Mann – Whitney U-test and Wilcoxon test . Results The plasma levels of ADMA in the intervention group were decreased significantly ( p=0.04 ) . Also , no patient had increased EDSS score in the supplement group , where 2 out of 12 patients in the placebo group experienced so . Comparing the serum level of ADMA between the two groups failed to show any significant change in the supplement group compared with the control group . Conclusion Considering that ADMA is produced by oxidative stress in MS patients and leads to increase of inflammation , ALA may have the potential of beneficial effects in them , in part , by decreasing the plasma level of ADMA and stopping progression . Trial registration The trial was registered at the Iranian Registry of Clinical Trials ( http://www.i rct .ir ) with the I rct ID : No. I RCT 138812222602N2 . Funding The authors received no financial support for the research , authors hip , and /or publication of this article OBJECTIVE To evaluate effects of supplementation with alpha-lipoic acid ( ALA ) on the spermatogram and seminal oxidative stress biomarkers . DESIGN R and omized , triple-blind , placebo-controlled clinical trial . SETTING Infertility clinic . PATIENT(S ) Infertile men . INTERVENTION(S ) ALA ( 600 mg ) or placebo for 12 weeks . MAIN OUTCOME MEASURE(S ) Semen analysis , anthropometric , dietary , and physical activity assessment s , total antioxidant capacity , and malondialdehyde . RESULT ( S ) At the end of study , the total sperm count , sperm concentration , and motility in the intervention group were significantly higher than in the control group . In the ALA group , the total sperm count , sperm concentration , and motility levels were also significantly increased at the end of study compared with baseline values . However , there were no significant differences in ejaculate volume , normal morphology percentage , and live sperm between groups . ALA supplementation also result ed in a significant improvement in seminal levels of total antioxidant capacity ( TAC ) and malondialdehyde compared with the placebo . CONCLUSION ( S ) According to the results , medical therapy of asthenoteratospermia with ALA supplement could improve quality of semen parameters . However , further investigation is suggested in this regard . CLINICAL TRIAL REGISTRATION NUMBER I RCT 2013111010181N3 Background Chronic renal failure is a progressive and irreversible loss of kidney function , and the hemodialysis ( HD ) is one of the most common modalities in this regard . Oxidative stresses [ like interleukin-8 ( IL-8 ) and tumor necrosis factor-alpha ( TNF-α ) ] and inflammation are the main risk factors associated with cardiovascular diseases and other complications in many organs in hemodialysis patients ; meanwhile , antioxidants like alpha lipoic acid ( ALA ) may reduce the oxidative stress markers and the levels of inflammatory cytokines , so can improve of the patient ’s quality of life . Methods In this r and omized clinical trial study , 60 HD patients were r and omly categorized in two case and control groups . Case group received a daily capsule of 600 mg of ALA supplementation for 8 weeks , and the control group received placebo capsules daily . The serum level of IL-8 and TNF-α was measured in both groups before and after the intervention . Results There were no significant differences in age , gender , duration of dialysis , and causative factor for dialysis between both groups ( P > 0.05 ) . The mean of IL-8 and TNF-α after the intervention in case group was 26.20 ± 15.34 and 21.25 ± 9.61 , respectively ; the difference between both groups was not statistically significant ( P > 0.05 ) . Conclusion Based on the better feeling and other beneficial effects of ALA were found in our study ; we can conclude that it is a beneficial and recommended supplement , especially , for diabetic and dialysis patients Catheter ablation ( CA ) is a procedure commonly used to restore sinus rhythm in patients with atrial fibrillation ( AF ) . However , AF recurrence after CA remains a relevant clinical issue . We tested the effects of an oral antioxidant treatment ( alpha lipoic acid [ ALA ] ) on AF recurrence post-CA . Patients with paroxysmal AF have been enrolled in a r and omized , prospect i ve , double-blind , controlled placebo trial . After CA , patients have been r and omly assigned to receive ALA oral supplementation ( ALA group ) or placebo ( control group ) and evaluated at baseline and after a 12-month follow-up : 73 patients completed the 12-month follow-up  ( ALA : 33 and control : 40 ) . No significant difference has been detected between the 2 groups at baseline . Strikingly , 1 year after CA , ALA therapy significantly reduced serum markers of inflammation . However , there was no significant difference in AF recurrence events at follow-up comparing ALA with placebo group . Multivariate analysis revealed that the only independent prognostic risk factor for AF recurrence after CA is age . In conclusion , ALA therapy reduces serum levels of common markers of inflammation in ablated patients . Nevertheless , ALA does not prevent AF recurrence after an ablative treatment INTRODUCTION Increased oxidative stress , inflammation , and malnutrition are present in hemodialysis patients and these factors exacerbate cardiovascular comorbidities . Vitamin E and alpha-lipoic acid ( ALA ) may have a protective role against cardiovascular disease risk factors via anti-oxidative and anti-inflammatory properties . The aim of this study was to evaluate the effect of ALA and vitamin E administration ( alone or combined ) on hemodialysis-induced stress oxidation , inflammation , and malnutrition . MATERIAL S AND METHODS In a r and omized placebo-controlled trial , we examined the effects of 2-month supplementation by vitamin E and ALA ( alone or combined ) on biomarkers of lipid peroxidation ( malondialdehyde ) , inflammation ( high-sensitivity C-Reactive protein and interleukin-6 ) , and malnutrition ( Subjective Global Assessment and body mass index ) in 85 hemodialysis patients receiving ALA ( 600 mg ) , vitamin E ( 400 IU ) , ALA and vitamin E , and placebo .  RESULTS After supplementation , no significant changes were observed in malondialdehyde level ; however , there was a decrease in the ALA and vitamin E group during the period of the study . Also , a nonsignificant decrease was seen in the high-sensitivity C-Reactive protein concentration of the interventional groups . Supplementation of vitamin E with and without ALA significantly reduced interleukin-6 concentration . A significant improvement was observed in malnutrition status of all groups . CONCLUSIONS Vitamin E and ALA supplementation , especially their combination , might improve inflammation and malnutrition status , which suggest it as a potential preventive strategy against CVD among end-stage renal disease patients Clinical trial evidence exists that supports a role for the omega-3 polyunsaturated fatty acids in coronary heart disease prevention . However , the results from these clinical trials have varied and were conducted in diverse population groups using several different types of omega-3 polyunsaturated fatty acids , including eicosapentaenoic acid , docosahexaenoic acid , and alpha-linolenic acid ( ALA ) . Thus , we systematic ally review ed previously published reports assessing the different types of omega-3 polyunsaturated fatty acid interventions and cardiovascular outcomes . Fourteen r and omized clinical trials were included in the review . Six trials were included with fish oil , with 1 large trial ( 10,000 patients ) dominating the analysis . In aggregate , the fish oil trials demonstrated a reduction in total mortality and sudden death without a clinical ly significant reduction in nonfatal myocardial infa rct ion . The 6 trials with ALA supplements or an ALA-enriched diet were of poorer design than the fish oil trials and had limited power . Many of the trials with ALA involved other changes in dietary components . In aggregate , the ALA trials demonstrated possible benefits in reducing sudden death and nonfatal myocardial infa rct ion , but with wider confidence intervals than in the fish oil trials . In conclusion , the evidence suggests a role for fish oil ( eicosapentaenoic acid , docosahexaenoic acid ) or fish in secondary prevention because recent clinical trial data have demonstrated a significant reduction in total mortality , coronary heart disease death , and sudden death . The data on ALA have been limited by studies of smaller sample size and limited quality The aim of this study was to evaluate the efficacy of low-level laser therapy ( LLLT ) and alpha-lipoic acid ( ALA ) in the treatment of  burning mouth syndrome ( BMS ) and secondary oral burning ( SOB ) by unstimulated sialometry , symptom assessment , and measurement of salivary TNF-α levels . Forty-four patients were r and omized into four treatment groups : BMS/laser ( n = 10 ) , BMS/ALA ( n = 5 ) , SOB/laser ( n = 15 ) , and SOB/ALA ( n = 14 ) . The control group consisted of eight healthy female subjects . Unstimulated salivary flow was measured before and after treatment , and the collected saliva was stored at − 20 ° C for the analysis of TNF-α . Symptoms were evaluated before and after treatment using a pain visual analog scale . Most patients were women ( 81.8 % ) during menopause ( 72.2 % ) . LLLT and ALA were efficient in increasing salivary flow only in BMS but provided symptom relief in both conditions . TNF-α levels did not differ between patients with BMS and SOB or between those patients and the control group . No differences were observed in posttreatment TNF-α levels in either condition . The results of this study suggest that LLLT and ALA are efficient therapies in reducing burning mouth symptoms , with LLLT being more efficient than ALA Objective To create a data base of long-term r and omised controlled trials ( RCTs ) comparing higher with lower omega-3 , omega-6 or total polyunsaturated fatty acid ( PUFA ) , regardless of reported outcomes , and to develop methods to assess effects of increasing omega-6 , alpha-linolenic acid ( ALA ) , long-chain omega-3 ( LCn3 ) and total PUFA on health outcomes . Design Systematic review search , methodology and meta-analyses . Data sources Medline , Embase , CENTRAL , WHO International Clinical Trials Registry Platform , Clinical trials.gov and trials in relevant systematic review s. Eligibility criteria RCTs of ≥24 weeks ' duration assessing effects of increasing ALA , LCn3 , omega-6 or total PUFAs , regardless of outcomes reported . Data synthesis Methods included r and om-effects meta-analyses and sensitivity analyses . Funnel plots were examined , and subgrouping assessed effects of intervention type , replacement , baseline diabetes risk and use of diabetic medications , trial duration and dose . Quality of evidence was assessed using Grading of Recommendations Assessment , Development and Evaluation ( GRADE ) . Results Electronic search es generated 37 810 hits , de-duplicated to 19 772 titles and abstract s. We assessed 2155 full-text papers , conference abstract s and trials registry entries independently in duplicate . Included studies were grouped into 363 RCTs comparing higher with lower omega-3 , omega-6 and /or total PUFA intake of at least 6 months ’ duration —the Data base . Of these 363 included RCTs , 216 RCTs were included in at least one of our review s of health outcomes , data extracted and risk of bias assessed in duplicate . Ninety five RCTs were included in the Data base but not included in our current review s. Of these 311 completed trials , 27 altered ALA intake , 221 altered LCn3 intake and 16 trials altered omega-3 intake without specifying whether ALA or LCn3 . Forty one trials altered omega-6 and 59 total PUFA.The remaining 52 trials are ongoing though 13 ( 25 % ) appear to be outst and ing , or constitute missing data . Conclusions This extensive data base of trials is available to allow assessment of further health outcomes UNLABELLED Burning Mouth Syndrome ( BMS ) is a disease that manifests as burning in the tongue or in any area of the oral mucosa , in the absence of clinical ly verifiable injuries . OBJECTIVES To verify the efficacy of alpha lipoic acid ( ALA ) and gabapentin ( GABA ) , used individually and jointly , to reduce the burning in  patients with burning mouth and establish a drug therapy for the BMS . STUDY DESIGN During April and May 2008 , we conducted a r and omized , double-blind , placebo-controlled trial in the Department of Clinical Stomatology , Faculty of Dentistry , Rosario , Argentina . The gathering of patients was between those ones with BMS who were treated in our service between March 2003 and March 2008 without complying with the applied treatments . The 120 patients were r and omly divided into 4 groups and were provided , by lot and in a blinded fashion , with four different treatment cycles consisting of the following drugs : Group A ( n = 20 ) 600 mg / day of alpha lipoic acid for two months , Group B ( n = 20 ) 300 mg / day of gabapentin for two months , Group C ( n = 20 ) a combination of both drugs for two months and Group D ( n = 60 ) 100 mg / day of cellulose starch for two months ( control group ) . RESULTS AND CONCLUSIONS all 120 patients completed the treatment . The best response was obtained with the combination of ALA + GABA , with a 70 % of the cases with reduced burning in this group and a 13.2 times greater chance of presenting positive changes for these patients than those taking placebo . The combined use of drugs that act at different levels of the nociceptive system can be useful for the treatment of this syndrome Alpha-lipoic acid ( ALA ) , a naturally occuring compound and a radical scavenger was shown to enhance glucose transport and utilization in different experimental and animal models . Clinical studies described an increase of insulin sensitivity after acute and short-term ( 10 d ) parenteral administration of ALA . The effects of a 4-week oral treatment with alpha-lipoic acid were evaluated in a placebo-controlled , multicenter pilot study to determine see whether oral treatment also improves insulin sensitivity . Seventy-four patients with type-2 diabetes were r and omized to either placebo ( n = 19 ) ; or active treatment in various doses of 600 mg once daily ( n = 19 ) , twice daily ( 1200 mg ; n = 18 ) , or thrice daily ( 1800 mg ; n = 18 ) alpha-lipoic acid . An isoglycemic glucose-clamp was done on days 0 ( pre ) and 29 ( post ) . In this explorative study , analysis was done according to the number of subjects showing an improvement of insulin sensitivity after treatment . Furthermore , the effects of active vs. placebo treatment on insulin sensitivity was compared . All four groups were comparable and had a similar degree of hyperglycemia and insulin sensitivity at baseline . When compared to placebo , significantly more subjects had an increase in insulin-stimulated glucose disposal ( MCR ) after ALA treatment in each group . As there was no dose effect seen in the three different alpha-lipoic acid groups , all subjects receiving ALA were combined in the " active " group and then compared to placebo . This revealed significantly different changes in MCR after treatment ( + 27 % vs. placebo ; p < .01 ) . This placebo-controlled explorative study confirms previous observations of an increase of insulin sensitivity in type-2 diabetes after acute and chronic intravenous administration of ALA . The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes . The encouraging findings of this pilot trial need to be substantiated by further investigations UNLABELLED The burning mouth syndrome ( BMS ) is a chronic condition characterized by oral burning pain in the absence of clinical abnormalities and without established therapy . OBJECTIVES The purpose of this study was to evaluate the effectiveness of alpha lipoic acid ( ALA ) in the management of BMS symptoms through a r and omized double-blind placebo-controlled trial . METHODS Thirty-eight patients ( 34 women and four men , median age 62.9 years , range 36 - 78 ) were included and 31 completed the study . The patients were r and omized into two cycles of treatment : one with alpha lipoic acid and one with placebo both administered in identical capsules . These cycles were separated by a washout period of 20 days . The oral symptoms and the treatment response were assessed using a 100-mm visual analog scale before and after each cycle and the global perceived effect score , using a 5-point scale after each treatment cycle . RESULTS The level of reduction on burning was significant for both treatments ( paired t-test : P < 0.05 ; rp = 0.011 ; ral < 0.001 ) . Considering the two cycles together , 22 patients reported at least some improvement after ALA use and 23 patients after placebo . CONCLUSIONS Comparison of the oral assessment scores of the two cycles failed to demonstrate the effectiveness of ALA over placebo ( t-test : P > 0.05 ; r = 0.75 ) BACKGROUND Takotsubo syndrome is a stress cardiomyopathy , characterized by reversible left ventricle ( LV ) apical ballooning in the absence of significant angiographic coronary artery stenosis . The frequent association with emotional stress suggests in this disease an autonomic nervous system involvement . We could think that a therapeutic treatment targeting heart sympathetic dysfunction could be of crucial importance . METHODS From January 2010 to June 2012 , 886 patients were consecutively evaluated at Cardarelli Hospital , Naples , Italy . Among these , 48 patients met takotsubo cardiomyopathy ( TCM ) criteria . Each patient was assessed with history and physical examination , 12-lead electrocardiogram , serum troponin , coronary arteriography , and left ventricular angiogram , perfusion myocardial scintigraphy with technetium 99 m , with echocardiography and 123I-metaiodobenzylguanidine ( MIBG ) myocardial scintigraphy . At discharge , the surviving patients were r and omly assigned to α-lipoic acid ( ALA ) treatment ( 600 mg once daily ) or placebo . Following discharge , after the initial TCM event , patients returned to our outpatient clinic at Internal Medicine of the Second University Naples for the follow-up evaluation quarterly until 12 months . Routine analysis , myocardial damage serum markers , oxidative stress serum markers , pro-inflammatory cytokines , and sympathetic tone activity were evaluated in all patients . RESULTS ALA administration improved MIBG defect size at 12 months compared to placebo . CONCLUSIONS Adrenergic cardiac innervation dysfunction in TCM patients persists after previous experience of transient stress-induced cardiac dysfunction . ALA treatment improves the adrenergic cardiac innervation . This study evaluates whether sympatho-vagal alterations are TCM event-related Long-chain n-3 PUFA from fish oils are known to have anti-inflammatory effects . We evaluated the effect of alpha-linolenic acid ( ALA ) , precursor of n-3 fatty acids , on serum inflammatory markers and soluble cellular adhesion molecules ( sCAM ) of dyslipidaemic males , relative to their background diet . Participants were assigned to two groups , based upon food intake patterns : ( a ) twenty-one dyslipidaemic subjects who habitually ate a Mediterranean-Cretan-type diet ; ( b ) nineteen dyslipidaemic subjects who normally ate a Westernised Greek diet .  All were supplemented with 8.1 g ALA/d for 12 weeks . We determined serum amyloid A ( SAA ) , C-reactive protein ( CRP ) , macrophage colony-stimulating factor ( MCSF ) , IL-6 , soluble vascular cell adhesion molecule-1 ( sVCAM-1 ) , soluble intercellular adhesion molecule-1 and soluble E-selectin concentrations at the beginning and the end of the ALA supplementation period . Serum baseline concentrations of inflammatory markers and sCAM were similar across the diet groups . Type of diet had a significant impact on the response of inflammatory markers to ALA supplementation . The Westernised Greek diet group showed a reduction in SAA ( P<0.001 ) , CRP ( P=0.002 ) , MCSF ( P=0.005 ) and IL-6 ( P=0.04 ) concentrations . The Mediterranean-Cretan-type background diet group showed a significant reduction only in MCSF concentrations ( P=0.003 ) . The sVCAM-1 concentrations were significantly reduced in both the Westernised Greek diet group ( P=0.001 ) and the Mediterranean-Cretan-type diet group ( P<0.001 ) . The present study demonstrated that ALA supplementation lowered the serum concentrations of inflammatory markers more profoundly when the background diet was rich in saturated fatty acids and poor in MUFA OBJECTIVE Because alpha-lipoic acid ( ALA ) , a potent antioxidant , prevents or improves nerve conduction attributes , endoneurial blood flow , and nerve ( Na(+ ) K(+ ) ATPase activity in experimental diabetes and in humans and may improve positive neuropathic sensory symptoms , in this report we further assess the safety and efficacy of ALA on the Total Symptom Score ( TSS ) , a measure of positive neuropathic sensory symptoms . RESEARCH DESIGN AND METHODS Metabolically stable diabetic patients with symptomatic ( stage 2 ) diabetic sensorimotor polyneuropathy ( DSPN ) were r and omized to a parallel , double-blind study of ALA ( 600 mg ) ( n = 60 ) or placebo ( n = 60 ) infused daily intravenously for 5 days/week for 14 treatments . The primary end point was change of the sum score of daily assessment s of severity and duration of TSS . Secondary end points were sum scores of neuropathy signs ( NIS ) , symptoms ( NSC ) , attributes of nerve conduction , quantitative sensation tests ( QSTs ) , and an autonomic test . RESULTS At r and omization , the groups were not significantly different by the criteria of metabolic control or neuropathic end points . After 14 treatments , the TSS of the ALA group had improved from baseline by an average of 5.7 points and the placebo group by an average of 1.8 points ( P < 0.001 ) . Statistically significant improvement from baseline of the ALA , as compared with the placebo group , was also found for each item of the TSS ( lancinating and burning pain , asleep numbness and prickling ) , NIS , one attribute of nerve conduction , and global assessment of efficacy . CONCLUSIONS Intravenous racemic ALA , a potent antioxidant , rapidly and to a significant and meaningful degree , improved such positive neuropathic sensory symptoms as pain and several other neuropathic end points . This improvement of symptoms was attributed to improved nerve pathophysiology , not to increased nerve fiber degeneration . Because of its safety profile and its effect on positive neuropathic sensory symptoms and other neuropathic end points , this drug appears to be a useful ancillary treatment for the symptoms of diabetic polyneuropathy Background and purpose Nonalcoholic fatty liver disease ( NAFLD ) is one of the causes of a fatty liver , occurring when fat is deposited ( steatosis ) in the liver not due to excessive alcohol use . It is related to insulin resistance and the metabolic syndrome . The purpose of the present study was to evaluate the impact of combination therapy with alpha-lipoic acid ( ALA ) and ursodeoxycholic acid ( UDCA ) on NAFLD . Methods Alpha-lipoic acid 400 mg/day plus UDCA 300 mg/day ( ALAUDCA ) was investigated in patients over a period of 12 months using a r and omized , placebo (PLA)-controlled study with four parallel groups . Serum concentration of gamma-glutamyl transpeptidase ( GGT ) , alanine aminotransferase ( ALT ) , aspartate aminotransferase ( AST ) , albumin and platelets ( PLT ) were measured at the beginning and at the end of the treatment . Moreover , the AST/ALT ratio and the NAFLD fibrosis score were examined . Results A total of 120 patients were r and omly assigned to the four groups . ALA and UDCA were safe and well tolerated in the oral daily administration only . AST , ALT , GGT ( p < 0.001 ) showed a significant difference between ALAUDCA and other three groups . Besides , NAFLD fibrosis score underlined a significant reduction ( p < 0.04 ) in the ALAUDCA group , while AST/ALT ratio presented a moderate decline ( p > 0.05 ) . Conclusion ALAUDCA therapy reduced AST , ALT , GGT values and improved NAFLD fibrosis score and AST/ALT ratio , especially in patients who were on a hypocaloric diet . These findings will be useful in patient selection in future clinical trials with ALAUDCA in long-term studies OBJECTIVE Although increased oxidative stress and inflammation are highly prevalent in chronic kidney disease ( CKD ) , few studies have investigated whether oral antioxidant therapy can alter markers of inflammation or oxidative stress in patients with CKD . The purpose of this study was to investigate whether a combination of mixed tocopherols and alpha lipoic acid ( ALA ) would alter biomarkers of oxidative stress and inflammation in subjects with stage 3 to 4 CKD . METHODS This was a prospect i ve , r and omized , double-blind , placebo-controlled pilot trial . In all , 62 subjects were enrolled and were r and omly assigned to receive a combination of mixed tocopherols 666 IU/day , in addition to ALA 600 mg/day , or their matching placebos for a total of 8 weeks . Plasma F(2)-isoprostane and protein thiol concentration were measured as biomarkers of oxidative stress , and C-reactive protein and interleukin-6 concentration as biomarkers of systemic inflammation . RESULTS There were no significant differences in demographics , diabetic status , or estimated glomerular filtration rate between study treatment and placebo groups at baseline . Of the 62 r and omized subjects , 58 ( 93 % ) completed the study protocol . After 2 months of treatment , there were no significant changes in the concentrations of F(2)-isoprostanes , protein thiols , C-reactive protein , and interleukin-6 with respect to treatment with mixed tocopherols and ALA as compared with matching placebos , whether analyzed as intention to treat or as treated . Diabetic status and baseline body mass index did not influence the results . CONCLUSIONS Combination of oral mixed tocopherols and ALA treatment for 2 months does not influence biomarkers of oxidative stress and inflammation in patients with stage 3 to 4 CKD OBJECTIVE To examine the effects of alpha-lipoic acid ( ALA ) treatment over a period of 2 months on fasting blood glucose ( FBG ) , insulin resistance ( IR ) , and glutathione peroxidase ( GH-Px ) activity in type 2 diabetes ( T2DM ) patients . METHODS This study took place in Motahari Clinic , Shiraz , Iran , which is affiliated to Shiraz University of Medical Sciences from May to October 2006 . Type 2 DM patients ( n=57 ) were divided into 2 groups to receive either ALA ( 300 mg daily ) or placebo by systematic r and omization , and were followed-up for 8 weeks . After an overnight fasting and 2 hours after breakfast , patients ' blood sample s were drawn and tested for FBG , 2 hours  PPG , serum insulin level , and GH-Px activity .  RESULTS The result of the study showed a significant decrease in FBG and PPG levels , IR-Homeostasis Model Assessment ( IR-HOMA index ) and GH-Px level in the ALA group . The comparison of differences between FBG and IR at the beginning and at the end of study in the ALA treated group and the placebo group were also significant . CONCLUSION This study supports the use of ALA as an antioxidant in the care of diabetic patients The aim of this study was to follow up whether the modification of pro-antioxidant status by oral thiol administration such as N-acetylcysteine and alpha-lipoic acid affects the  hematological response . Twenty-eight healthy men participated in two independent experiments . Subjects were r and omly assigned to one of four groups : controls ( C(NAC ) and C(ALA ) ) , N-acetylcysteine ( NAC ) and alpha-lipoic acid ( ALA ) . 1200 mg of N-acetylcysteine , 600 mg of alpha-lipoic acid or placebo were administered for 8 days in two doses . NAC or ALA administration significantly elevated plasma total antioxidant status ( TAS ) and reduced protein carbonylation ( PC ) and lipid peroxidation ( TBARS ) by more than 30 % . The reduced glutathione ( GSH ) and hematological parameters changed only in response to NAC administration . NAC significantly elevated the level of GSH ( + 33 % ) , EPO ( + 26 % ) , Hb ( + 9 % ) and Hct ( + 9 % ) compared with C(NAC ) . The mean corpuscular volume ( MCV ) and the mean corpuscular hemoglobin ( MCH ) also increased by more than 12 % after NAC . The numerous negative or positive correlations between the measures of TAS , PC , TBARS and hematological parameters were found , which suggest the NAC-induced interaction between pro-antioxidant and hematological values . Our study has shown that both N-acetylcysteine and alpha-lipoic acid intake reveal an antioxidant action , but only N-acetylcysteine improves the haematological response Polyunsaturated fatty acid ( PUFA ) use in pregnancy has been promoted as beneficial for visual and neurobehavioural development in the fetus . However , no systematic review of the r and omized trials has been conducted . The objective of this review was to evaluate potential advantages of this regiment by review ing all r and omized trials in pregnancy . Methods . Systematic review of r and omized controlled studies comparing cognitive and visual achievements among infants whose mothers were treated and untreated with PUFA during gestation . Results . Nine studies met the inclusion criteria , three focusing on  visual and six on neurobehavioural development . Due to differing outcome measurements in the infants , the studies could not be combined into a formal meta- analysis . Synthesizing the existing data , for both visual and neurobehavioural development , most studies could not show sustained benefits to infant cognition or visual development . Conclusion . At the present time a recommendation to change practice and supplement all expecting mothers with PUFA  to improve offspring vision or neurobehavioural function is not supported by existing evidence
Conclusion In summary , the current meta- analysis demonstrated the promising impact of ALA administration on decreasing inflammatory markers such as CRP , IL-6 and TNF-α among patients with MetS and related disorders
Objective This systematic review and meta- analysis of r and omized controlled trials ( RCTs ) was conducted to determine the effect of alpha-lipoic acid ( ALA ) supplementation on the inflammatory markers among patients with metabolic syndrome ( MetS ) and related disorders .