Exploring the Role of Alpha Lipoic Acid in the Treatment of Traumatic Brain Injury: Pathways and Perspectives.

IF 3.6 3区医学 Q2 CLINICAL NEUROLOGY

Neurocritical Care Pub Date : 2025-10-13 DOI:10.1007/s12028-025-02383-1

Mazyar Ataei, Amirreza Peyrovinasab, Moloud Saleh, Hedieh Sadat Shamsnia, Leila Mohaghegh Shalmani, Amir Hossein Abdolghaffari

{"title":"Exploring the Role of Alpha Lipoic Acid in the Treatment of Traumatic Brain Injury: Pathways and Perspectives.","authors":"Mazyar Ataei, Amirreza Peyrovinasab, Moloud Saleh, Hedieh Sadat Shamsnia, Leila Mohaghegh Shalmani, Amir Hossein Abdolghaffari","doi":"10.1007/s12028-025-02383-1","DOIUrl":null,"url":null,"abstract":"Background: Traumatic brain injury (TBI) is known to be a critical health challenge with a significant number of hospital admissions. In addition to the primary injury and its complications, the secondary phase of the injury also causes numerous health issues. Neuroinflammation, oxidative stress (OS), and neuronal cell death are among the main outcomes of secondary injury. Although so far there are no drugs approved by the Food and Drug Administration for TBI's pharmacological treatment, numerous pharmaceutical compounds have been studied to help patients. Alpha lipoic acid (ALA), as a potent antioxidant agent, has been investigated for a considerable period.Methods: Eligible original studies written in English on the effects of ALA in TBI were collected from PubMed, Embase, Scopus, Web of Science, and Google Scholar for clinical, in vivo, and in vitro studies.Results: ALA is able to enter the blood-brain barrier due to its distinctive combination of hydrophilic and hydrophobic characteristics, enabling it to directly affect brain regions. It acts as a cofactor for enzymes in mitochondria, helping in oxidative carboxylation and replenishing other antioxidants like glutathione. This improves the glutathione/glutathione disulfide ratio during cellular stress, hence reducing cell death. In addition, ALA regulates oxidative, inflammatory, and apoptotic pathways by controlling the activity of caspase 3, caspase 9, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and inflammatory proteins, including tumor necrosis factor and inducible nitric oxide synthase. These methods highlight the potential of ALA in decreasing neuronal damage and OS in brain-related illnesses, including TBI.Conclusions: Based on this review, it can be concluded that ALA can potentially be administered as a therapeutic option for patients with TBI. However, more studies and trials are required to adjust the optimum dosing of ALA for the treatment of patients.","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurocritical Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12028-025-02383-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Traumatic brain injury (TBI) is known to be a critical health challenge with a significant number of hospital admissions. In addition to the primary injury and its complications, the secondary phase of the injury also causes numerous health issues. Neuroinflammation, oxidative stress (OS), and neuronal cell death are among the main outcomes of secondary injury. Although so far there are no drugs approved by the Food and Drug Administration for TBI's pharmacological treatment, numerous pharmaceutical compounds have been studied to help patients. Alpha lipoic acid (ALA), as a potent antioxidant agent, has been investigated for a considerable period.

Methods: Eligible original studies written in English on the effects of ALA in TBI were collected from PubMed, Embase, Scopus, Web of Science, and Google Scholar for clinical, in vivo, and in vitro studies.

Results: ALA is able to enter the blood-brain barrier due to its distinctive combination of hydrophilic and hydrophobic characteristics, enabling it to directly affect brain regions. It acts as a cofactor for enzymes in mitochondria, helping in oxidative carboxylation and replenishing other antioxidants like glutathione. This improves the glutathione/glutathione disulfide ratio during cellular stress, hence reducing cell death. In addition, ALA regulates oxidative, inflammatory, and apoptotic pathways by controlling the activity of caspase 3, caspase 9, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and inflammatory proteins, including tumor necrosis factor and inducible nitric oxide synthase. These methods highlight the potential of ALA in decreasing neuronal damage and OS in brain-related illnesses, including TBI.

Conclusions: Based on this review, it can be concluded that ALA can potentially be administered as a therapeutic option for patients with TBI. However, more studies and trials are required to adjust the optimum dosing of ALA for the treatment of patients.

查看原文本刊更多论文

α硫辛酸在创伤性脑损伤治疗中的作用：途径和观点。

背景：众所周知，创伤性脑损伤（TBI）是一种严重的健康挑战，入院人数很多。除了原发损伤及其并发症外，继发损伤也会引起许多健康问题。神经炎症、氧化应激（OS）和神经元细胞死亡是继发性损伤的主要结果。虽然到目前为止，食品和药物管理局还没有批准用于TBI的药物治疗，但已经研究了许多药物化合物来帮助患者。α硫辛酸（ALA）作为一种有效的抗氧化剂，已经被研究了相当长的时间。方法：从PubMed、Embase、Scopus、Web of Science和谷歌Scholar中收集符合条件的关于ALA在TBI中的作用的英文原创研究，进行临床、体内和体外研究。结果：ALA具有亲疏水特性，能够进入血脑屏障，直接作用于脑区。它作为线粒体酶的辅助因子，帮助氧化羧化，补充其他抗氧化剂，如谷胱甘肽。这提高谷胱甘肽/谷胱甘肽二硫比在细胞应激，从而减少细胞死亡。此外，ALA通过控制caspase 3、caspase 9、活化B细胞核因子κB轻链增强子（NF-κB）和炎性蛋白（包括肿瘤坏死因子和诱导型一氧化氮合酶）的活性，调节氧化、炎症和凋亡途径。这些方法强调了ALA在减少脑相关疾病（包括TBI）中的神经元损伤和OS方面的潜力。结论：基于这一综述，可以得出结论，ALA可以作为TBI患者的一种潜在治疗选择。然而，需要更多的研究和试验来调整ALA治疗患者的最佳剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Neurocritical Care 医学-临床神经学

CiteScore

7.40

自引率

8.60%

发文量

221

审稿时长

4-8 weeks

期刊介绍： Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.