Alpha-lipoic acid in pharmaceutical development: a comprehensive review of its therapeutic potential and molecular mechanisms

Authors

  • Oruç Yunusoğlu a:1:{s:5:"en_US";s:90:"1Department of Pharmacology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu";}
  • Esma Koyuncu Department of Pharmacology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey

DOI:

https://doi.org/10.56782/pps.456

Keywords:

alpha-lipoic acid, therapeutic potential, pharmacological activities, pharmacokinetics, pharmaceutical development

Abstract

Alpha-lipoic acid (ALA), also known as thioctic acid, is a lipid acid with strong biological activity synthesized from octanoic acid in prokaryotic and eukaryotic microorganisms, plants, and animals. It is gaining attention for its potential therapeutic benefits for a wide range of health problems. A comprehensive systematic literature review on ALA has been performed without temporal restrictions, utilizing the PubMed, Scopus, Embase, ScienceDirect, SciELO, and SciVerse databases. Different in vitro, in vivo, and clinical studies have demonstrated numerous potent pharmacological activities of ALA, including antioxidant, anti-inflammatory, antimicrobial, anti-Alzheimer’s, antiepileptic, antiparkinsonian, anxiolytic, effects on schizophrenia, neuroprotective, antidiabetic, antiallergic, anticancer, anti-osteoporosis, cardioprotective, hepatoprotective, anti-obesity, anti-aging, and effects on the reproductive system, etc. Although dietary supplements (tablets, capsules, etc.) containing ALA are available due to their various biological activities, there are no Food and Drug Administration (FDA) or European Medicines Agency (EMA)-approved over-the-counter (OTC) ALA drugs worldwide. Pharmacokinetically, ALA has an oral bioavailability of approximately 30% due to its brief blood half-life, significant presystemic clearance, and hepatic first-pass metabolism. However, the use of different innovative formulations has greatly enhanced ALA bioavailability. The data obtained show that ALA liquid formulations have higher plasma concentrations and therefore bioavailability compared to solid dosage forms. These innovative approaches hold promise for the development of improved ALA-based treatments across a broad spectrum of health conditions.

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References

1. Morikawa, T.; Yasuno, R.; Wada, H. Do mammalian cells synthesize lipoic acid? Identification of a mouse cDNA encoding a lipoic acid synthase located in mitochondria. FEBS Lett. 2001, 498(1), 16-21. DOI: 10.1016/S0014-5793(01)02469-3

2. Onder, N. T.; Alcay, S.; Nur, Z. Effects of alpha‐lipoic acid on ram semen cryopreservation and post‐thaw life span. Andrologia 2022, 54(1), Art. No: e14249. DOI: 10.1111/and.14249

3. Salehi, B.; Yılmaz, B.; Antika, G. Insights on the use of α-lipoic acid for therapeutic purposes. Biomolecules 2019, 9(8), Art. No: 356. DOI: 10.3390/biom9080356

4. Tibullo, D.; Li Volti, G.; Giallongo, C. Biochemical and clinical relevance of alpha lipoic acid: antioxidant and anti-inflammatory activity, molecular pathways and therapeutic potential. Inflamm. Res. 2017, 66, 947–959. DOI: 10.1007/s00011-017-1079-6

5. Nikolić, R. S.; Krstić, N. S.; Nikolić, G. M. Molecular mechanisms of beneficial effects of lipoic acid in copper intoxicated rats assessment by FTIR and ESI-MS. Polyhedron 2014, 80, 223-227. DOI: 10.1016/j.poly.2014.04.033

6. Baumgartner, M. R.; Schmalle, H.; Dubler, E. The interaction of transition metals with the coenzyme α-lipoic acid: synthesis, structure and characterization of copper and zinc complexes. Inorganica Chim. Acta. 1996, 252, 319-331. DOI: 10.1016/S0020-1693(96)05331-5

7. Uchida, R.; Okamoto, H.; Ikuta, N. Enantioselective pharmacokinetics of α-lipoic acid in rats. Int. J. Mol. Sci. 2015, 16, 22781-22794. DOI: 10.3390/ijms160922781

8. Devasagayam, T. P.; Subramanian, M.; Sies, H. Prevention of singlet oxygen-induced DNA damage by lipoate. Chem. Biol. Interact. 1993, 86, 79-92. DOI: 10.1016/0009-2797(93)90113-D

9. Tripathi, A. K.; Ray, A. K.; Mishra, S. K. Molecular and therapeutic insights of alpha-lipoic acid as a potential molecule for disease prevention. Rev. Bras. Farmacogn. 2023, 33, 272–287. DOI: 10.1007/s43450-023-00370-1

10. Rezaei, Z. S.; Hasani, M.; Morvaridzadeh, M. Effect of alpha-lipoic acid on oxidative stress parameters: a systematic review and meta-analysis. J. Funct. Foods 2021, 87, Art. No: 104774. DOI: 10.1016/j.jff.2021.104774

11. Monastra, G.; De Grazia, S.; Unfer, V. Immunomodulatory activities of alpha lipoic acid with a special focus on its efficacy in preventing miscarriage. Expert Opin. Drug Deliv. 2016, 13, 1695-1708. DOI: 10.1080/17425247.2016.1200556

12. Cremer, D. R.; Rabeler, R.; Lynch, B. Safety evaluation of α-lipoic acid (ALA). Regul. Toxicol. Pharmacol. 2006, 46, 29-41. DOI: 10.1016/j.yrtph.2006.06.004

13. Ou, P.; Tritschler, H. J.; Wolff, S. P. Thioctic (lipoic) acid: a therapeutic metal-chelating antioxidant? Biochem. Pharmacol. 1995, 50, 123-126. DOI: 10.1016/0006-2952(95)00116-H

14. Spector, A.; Huang, R. R.; Wang, R. R. Thioredoxin fragment 31-36 is reduced by dihydrolipoamide and reduces oxidized protein. Biochem. Biophys. Res. Commun. 1988, 150, 156-162. DOI: 10.1016/0006-291X(88)90499-8

15. Guseva, E. A.; Pavlova, J. A.; Sergiev, P. V. Synthetic activators of autophagy. Biochem. Mosc. 2024, 89, 27–52. DOI: 10.1134/S0006297924010024

16. Pavlova, J. A.; Guseva, E. A.; Sergiev, P. V. Natural activators of autophagy. Biochem. Mosc. 2024, 89, 1–26. DOI: 10.1134/S0006297924010012

17. Bossio, S.; Perri, A.; Gallo, R. Alpha-lipoic acid reduces cell growth, inhibits autophagy, and counteracts prostate cancer cell migration and invasion: evidence from in vitro studies. Int. J. Mol. Sci. 2023, 24, Art. No: 17111. DOI: 10.3390/ijms242317111

18. Peng, P.; Zhang, X.; Qi, T. Alpha‐lipoic acid inhibits lung cancer growth via mTOR‐mediated autophagy inhibition. FEBS. Open Bio. 2020, 10, 607–618. DOI: 10.1002/2211-5463.12820

19. Stoll, S.; Hartmann, H.; Cohen, S. A. The potent free radical scavenger α-lipoic acid improves memory in aged mice: putative relationship to NMDA receptor deficits. Pharmacol. Biochem. Behav. 1993, 46, 799-805. DOI: 10.1016/0091-3057(93)90204-7

20. Stoll, S.; Rostock, A.; Bartsch, R. The potent free radical scavenger α‐lipoic acid improves cognition in rodents. Ann. N. Y. Acad. Sci. 1994, 717, 122-128. DOI: 10.1111/j.1749-6632.1994.tb12079.x

21. Xu, C.; Li, E.; Liu, S. Effects of α-lipoic acid on growth performance, body composition, antioxidant status and lipid catabolism of juvenile Chinese mitten crab Eriocheir sinensis fed different lipid percentage. Aquaculture 2018, 484, 286-292. DOI: 10.1016/j.aquaculture.2017.09.036

22. Lovell, M. A.; Xie, C.; Xiong, S. Protection against amyloid beta peptide and iron/hydrogen peroxide toxicity by alpha lipoic acid. J. Alzheimer’s Dis. 2003, 5, 229-239. DOI: 10.3233/JAD-2003-5306

23. Fiedler, S. E.; Yadav, V.; Kerns, A. R. Lipoic acid stimulates cAMP production in healthy control and secondary progressive MS subjects. Mol. Neurobiol. 2018, 55, 6037-6049. DOI: 10.1007/s12035-017-0813-y

24. Scumpia, P. O.; Stevens, B. R. Alpha-lipoic acid effects on brain glial functions accompanying double-stranded RNA antiviral and inflammatory signaling. Neurochem. Int. 2014, 64, 55-63. DOI: 10.1016/j.neuint.2013.11.006

25. Micili, S. C.; Goker, A.; Kuscu, K. α-lipoic acid vaginal administration contrasts inflammation and preterm delivery in rats. Reproductive Sci. 2019, 26, 128-138. DOI: 10.1177/1933719118766266

26. Suh, J. H.; Shenvi, S. V.; Hagen, T. M. Decline in transcriptional activity of Nrf2 causes age-related loss of glutathione synthesis, which is reversible with lipoic acid. Proc. Natl. Acad. Sci. USA. 2004, 101, 3381-3386. DOI: 10.1073/pnas.0400282101

27. Kozlov, A. V.; Gille, L.; Staniek, K. Dihydrolipoic acid maintains ubiquinone in the antioxidant active form by two-electron reduction of ubiquinone and one-electron reduction of ubisemiquinone. Arch. Biochem. Biophys. 1999, 363, 148-154. DOI: 10.1006/abbi.1998.1064

28. Chen, W. L.; Kang, C. H.; Lee, H. M. α-lipoic acid regulates lipid metabolism through induction of Sirtuin 1 (SIRT1) and activation of AMP-activated protein kinase. Diabetologia 2012, 55, 1824-1835. DOI: 10.1007/s00125-012-2530-4

29. Smith, A. R.; Shenvi, S. V.; Widlansky, M. Lipoic acid as a potential therapy for chronic diseases associated with oxidative stress. Curr. Med. Chem. 2012, 11, 1135-1146. DOI: 10.2174/0929867043365387

30. Zhang, W. J.; Bird, K. E.; Frei, B. Dietary α-lipoic acid supplementation inhibits atherosclerotic lesion development in apolipoprotein e-deficient and apolipoprotein e/low-density lipoprotein receptor-deficient mice. Circulation 2008, 117, 421-428. DOI: 10.1161/CIRCULATIONAHA.107.725275

31. Packer, L.; Witt, E. H.; Tritschler, H. J. Alpha-lipoic acid as a biological antioxidant. Free Radic. Biol. Med. 1995, 19, 227-250. DOI: 10.1016/0891-5849(95)00017-R

32. Abdulghani, M.; Naser, A. Estimation of pharmacokinetic parameters of alpha-lipoic acid in the chicks model. Baghdad J. Biochem. Appl. Biol. Sci. 2022, 3, 122-132. DOI: 10.47419/bjbabs.v3i02.91

33. Hagen, T. M.; Ingersoll, R. T.; Ames, B. N. (R)‐α‐Lipoic acid‐supplemented old rats have improved mitochondrial function, decreased oxidative damage, and increased metabolic rate. The FASEB Journal 1999, 13, 411-418. DOI: 10.1096/fasebj.13.2.411

34. Murali, P.; George, S. K.; Dominic, G. Effect of dietary supplementation of l-carnitine on serum lipid profile and antioxidant status in broiler chicken fed with animal fat-rich diet. Appl. Biol. Res. 2020, 22, 118-122. DOI: 10.5958/0974-4510.2020.00018.9

35. Banik, S.; Halder, S.; Onoue, S. Self-emulsifying drug delivery system of (R)-α-lipoic acid to improve its stability and oral absorption. Biopharm. Drug Dispos. 2021, 42, 226-233. DOI: 10.1002/bdd.2277

36. Brufani, M. α-lipoic acid: drug or dietary supplement? An overview on the pharmacokinetics, available for-mulations and clinical evidence in the diabetes complications. Progress in Nutrition 2014, 16, 62-74. DOI: 10.23751/pn.v19i1.6325

37. Hermann, R.; Mungo, J.; Ziegler, D. Enantiomer-selective pharmacokinetics, oral bioavailability, and sex effects of various alpha-lipoic acid dosage forms. Clin. Pharmacol. 2014, 6, 195–204. DOI: 10.2147/CPAA.S71574

38. Bustamante, J.; Lodge, J. K.; Marcocci, L. α-lipoic acid in liver metabolism and disease. Free Radic. Biol. Med. 1998, 24, 1023-1039. DOI: 10.1016/S0891-5849(97)00371-7

39. Wepierre, J.; Corroller, M.; Dupuis, D. In vivo cutaneous distribution of linoleic acid following topical application in the hairless rat. J. Soc. Cosmet. Chem. Jpn. 1986, 37, 191-198.ISSN: 0037-9832

40. Wepierre, J.; Corroller, M.; Didry, J. R. Distribution and dissociation of benzoyl peroxide in cutaneous tissue after application on skin in the hairless rat. Int. J. Cosmet Sci. 1986, 8, 97-104. DOI: 10.1111/j.1467-2494.1986.tb00437.x

41. Podda, M.; Rallis, M.; Traber, M. G. Kinetic study of cutaneous and subcutaneous distribution following topical application of [7,8-14C]rac-α-lipoic acid onto hairless mice. Biochem. Pharmacol. 1996, 52, 627-633. DOI: 10.1016/0006 2952(96)00337-1

42. Teichert, J.; Hermann, R.; Preiss, R. Plasma kinetics, metabolism, and urinary excretion of alpha-lipoic acid following oral administration in healthy volunteers. J. Clin. Pharmacol. 2003, 43, 1257-1267. DOI: 10.1177/0091270003258654

43. Angelucci, L.; Mascitelli-Coriandoli, E. Anticholesterol activity of α-lipoic acid. Nature 1958, 182, 911-912. DOI: 10.1038/182396b0

44. Brufani, M.; Figliola, R. (R)-α-lipoic acid oral liquid formulation: pharmacokinetic parameters and therapeutic efficacy. Acta Biomed. 2014, 85, 108-115.

45. Teichert, J.; Tuemmers, T.; Achenbach, H. Pharmacokinetics of alpha-lipoic acid in subjects with severe kidney damage and end-stage renal disease. J. Clin. Pharmacol. 2005, 45, 313-328. DOI: 10.1177/0091270004270792

46. Akünal, T. C.; Yunusoğlu, O. Oleanolic acid suppresses pentylenetetrazole-induced seizure in vivo. Int. J. Environ. Health. Res. 2023, 33, 529–540. DOI: 10.1080/09603123.2023.2167947

47. Berköz, M.; Yunusoğlu, O.; Bozkurt, A. Investigation of antiepileptic potentials of usnic acid and some lichen species on the behavioral and biochemical levels in pentylenetetrazole-induced kindling model of epilepsy. J. Res. Pharm. 2024, 28, 1378–1390. DOI: 10.29228/jrp.816

48. Yunusoğlu, O.; Ayaz, İ.; Dovankaya, E.H. Pharmacological, medicinal and biological properties of flavonoids: A comprehensive review. J. Res. Pharm. 2025, 29(2), 561-584. DOI: 10.12991/jrespharm.1661054

49. Sevindik, M.; Krupodorova, T.; Sevindik, E. Elaeagnus angustifolia L.: A comprehensive review of its biological activities, phenolic and chemical constituents, and applications. Appl. Fruit Sci. 2025, 67(2), Art. No: 70. DOI: 10.1007/s10341-025-01294-x

50. Lasota, M.; Jankowski, D.; Wiśniewska, A. Interaction of avapritinib with congo red in pancreatic cancer cells: molecular modeling and biophysical studies. Int. J. Mol. Sci. 2025, 26(5), Art. No: 1980. DOI: 10.3390/ijms26051980

51. Shay, K. P.; Moreau, R. F.; Smith, E. J. Alpha-lipoic acid as a dietary supplement: molecular mechanisms and therapeutic potential. Biochim. Biophys. Acta. Gen. Subj. 2009, 1790, 1149–1160. DOI: 10.1016/j.bbagen.2009.07.026

52. Peng, P.; Zhang, X.; Qi, T. Alpha‐lipoic acid inhibits lung cancer growth via mTOR‐mediated autophagy inhibition. FEBS Open Bio. 2020, 10, 607–618. DOI: 10.1002/2211-5463.12820

53. Hassan, A.; Ibrahim, A.; Mbodji, K. An α-linolenic acid-rich formula reduces oxidative stress and inflammation by regulating NF-κB in rats with TNBS-induced colitis. J. Nutr. 2010, 140, 1714-1721. DOI: 10.3945/jn.109.119768

54. Kütter, M. T.; Monserrat, J. M.; Primel, E. G. Effects of dietary α-lipoic acid on growth, body composition and antioxidant status in the plata pompano Trachinotus Marginatus (Pisces, Carangidae). Aquaculture 2012, 368–369, 29–35. DOI: 10.1016/j.aquaculture.2012.09.010

55. Cruz, L. C.; Josende, M. E.; Tavares, P. B. Lipoic acid modulates energetic metabolism and antioxidant defense systems in Litopenaeus vannamei under hypoxia/reoxygenation conditions. Aquaculture 2018, 497, 396–404. DOI: 10.1016/j.aquaculture.2018.08.020

56. He, M.; Wu, Y.; Hong, M. α-Lipoic acid treatment alleviates postharvest pericarp browning of litchi fruit by regulating antioxidant ability and energy metabolism. Postharvest Biol. Technol. 2021, 180, Art. No: 111629. DOI: 10.1016/j.postharvbio.2021.111629

57. Turk, H.; Erdal, S.; Karayel, U. Attenuation of lead toxicity by promotion of tolerance mechanism in wheat roots by lipoic acid. Cereal Res. Commun. 2018, 46, 424–435. DOI: 10.1556/0806.46.2018.020

58. Monserrat, J. M.; Garcia, M. L.; Ventura-Lima, J. Antioxidant, phase II and III responses induced by lipoic acid in the fish Jenynsia multidentata (Anablapidae) and its influence on endolsulfan accumulation and toxicity. Pesticide Biochem. Physiol. 2014, 108, 8–15. DOI: 10.1016/j.pestbp.2013.10.009

59. Zhao, G.; Hu, C.; Xue, Y. In vitro evaluation of chitosan‐coated liposome containing both coenzyme Q10 and alpha‐lipoic acid: cytotoxicity, antioxidant activity, and antimicrobial activity. J. Cosmet. Dermatol. 2018, 17, 258–262. DOI: 10.1111/jocd.12369

60. Piechota-Polanczyk, A.; Zielińska, M.; Fichna, J. The influence of lipoic acid on caveolin-1-regulated antioxidative enzymes in the mouse model of acute ulcerative colitis. Biomed. Pharmacother 2016, 84, 470-475. DOI: 10.1016/j.biopha.2016.09.066

61. Bhattacharyya, A.; Chattopadhyay, R.; Crowe, S. E. Oxidative stress: an essential factor in the pathogenesis of gastrointestinal mucosal diseases. Physiol. Rev. 2014, 94, 329-354. DOI: 10.1152/physrev.00040.2012

62. Packer, L.; Kraemer, K.; Rimbach, G. Molecular aspects of lipoic acid in the prevention of diabetes complications. Nutrition 2001, 17, 888-895. DOI: 10.1016/S0899-9007(01)00658-X

63. Sezgin, A.; Altuntaş, C.; Demiralay, M. Exogenous alpha lipoic acid can stimulate photosystem II activity and the gene expressions of carbon fixation and chlorophyll metabolism enzymes in maize seedlings under drought. J. Plant Physiol. 2019, 232, 65–73. DOI: 10.1016/j.jplph.2018.11.026

64. Biewenga, G. P.; Dorstijn, M. A.; Verhagen, J. V. Reduction of lipoic acid by lipoamide dehydrogenase. Biochem. Pharmacol. 1996, 51, 233-238. DOI: 10.1016/0006-2952(95)02124-8

65. Tan, W.; Zhang, J.; Mi, Y. Synthesis and characterization of α-lipoic acid grafted chitosan derivatives with antioxidant activity. React. Funct. Polym. 2022, 172, 583–592 DOI: 10.1016/j.reactfunctpolym.2022.105205

66. El Basuini, M. F.; Shahin, S. A.; Eldenary, M. E. Growth variables, feed efficacy, survival rate, and antioxidant capacity of european seabass (Dicentrarchus labrax l.) larvae treated with coenzyme Q10 or lipoic acid. Aquac. Rep. 2022, 27, Art. No: 101373. DOI: 10.1016/j.aqrep.2022.101373

67. Huang, C.; Sun, J.; Ji, H. Influence of dietary alpha-lipoic acid and lipid level on the growth performance, food intake and gene expression of peripheral appetite regulating factors in juvenile grass carp (Ctenopharyngodon idellus). Aquaculture 2019, 505, 412–422. DOI: 10.1016/j.aquaculture.2019.02.054

68. Biewenga, G. P.; Bast, A. The pharmacology of the antioxidant: lipoic acid. Gen. Pharmacol. 1997, 29, 315-331. DOI: 10.1016/S0306-3623(96)00474-0

69. Lopez-Maldonado, A.; Pastoriza, S.; Rufián-Henares, J. Á. Assessing the antioxidant and metabolic effect of an alpha-lipoic acid and acetyl-L-carnitine nutraceutical. Curr. Res. Food Sci. 2021, 4, 336-344. DOI: 10.1016/j.crfs.2021.05.002

70. Singer, A. J.; Clark, R. A. F. Cutaneous wound healing. N. Engl. J. Med. 1999, 341, 738–746. DOI: 10.1056/NEJM199909023411006

71. Leu, J.G.; Chen, S.A.; Chen, H.M. The effects of gold nanoparticles in wound healing with antioxidant epigallocatechin gallate and α-lipoic acid. Nanomedicine 2012, 8, 767–775. DOI: 10.1016/j.nano.2011.08.013

72. Alleva, R.; Tomasetti, M.; Sartini, D. α-Lipoic acid modulates extracellular matrix and angiogenesis gene expression in non-healing wounds treated with hyperbaric oxygen therapy. Mol. Med. 2008, 14, 175-183. DOI: 10.2119/2007-00095.Alleva

73. Salinthone, S.; Schillace, R. V.; Marracci, G. H. Lipoic acid stimulates cAMP production via the EP2 and EP4 prostanoid receptors and inhibits IFN gamma synthesis and cellular cytotoxicity in NK cells. J. Neuroimmunol. 2008, 199, 46-55. DOI: 10.1016/j.jneuroim.2008.05.003

74. Tanaka, Y.; Kaibori, M.; Miki, H. Alpha-lipoic acid exerts a liver-protective effect in acute liver injury rats. J. Surg. Res. 2015, 193, 675-683. DOI: 10.1016/j.jss.2014.08.057

75. Mor, G.; Cardenas, I.; Abrahams, V. Inflammation and pregnancy: the role of the immune system at the implantation site. Ann. N. Y. Acad. Sci. 2011, 1221, 80-87. DOI: 10.1111/j.1749-6632.2010.05938.x

76. Bao, P.; Kodra, A.; Tomic-Canic, M. The role of vascular endothelial growth factor in wound healing. J. Surg. Res. 2009, 153, 347-358. DOI: 10.1016/j.jss.2008.04.023

77. Gora̧ca, A.; Piechota, A.; Kleniewska, P. Lipoic acid - biological activity and therapeutic potential. Pharmacol. Rep. 2011, 63, 849-858. DOI: 10.1016/S1734-1140(11)70600-4

78. Collins, T.; Maniatis, T. Transcriptional regulation of endothelial cell adhesion molecules: NF-kappa B and cytokine-inducible enhancers. FASEB. J. 1995, 9, 899-909. DOI: 10.1096/fasebj.9.10.7542214

79. Zhang, W. J.; Frei, B. α‐lipoic acid inhibits TNF‐a‐induced NF‐κB activation and adhesion molecule expression in human aortic endothelial cells. FASEB. J. 2001, 15, 2423-2432. DOI: 10.1096/fj.01-0260com

80. Weber, C.; Erl, W.; Pietsch, A. Aspirin inhibits nuclear factor-κB mobilization and monocyte adhesion in stimulated human endothelial cells. Circulation 1995, 91, 1914-1917. DOI: 10.1161/01.CIR.91.7.1914

81. Albelda, S. M.; Smith, C. W.; Ward, P. A. Adhesion molecules and inflammatory injury. FASEB. J. 1994, 8, 504-512. DOI: 10.1096/fasebj.8.8.8181668

82. Yadav, V.; Marracci, G.; Lovera, J. Lipoic acid in multiple sclerosis: a pilot study. Mult. Scler. 2005, 11, 159-165. DOI: 10.1191/1352458505ms1143oa

83. Ziegler, Dan. Thioctic acid for patients with symptomatic diabetic polyneuropathy: a critical review. Treat Endocrinol. 2004, 3, 173-189. DOI: 10.2165/00024677-200403030-00005

84. Melhem, A.; Stern, M.; Shibolet, O. Treatment of chronic hepatitis C virus infection via antioxidants. J. Clin. Gastroenterol 2005, 39, 737–742. DOI: 10.1097/01.mcg.0000174023.73472.29

85. Jesudason, E. P.; Masilamoni, J. G.; Jayakumar, R. The protective role of DL-α-lipoic acid in the oxidative vulnerability triggered by Aβ-amyloid vaccination in mice. Mol. Cell. Biochem 2005, 270, 29–37. DOI: 10.1007/s11010-005-3301-z

86. Guha, M.; Mackman, N. The phosphatidylinositol 3-kinase-akt pathway limits lipopolysaccharide activation of signaling pathways and expression of inflammatory mediators in human monocytic cells. J. Biol. Chem. 2002, 277, 32124–32132. DOI: 10.1074/jbc.M203298200

87. Fukao, T.; Koyasu, S. PI3K and negative regulation of TLR signaling. Trends Immunol. 2003, 24, 358–363. DOI: 10.1016/S1471-4906(03)00139-X

88. Alhakamy, N. A.; Al-Rabia, M. W.; Asfour, H. Z. 2-Methoxy-estradiol loaded alpha lipoic acid nanoparticles augment cytotoxicity in MCF-7 breast cancer cells. Dose Response 2021, 19(4), Art. No: 15593258211055023. DOI: 10.1177/15593258211055023

89. Campoccia, D.; Montanaro, L.; Arciola, C. R. The significance of infection related to orthopedic devices and issues of antibiotic resistance. Biomaterials 2006, 27, 2331-2339. DOI: 10.1016/j.biomaterials.2005.11.044

90. Choi, M. J.; Kim, S. A.; Rhee, M. S. New decontamination method based on caprylic acid in combination with citric acid or vanillin for eliminating Cronobacter sakazakii and Salmonella enterica serovar typhimurium in reconstituted infant formula. Int. J. Food Microbiol. 2013, 166, 499-507. DOI: 10.1016/j.ijfoodmicro.2013.08.016

91. Abdelmoneim, D.; Porter, G.; Duncan, W. Three-dimensional evaluation of the cytotoxicity and antibacterial properties of alpha lipoic acid-capped silver nanoparticle constructs for oral applications. Nanomaterials 2023, 13, Art. No: 705. DOI: 10.3390/nano13040705

92. Iversen, C.; Waddington, M.; Forsythe, S. Identification and phylogeny of Enterobacter sakazakii relative to Enterobacter and Citrobacter species. J. Clin. Microbiol. 2004, 42, 5368-5370. DOI: 10.1128/JCM.42.11.5368-5370.2004

93. Hajtuch, J.; Wojcik, M.; Tomczyk, E. Lipoic acid-coated silver nanoparticles: biosafety potential on the vascular microenvironment and antibacterial properties. Front. Pharmacol. 2022, 12., Art. No: 733743 DOI: 10.3389/fphar.2021.733743

94. Martínez, G. K.; Zertuche, A. T.; Iñiguez, E. Radical scavenging, hemocompatibility, and antibacterial activity against MDR Acinetobacter baumannii in alginate-based aerogels containing lipoic acid-capped silver nanoparticles. ACS Omega 2024, 9, 2350-2361. DOI: 10.1021/acsomega.3c06114

95. Wright, E. J.; Brew, B. J.; Wesselingh, S. L. Pathogenesis and diagnosis of viral infections of the nervous system. Neurol. Clin. 2008, 26, 617-633. DOI: 10.1016/j.ncl.2008.03.006

96. Cure, E.; Cumhur Cure, M. Alpha-lipoic acid may protect patients with diabetes against COVID-19 infection. Med. Hypotheses 2020, 143, Art. No: 110185. DOI: 10.1016/j.mehy.2020.110185

97. Koufaki, M.; Detsi, A.; Kiziridi, C. Multifunctional lipoic acid conjugates. Curr. Med. Chem. 2009, 16, 4728-4742. DOI: 10.2174/092986709789878274

98. Spisakova, M.; Cizek, Z.; Melkova, Z. Ethacrynic and α-lipoic acids inhibit vaccinia virus late gene expression. Antiviral Res. 2009, 81, 156–165. DOI: 10.1016/j.antiviral.2008.11.001

99. Zhang, W.; Chen, X.; Yu, F. α-lipoic acid exerts its antiviral effect against viral hemorrhagic septicemia virus (VHSV) by promoting upregulation of antiviral genes and suppressing VHSV-induced oxidative stress. Virol. Sin. 2021, 36, 1520–1531. DOI: 10.1007/s12250-021-00440-5

100. Baur, A.; Harrer, T.; Peukert, M. Alpha-lipoic acid is an effective inhibitor of human immuno-deficiency virus (HIV-1) replication. Klin. Wochenschrift 1991, 69, 722-724. DOI: 10.1007/BF01649442

101. Ray, P. D.; Huang, B.W.; Tsuji, Y. Reactive oxygen species (ROS) homeostasis and redox regulation in cellular signaling. Cell Signal. 2012, 24, 981–990. DOI: 10.1016/j.cellsig.2012.01.008

102. Huang, W.J.; Zhang, X.; Chen, W.W. Role of oxidative stress in Alzheimer’s disease. Biomed. Rep. 2016, 4, 519–522. DOI: 10.3892/br.2016.630

103. Iqbal, K.; Grundke-Iqbal, I. Alzheimer neurofibrillary degeneration: significance, etiopathogenesis, therapeutics and prevention: Alzheimer review series. J. Cell Mol. Med. 2008, 12, 38-55. DOI: 10.1111/j.1582-4934.2008.00225.x

104. Rubio-Perez, J. M.; Morillas-Ruiz, J. M. A review: inflammatory process in alzheimer’s disease, role of cytokines. Sci. World J. 2012, 2012, Art. No: 756357. DOI: 10.1100/2012/756357

105. Sano, M.; Ernesto, C.; Thomas, R. G. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for alzheimer’s disease. N. Engl. J. Med. 1997, 336, 1216-1222. DOI: 10.1056/nejm199704243361704

106. Dinicola, S.; Proietti, S.; Cucina, A. Alpha-lipoic acid downregulates IL-1β and IL-6 by DNA hypermethylation in SK-N-BE neuroblastoma cells. Antioxidants 2017, 6, Art. No: 74. DOI: 10.3390/antiox6040074

107. Jia, Z.; Hallur, S.; Zhu, H. Potent upregulation of glutathione and NAD(P)H: quinone oxidoreductase 1 by alpha-lipoic acid in human neuroblastoma SH-SY5Y cells: protection against neurotoxicant-elicited cytotoxicity. Neurochem. Res. 2008, 33, 790-800. DOI: 10.1007/s11064-007-9496-5

108. Cacciatore, I.; Marinelli, L.; Fornasari, E. Novel NSAID-derived drugs for the potential treatment of alzheimer’s disease. Int. J. Mol. Sci. 2016, 17, Art. No: 1035. DOI: 10.3390/ijms17071035

109. Allahverdiyev, O.; Dzhafar, S.; Berköz, M. Advances in current medication and new therapeutic approaches in epilepsy. Eastern J. Med. 2018, 23, 48–59. DOI: 10.5505/ejm.2018.62534

110. Büget, B.; Türkmen, A. Z.; Allahverdiyev, O. Antimuscarinic-induced convulsions in fasted animals after food intake: evaluation of the effects of levetiracetam, topiramate and different doses of atropine. Naunyn-Schmiedebergs Arch. Pharmacol. 2016, 389, 57–62. DOI: 10.1007/s00210-015-1175-5

111. Martinc, B.; Grabnar, I.; Vovk, T. The role of reactive species in epileptogenesis and influence of antiepileptic drug therapy on oxidative stress. Curr. Neuropharmacol. 2012, 10, 328-343. DOI: 10.2174/157015912804143504

112. Javaid, M. S.; Antonic-Baker, A.; Pitsillou, E. Alpha-lipoic acid analogues in the regulation of redox balance in epilepsy: a molecular docking and simulation study. J. Mol. Graph Model 2022, 112, Art. No: 108116. DOI: 10.1016/j.jmgm.2021.108116

113. Sagmanligil, H.; Yunusoglu, O.; Catalkaya, E. Investigation of the pharmacological, behavioral and biochemical effects of boron on rats with rotenone-induced parkinson’s disease. Cell Mol. Biol. 2022, 68, 13–21. DOI: 10.14715/cmb/2022.68.8.3

114. Kaygısız, M.; Gürer, E. S. Determination of the antimicrobial, antioxidant activities and effects on oxidative DNA damage of extracts from three different Salvia species grown in Turkey. Prospects Pharm. Sci. 2025, 23(1), 1-8. DOI: 10.56782/pps.300

115. Xicoy, H.; Wieringa, B.; Martens, G. J. M. The role of lipids in Parkinson’s disease. Cells 2019, 8, Art. No: 27. DOI: 10.3390/cells8010027

116. Zheng, Q.; Ma, P.; Yang, P. Alpha lipoic acid ameliorates motor deficits by inhibiting ferroptosis in Parkinson’s disease. Neurosci. Lett. 2023, 810, Art. No: 137346. DOI: 1016/j.neulet.2023.137346

117. Piersimoni, M. E.; Teng, X.; Ying, L. Antioxidant lipoic acid ligand-shell gold nanoconjugates against oxidative stress caused by α-synuclein aggregates. Nanoscale Adv. 2020, 2, 5666–5681. DOI: 10.1039/D0NA00688B

118. Tai, S.; Zheng, Q.; Zhai, S. Alpha-lipoic acid mediates clearance of iron accumulation by regulating iron metabolism in a parkinson’s disease model induced by 6-OHDA. Front. Neurosci. 2020, 14, Art. No: 612. DOI: 10.3389/fnins.2020.00612

119. Li, X.; Zou, Y.; Xing, J. A-lipoic acid alleviates folic acid-induced renal damage through inhibition of ferroptosis. Front. Physiol. 2021, 12. Art. No: 680544 DOI: 10.3389/fphys.2021.680544

120. Abdin, A. A.; Sarhan, N. I. Intervention of mitochondrial dysfunction-oxidative stress-dependent apoptosis as a possible neuroprotective mechanism of α-lipoic acid against rotenone-induced parkinsonism and l-dopa toxicity. Neurosci. Res. 2011, 71, 387–39. DOI: 10.1016/j.neures.2011.08.008

121. Pei, X.; Hu, F.; Hu, Z. Neuroprotective effect of α-lipoic acid against Aβ25–35-induced damage in BV2 cells. Molecules 2023, 28, Art. No: 1168. DOI: 10.3390/molecules28031168

122. Sahin, M.; Sagdıc, G.; Elmas, O. Effect of chronic restraint stress and alpha-lipoic acid on lipid peroxidation and antioxidant enzyme activities in rat peripheral organs. Pharmacol. Res. 2006, 54, 247–252. DOI: 10.1016/j.phrs.2006.05.007

123. Liu, J.; Wang, X.; Mori, A. Immobilization stress-induced antioxidant defense changes in rat plasma: effect of treatment with reduced glutathione. Int. J. Biochem. 1994, 26, 511-517. DOI: 10.1016/0020-711X(94)90008-6

124. Akotkar, L.; Aswar, U.; Patil, R. Antidepressant effect of alpha lipoic acid in rats exposed to chronic unpredictable mild stress: putative role of neurotransmitters and 5HT3 receptor. Future Pharmacol. 2023, 3, 407–425. DOI: 10.3390/futurepharmacol3020025

125. Sampaio, L. R.; Cysne Filho, F. M.; Vasconcelos, S. M.; Advantages of the alpha-lipoic acid association with chlorpromazine in a model of schizophrenia induced by ketamine in rats: behavioral and oxidative stress evidences. Neuroscience 2018, 373, 72–81. DOI: 10.1016/j.neuroscience.2018.01.008

126. Mansur, R. B.; Cha, D. S.; Asevedo, E. Selfish brain and neuroprogression in bipolar disorder. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2013, 43, 66-71. DOI: 10.1016/j.pnpbp.2012.12.004

127. Kim, M. S.; Park, J. Y.; Namkoong, C. Anti-obesity effects of α-lipoic acid mediated by suppression of hypothalamic AMP-activated protein kinase. Nat. Med. 2004, 10, 727-733. DOI: 10.1038/nm1061

128. Kim, E.; Park, D. W.; Choi, S. H. A preliminary investigation of α-lipoic acid treatment of antipsychotic drug-induced weight gain in patients with schizophrenia. J. Clin. Psychopharmacol. 2008, 28, 138-146. DOI: 10.1097/JCP.0b013e31816777f7

129. Sampaio, L. R.; Borges, L. T.; Barbosa, T. M. Electroencephalographic study of chlorpromazine alone or combined with alpha-lipoic acid in a model of schizophrenia induced by ketamine in rats. J. Psychiatr. Res. 2017, 86, 73–82. DOI: 10.1016/j.jpsychires.2016.12.003

130. Farr, S. A.; Poon, H. F.; Drake, J. The antioxidants α‐lipoic acid and N ‐acetylcysteine reverse memory impairment and brain oxidative stress in aged SAMP8 mice. J. Neurochem. 2003, 84, 1173–1183. DOI: 10.1046/j.1471-4159. 2003.01580.x

131. Memudu, A. E.; Adanike, R. P. Alpha lipoic acid reverses scopolamine-induced spatial memory loss and pyramidal cell neurodegeneration in the prefrontal cortex of wistar rats. IBRO. Neurosci. Rep. 2022, 13, 1–8. DOI: 10.1016/j.ibneur.2022.05.005

132. Liu, B.; Ma, X.; Guo, D. Neuroprotective effect of alpha-lipoic acid on hydrostatic pressure-induced damage of retinal ganglion cells in vitro. Neurosci. Lett. 2012, 526, 24–28. DOI: 10.1016/j.neulet.2012.08.016

133. Han, D.; Sen, C. K.; Roy, S. Protection against glutamate-induced cytotoxicity in C6 glial cells by thiol antioxidants. Am. J. Physiol. Regul. Integr. Comp. Physiol. 1997, 273, 1771–1778. DOI: 10.1152/ajpregu.1997.273.5.R1771

134. Sun, H.; Yao, W.; Tang, Y. Urinary exosomes as a novel biomarker for evaluation of α-lipoic acid’s protective effect in early diabetic nephropathy. J. Clin. Lab. Anal. 2017, 31(6), Art. No: e22129. DOI: 10.1002/jcla.22129

135. Lin, H.; Ye, S.; Xu, J. The alpha-lipoic acid decreases urinary podocalyxin excretion in type 2 diabetics by inhibiting oxidative stress in vivo. J. Diabetes Complicat. 2015, 29, 64–67. DOI: 10.1016/j.jdiacomp.2014.09.011

136. Wang, L.; Tang, Y.; Eisner, W. Augmenting podocyte injury promotes advanced diabetic kidney disease in Akita mice. Biochem. Bioph. Res. Commun. 2014, 444, 622-627. DOI: 10.1016/j.bbrc.2014.01.115

137. Gui, D.; Guo, Y.; Wang, F. Astragaloside IV, a novel antioxidant, prevents glucose-induced podocyte apoptosis in vitro and in vivo. PLoS One 2012, 7, Art. No: e39824. DOI: 10.1371/journal.pone.0039824

138. Jacob, S.; Streeper, R. S., Fogt, D. L. The antioxidant α-lipoic acid enhances insulin-stimulated glucose metabolism in insulin-resistant rat skeletal muscle. Diabetes 1996, 45, 1024-1029. DOI: 10.2337/diabetes.45.8.1024

139. Khamaisi, M.; Potashnik, R.; Tirosh, A. Lipoic acid reduces glycemia and increases muscle GLUT4 content in streptozotocin-diabetic rats. Metabolism 1997, 46, 763-768. DOI: 10.1016/S0026-0495(97)90120-7

140. Nagamatsu, M.; Nickander, K. K.; Schmelzer, J. D. Lipoic acid improves nerve blood flow, reduces oxidative stress, and improves distal nerve conduction in experimental diabetic neuropathy. Diabetes Care 1995, 18, 1160-1167. DOI: 10.2337/diacare.18.8.1160

141. Papanas, N.; Ziegler, D. Efficacy of α-lipoic acid in diabetic neuropathy. Expert. Opin. Pharmacother. 2014, 15, 2721–2731. DOI: 10.1517/14656566.2014.972935

142. Jain, S. K.; Lim, G. Lipoic acid decreases lipid peroxidation and protein glycosylation and increases (Na+ + K+) and Ca++ATPase activities in high glucose-treated human erythrocytes. Free Radic. Biol. Med. 2000, 29, 1122-1128. DOI: 10.1016/S0891-5849(00)00410-X

143. Ziegler, D.; Hanefeld, M.; Ruhnau, K. J. Treatment of symptomatic diabetic polyneuropathy with the antioxidant α-lipoic acid: a 7-month multicenter randomized controlled trial (ALADIN III study). Diabetes Care 1999, 22, 1296-1301. DOI: 10.2337/diacare.22.8.1296

144. Mervaala, E.; Finckenberg, P.; Lapatto, R. Lipoic acid supplementation prevents angiotensin II-induced renal injury. Kidney Int. 2003, 64, 501-508. DOI: 10.1046/j.1523-1755.2003.00108.x

145. Melhem, M. F.; Craven, P. A.; DeRubertis, F. R. Effects of dietary supplementation of α-lipoic acid on early glomerular injury in diabetes mellitus. J. Am. Soc. Nephrol. 2001, 12, 124-133. DOI: 10.1681/asn.v121124

146. Dinçer, Y.; Telci, A.; Kayali, R. Effect of α-lipoic acid on lipid peroxidation and anti-oxidant enzyme activities in diabetic rats. Clin. Exp. Pharmacol. Physiol. 2002, 29, 281-284. DOI: 10.1046/j.1440-1681.2002.03642.x

147.Maritim, A. C.; Sanders, R. A.; Watkins, J. B. Effects of α-lipoic acid on biomarkers of oxidative stress in streptozotocin-induced diabetic rats. J. Nutr. Biochem. 2003, 14, 288-294. DOI: 10.1016/S0955-2863(03)00036-6

148. Bhatti, F.; Mankhey, R. W.; Asico, L. Mechanisms of antioxidant and pro-oxidant effects of α-lipoic acid in the diabetic and nondiabetic kidney. Kidney Int. 2005, 67, 1371-1380. DOI: 10.1111/j.1523-1755.2005.00214.x

149. Manaviat M.; Rashidi M.; Shoja RM. Prevalence of dry eye syndrome and diabetic retinopathy in type 2 diabetic patients. BMC. Ophthalmol. 2008, 8, Art. No: 10. DOI: 10.1186/1471-2415-8-10

150. Alvarez-Rivera F.; Fernández-Villanueva D.; Concheiro A. α-Lipoic acid in Soluplus(®) polymeric nanomicelles for ocular treatment of diabetes-associated corneal diseases. J. Pharm. Sci. 2016, 105, 2855–2863. DOI: 10.1016/j.xphs.2016.03.006

151. Pawankar, R. Allergic diseases and asthma: a global public health concern and a call to action. World Allergy Organ. J. 2014, 7, Art. No: 12. DOI: 10.1186/1939-4551-7-12

152. Druce, H. M. Allergic Rhinitis. JAMA. 1988, 259, Art. No: 260. DOI: 10.1001/jama.1988.03720020062038

153. Choi, Y. H.; Chai, O. H.; Han, E.H. Lipoic acid suppresses compound 48/80-induced anaphylaxis-like reaction. Anat. Cell. Biol. 2010, 43, Art. No: 317. DOI: 10.5115/acb.2010.43.4.317

154. Small, P., and Kim, H. Allergic rhinitis. Allergy, Asthma Clin. Immunol. 2011, 7(Suppl.1), Art. No: S3. DOI: 10.1186/1710-1492-7-S1-S3

155. Van Nguyen, T.; Piao, C. H.; Fan, Y. J. Anti-allergic rhinitis activity of α-lipoic acid via balancing Th17/Treg expression and enhancing Nrf2/HO-1 pathway signaling. Sci. Rep. 2020, 10, Art. No: 12528. DOI: 10.1038/s41598-020-69234-1

156. Zhao, H.; Zhao, X.; Liu, L. Neurochemical effects of the R form of α-lipoic acid and its neuroprotective mechanism in cellular models of parkinson’s disease. Int. J. Biochem. Cell Biol. 2017, 87, 86–94. DOI: 10.1016/j.biocel.2017.04.002

157. Sen, C. K.; Roy, S.; Packer, L. Fas mediated apoptosis of human jurkat T-cells: intracellular events and potentiation by redox-active α-lipoic acid. Cell Death Differ. 1999, 6, 481-491. DOI: 10.1038/sj.cdd.4400514

158. Wenzel, U.; Nickel, A.; Daniel, H. α-Lipoic acid induces apoptosis in human colon cancer cells by increasing mitochondrial respiration with a concomitant O2− generation. Apoptosis 2005, 10, 359–368. DOI: 10.1007/s10495-005-0810-x

159. Schwartz, L.; Abolhassani, M.; Guais, A. A combination of alpha lipoic acid and calcium hydroxycitrate is efficient against mouse cancer models: preliminary results. Oncol. Rep. 2010, 23, 1407-1416. DOI: 10.3892/or_00000778

160. Ahmadi, A.; Hosseini, F.; Soukhtanloo, M. Anticancer effects of alpha-lipoic acid, a potent organosulfur compound by modulating matrix metalloproteinases and apoptotic markers in osteosarcoma MG-63 cells. J. Steroid Biochem. Mol. Biol. 2025, 247, Art. No: 106664. DOI: 10.1016/j.jsbmb.2024.106664

161. Jeon, M. J.; Kim, W. G.; Lim, S. Alpha lipoic acid inhibits proliferation and epithelial mesenchymal transition of thyroid cancer cells. Mol. Cell Endocrinol. 2016, 419, 113–123. DOI: 10.1016/j.mce.2015.10.005

162.Na, M. H.; Seo, E. Y.; Kim, W. K. Effects of α-lipoic acid on cell proliferation and apoptosis in MDA-MB-231 human breast cells. Nutr. Res. Pract. 2009, 3, Art. No: 265. DOI: 10.4162/nrp.2009.3.4.265

163. Kuban-Jankowska, A.; Gorska-Ponikowska, M.; Wozniak, M. Lipoic acid decreases the viability of breast cancer cells and activity of PTP1B and SHP2. Anticancer Res. 2017, 37, 2893-2898. DOI: 10.21873/anticanres.11642

164. Zhang, W. J.; Wei, H.; Frei, B. α-Lipoic acid attenuates LPS-induced inflammatory responses by activating the phosphoinositide 3-kinase/Akt signaling pathway. Proc. Natl. Acad. Sci. 2007, 104, 4077–4082. DOI: 10.1073/pnas.0700305104

165. Faverani, L. P.; Polo, T. O.; Ramalho-Ferreira, G. Raloxifene but not alendronate can compensate the impaired osseointegration in osteoporotic rats. Clin. Oral Investig. 2018, 22, 255-265.

166. Koh, J. M.; Lee, Y. S.; Byun, C. H. α-Lipoic acid suppresses osteoclastogenesis despite increasing the receptor activator of nuclear factor κB ligand/osteoprotegerin ratio in human bone marrow stromal cells. J. Endocrinol. 2005, 185, 401-413. DOI: 10.1677/joe.1.05995

167. Lin, Z.; Guichun, Z.; Lifeng, L. Protective effect of α-lipoic acid against antimycin a cytotoxicity in MC3T3-E1 osteoblastic cells. Cell Stress Chaperones 2017, 22, 5–13. DOI: 10.1007/s12192-016-0735-z

168. Cheng, M.; Wang, Q.; Fan, Y. A traditional Chinese herbal preparation, er-zhi-wan, prevent ovariectomy-induced osteoporosis in rats. J. Ethnopharmacol. 2011, 138, 279–285. DOI: 10.1016/j.jep.2011.09.030

169. Vivanco, I.; Sawyers, C. L. The phosphatidylinositol 3-kinase–AKT pathway in human cancer. Nat. Rev. Cancer 2002, 2, 489–501. DOI: 10.1038/nrc839

170. Fu, C.; Xu, D.; Wang, C. Y. Alpha-lipoic acid promotes osteoblastic formation in H2O2-treated MC3T3-E1 cells and prevents bone loss in ovariectomized rats. J. Cell Physiol. 2015, 230, 2184-2201. DOI: 10.1002/jcp.24947

171. Xiao, Y.; Cui, J.; Le, G. Lipoic acid increases the expression of genes involved in bone formation in mice fed a high-fat diet. Nutr. Res. 2011, 31, 309–317. DOI: 10.1016/j.nutres.2011.03.013

172. Abdelhalim, M. A.; Qaid, H. A.; Ghannam, M. M. The protective roles of vitamin E and α-lipoic acid against nephrotoxicity, lipid peroxidation, and inflammatory damage induced by gold nanoparticles. Int. J. Nanomed. 2020, 15, 729–734. DOI: 10.2147/IJN.S192740

173. Ossipov, D. A. Bisphosphonate-modified biomaterials for drug delivery and bone tissue engineering. Expert Opin Drug. Deliv. 2015, 12, 1443–1458. DOI: 10.1517/17425247.2015.1021679

174. Gao, W.; Li, J. J.; Shi, J. Ångstrom-scale gold particles loaded with alendronate via alpha-lipoic acid alleviate bone loss in osteoporotic mice. J. Nanobiotechnology 2024, 22, Art. No: 212. DOI: 10.1186/s12951-024-02466-9

175. Lu, S.Y.; Wang, C.Y.; Jin, Y. The osteogenesis-promoting effects of alpha-lipoic acid against glucocorticoid-induced osteoporosis through the NOX4, NF-kappaB, JNK and PI3K/AKT pathways. Sci. Rep. 2017, 7, Art. No: 3331. DOI: 10.1038/s41598-017-03187-w

176. Wollin, S. D.; Wang, Y.; Jones, P. J. Effects of a medium chain triglyceride oil mixture and α-lipoic acid diet on body composition, antioxidant status, and plasma lipid levels in the golden syrian hamster. J. Nutr. Biochem. 2004, 15, 402–410. DOI: 10.1016/j.jnutbio.2003.12.001

177. Bai, J.; Chen, C.; Sun, Y. α-LA attenuates microcystin-LR-induced hepatocellular oxidative stress in mice through Nrf2-mediated antioxidant and detoxifying enzymes. Toxicon. 2023, 235, Art. No: 107313. DOI: 10.1016/j.toxicon.2023.107313

178. Zhang, L.; Zou, J.; Chai, E. Alpha-lipoic acid attenuates cardiac hypertrophy via downregulation of PARP-2 and subsequent activation of SIRT-1. Eur. J. Pharmacol. 2014, 744, 203–210. DOI: 10.1016/j.ejphar.2014.09.037

179. Quinn, M. T.; Parthasarathy, S.; Steinberg, D. Oxidatively modified low density lipoproteins: a potential role in recruitment and retention of monocyte/macrophages during atherogenesis. Proc. Natl. Acad. Sci. USA. 1987, 84, 2995-2998. DOI: 10.1073/pnas.84.9.2995

180. Meneses, L. N.; Vasconcelos, G. S.; Da Silva Medeiros, I. Neuroprotective evidence of alpha-lipoic acid and desvenlafaxine on memory deficit in a neuroendocrine model of depression. Naunyn Schmiedebergs Arch. Pharmacol. 2018, 391, 803-817. DOI: 10.1007/s00210-018-1509-1

181. Berköz, M.; Aslan, A.; Yunusoğlu, O. Hepatoprotective potentials of Usnea longissima Ach. and Xanthoparmelia somloensis (gyelnik) hale extracts in ethanol-induced liver injury. Drug Chem. Toxicol. 2025, 48, 136–149. DOI: 10.1080/01480545.2024.2407867

182. Ceylanlı, D.; Şehirli, A. Ö.; Gençosman, S.; Teralı, K.; Şah, H.; Gülmez, N.; Sayıner, S. Protective Effects of Alpha-Lipoic Acid against 5-Fluorouracil-Induced Gastrointestinal Mucositis in Rats. 2022, 11, Art. No:. 1930. DOI: 10.3390/antiox11101930

183. Babu, S.; Manoharan, S.; Perumal, E. Role of oxidative stress-mediated cell death and signaling pathways in experimental fluorosis. Chem. Biol. Interact. 2022, 365, Art. No: 110106. DOI: 10.1016/j.cbi.2022.110106

184. Elshazly, S. M.; El-Moselhy, M. A.; Barakat, W. Insights in the mechanism underlying the protective effect of α-lipoic acid against acetaminophen-hepatotoxicity. Eur. J. Pharmacol. 2014, 726, 116–123. DOI: 10.1016/j.ejphar.2014.01.042

185. Keith, D. J.; Butler, J. A.; Bemer, B. Age and gender dependent bioavailability of R- and S-α-lipoic acid: a pilot study. Pharmacol. Res. 2012, 66, 199-206. DOI: 10.1016/j.phrs.2012.05.002

186. Guzel, E. E.; Kaya, N.; Ozan, G. The investigation of effect of alpha lipoic acid against damage on neonatal rat lung to maternal tobacco smoke exposure. Toxicol. Rep. 2018, 5, 714–722. DOI: 10.1016/j.toxrep.2018.05.014

187. Yunusoglu, O.; Türkmen, Ö.; Berkoz, M. In vitro anti-obesity effect of aloe vera extract through transcription factors and lipolysis-associated genes. Eastern J. Med. 2022, 27, 519–528. DOI: 10.5505/ejm.2022.13285

188. Romo-Hualde, A.; Huerta, A. E.; González-Navarro, C. J. Untargeted metabolomic on urine samples after

α-lipoic acid and/or eicosapentaenoic acid supplementation in healthy overweight/obese women. Lipids Health Dis. 2018, 17, Art. No: 103. DOI: 10.1186/s12944-018-0750-4

189. Namazi, N.; Larijani, B.; Azadbakht, L. Alpha-lipoic acid supplement in obesity treatment: a systematic review and meta-analysis of clinical trials. Clin. Nutr. 2018, 37, 419–428. DOI: 10.1016/j.clnu.2017.06.002

190. Dajnowicz-Brzezik, P.; Żebrowska, E.; Maciejczyk, M. The effect of α-lipoic acid on oxidative stress in adipose tissue of rats with obesity-induced insulin resistance. Cell Physiol. Biochem. 2022, 56, 239–253. DOI: 10.33594/000000528

191. McNeilly, A. M.; Davison, G. W.; Murphy, M. H. Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance. Lipids Health Dis. 2011, 10(1), Art. No: 217. DOI: 10.1186/1476-511X-10-217

192. Arivazhagan, P.; Ramanathan, K.; Panneerselvam, C. Effect of DL-α-lipoic acid on the status of lipid peroxidation and antioxidants in mitochondria of aged rats. J. Nutr. Biochem. 2001, 12, 2–6. DOI: 10.1016/S0955-2863(00)00138-8

193. Yawalkar, N. Drug hypersensitivity. Acta. Clin. Belg. 2009, 64, 529–533. DOI: 10.1179/acb.2009.090

194. Gomaa, A. M.; Abd El-Mottaleb, N. A.; Aamer, H. A. Antioxidant and anti-inflammatory activities of alpha lipoic acid protect against indomethacin-induced gastric ulcer in rats. Biomed. Pharmacother. 2018, 101, 188–194. DOI: 10.1016/j.biopha.2018.02.070

195. Brownlee, M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001, 414, 813-820. DOI: 10.1038/414813a

196. Azevedo, Í. M.; Lima, M. L.; Moreira, M. D. Effects of simvastatin on 5-fluorouracil-induced gastrointestinal mucositis in rats. Rev. Col. Bras. Cir. 2018, 45(5), 22–32. DOI: 10.1590/0100-6991e-20181968

197. Kleniewska, P.; Pawliczak, R. The influence of apocynin, lipoic acid and probiotics on antioxidant enzyme levels in the pulmonary tissues of obese asthmatic mice. Life Sci. 2019, 234, Art. No: 116780. DOI: 10.1016/j.lfs.2019.116780

198. Mims, J. W. Asthma: definitions and pathophysiology. Int. Forum Allergy Rhinol. 2015, 5, 2-6. DOI: 10.1002/alr.21609

199. Sook Cho, Y.; Lee, J.; Lee, T.H. α-Lipoic acid inhibits airway inflammation and hyperresponsiveness in a mouse model of asthma. J. Allergy Clin. Immunol. 2004, 114, 429–435. DOI: 10.1016/j.jaci.2004.04.004

200. Dhar, D.; Baglieri, J.; Kisseleva, T. Mechanisms of liver fibrosis and its role in liver cancer. Exp. Biol. Med. 2020, 245, 96-108. DOI: 10.1177/1535370219898141

201. El-Senousey, H. K.; Chen, B.; Wang, J. Y. Effects of dietary vitamin C, vitamin E, and alpha-lipoic acid supplementation on the antioxidant defense system and immune-related gene expression in broilers exposed to oxidative stress by dexamethasone. Poultry Sci. 2018, 97, 30–38. DOI: 10.3382/ps/pex298

202. Morini, M.; Roccatagliata, L.; Dell’Eva, R. α-Lipoic acid is effective in prevention and treatment of experimental autoimmune encephalomyelitis. J. Neuroimmunol. 2004, 148, 146–153. DOI: 10.1016/j.jneuroim.2003.11.021

203. Li, Y.; Ma, Q.G.; Zhao, L.H. Effects of lipoic acid on immune function, the antioxidant defense system, and inflammation-related genes expression of broiler chickens fed aflatoxin contaminated diets. Int. J. Mol. Sci. 2014, 15, 5649–5662. DOI: 10.3390/ijms15045649

204. Prathima, P.; Venkaiah, K.; Reddy, M. H. Antioxidant effects of α-lipoic acid against epididymal oxidative damage in adult offspring rats exposed to maternal hypothyroidism stress. Reprod. Toxicol. 2024, 125. Art. No: 108555. DOI: 10.1016/j.reprotox.2024.108555

205. Sastre, J.; Pallardó, F. V.; Plá, R. Aging of the liver: age-associated mitochondrial damage in intact hepatocytes. Hepatology 1996, 24, 1199-1205. DOI: 10.1002/hep.510240536

206. Jungwirth, A.; Giwercman, A.; Tournaye, H. European association of urology guidelines on male infertility: the 2012 update. Eur. Urol. 2012, 62, 324–332. DOI: 10.1016/j.eururo.2012.04.048

207. Gharagozloo, P.; Aitken, R. J. The role of sperm oxidative stress in male infertility and the significance of oral antioxidant therapy. Hum. Reprod. 2011, 26, 1628–1640. DOI: 10.1093/humrep/der132

208. Ibrahim, S. F.; Osman, K.; Das, S. A Study of the antioxidant effect of alpha lipoic acids on sperm quality. Clinics 2008, 63, 545–550. DOI: 10.1590/S1807-59322008000400022

209. Di Tucci, C.; Galati, G.; Mattei, G. The role of alpha lipoic acid in female and male infertility: a systematic review. Gynecol. Endocrinol. 2021, 37, 497–505. DOI: 10.1080/09513590.2020.1843619

210. Asci, H.; Erol, O.; Ellidag, H. Y. Pathology of cigarettes on the reproductive system and ameliorative effects of alpha lipoic acid: a rat model study. Toxicol. Ind. Health 2018, 34, 385–395. DOI: 10.1177/0748233718755160

211. Genazzani, A. D.; Prati, A.; Marchini, F. Differential insulin response to oral glucose tolerance test (OGTT) in overweight/obese polycystic ovary syndrome patients undergoing to myo-inositol (MYO), alpha lipoic acid (ALA), or combination of both. Gynecol. Endocrinol. 2019, 35, 1088–1093. DOI: 10.1080/09513590.2019.1640200

212. Fruzzetti, F.; Benelli, E.; Fidecicchi, T. Clinical and metabolic effects of alpha-lipoic acid associated with two different doses of myo-inositol in women with polycystic ovary syndrome. Int. J. Endocrinol. 2020, 2020, Art. No: 2901393. DOI: 10.1155/2020/2901393

213. Fruzzetti, F.; Capozzi, A.; Lello, S. Treatment with d-chiro-inositol and alpha lipoic acid in the management of polycystic ovary syndrome. Gynecol. Endocrinol. 2019, 35, 506–510. DOI: 10.1080/09513590.2018.1540573

214. Emir, D. F.; Ozturan, I. U.; Yilmaz, S. Alpha lipoic acid intoxication: an adult. Am. J. Emerg. Med. 2018, 36, 1125.e3-1125.e5. DOI: 10.1016/j.ajem.2018.03.022

215. Vidović, B.; Milovanović, S.; Stefanović, A. Effects of alpha-lipoic acid supplementation on plasma adiponectin levels and some metabolic risk factors in patients with schizophrenia. J. Med. Food 2017, 20, 79-85. DOI: 10.1089/jmf.2016.0070

216. Schuff-Werner, P.; Pönisch, W.; Kaiser, T. Transient Howell-Jolly-body-like cytoplasmic inclusions in neutrophils after severe intoxication with alpha-lipoic acid. Scand. J. Clin. Lab. Invest. 2021, 81, 8–11. DOI: 10.1080/00365513.2020.1855468

217. Gatti, M.; Ippoliti, I.; Poluzzi, E. Assessment of adverse reactions to α-lipoic acid containing dietary supplements through spontaneous reporting systems. Clin. Nutr. 2021, 40, 1176–1185. DOI: 10.1016/j.clnu.2020.07.028

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2025-08-17

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Alpha-lipoic acid in pharmaceutical development: a comprehensive review of its therapeutic potential and molecular mechanisms. (2025). Prospects in Pharmaceutical Sciences, 23(4), 67-86. https://doi.org/10.56782/pps.456

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