Székely E.1, Tasnádi GY.1, Pallai ZS.2, Kurucz T.2, Rapavi E.3, Bor M.1, Pusztai Á.1, Blázovics A.3
1Central Hospital of the Hungarian State Railways, 2Diachem Kft., 3Semmelweis University, Budapest, Hungary
Alpha-lipoic acid a coenzyme of pyruvate and alpha-ketoglutarate dehydrogenase, is unique in its ability to act as a fat-and water-soluble antioxidant in tissues in both its oxidized and reduced forms, therefore it is considered to be an ideal antioxidant. It is readily absorbed from an oral dose. This natural cofactors has long been suggested to improve glucose oxidation. Therapeutic application of it was justified in diabetic polyneuropathy, cataracts, glaucoma, ischaemia-reperfusion injury, and Amanita mushroom poisoning. Our aim was to establish the effectiveness of alpha-lipoic acid on the porphyria cutanea tarda (PCT). PCT is disorder of hem biosynthesis resulting from a decreased activity of uroporphyrinogen-decarboxylase enzyme. Hem precursors accumulate in the blood, liver, urine, stool and skin. Iron toxicity is associated with pathological free radical reactions. Patients were treated with alpha-lipoic acid (Thiogamma 600R) capsule for 8 weeks. We analysed the data of 24 PCT patients (M:18;F:6) (average age: M:60±15; F:58±12). The diagnosis of PCT was based on the results of blood, urine and faeces analyses. Rutin laboratory methods: AST, ALT, GGT, ALP, TG, chol, HDL-chol, LDL-chol, glucose HgA1c, Fe, transferrin and ferritin measurements were carried out. H-donor activity, reducing power were measured by spectrophotometry and chemiluminescent intensity of plasma and erythrocytes were measured with LB 9501 luminometer. These results of treatment signaled moderate beneficial changes of enzyme activities of liver. Significant decrease of GGT activity and concentration of bile acid were detected as well. Non-significant elevation of uric acid level of the plasma was measured after the treatment. The concentration of glucose and HgA1c were decreased non-significantly. The antioxidant property of alpha-lipoic acid was enforced in plasma and erythrocyte. Statistical analysis of data showed more favourable effects of alpha-lipoic acid on PCT in male patients. In conclusion, per os treatment with alpha-lipoic acid (600 mg/day) over 8 weeks is safe and effective in reducing symptoms of PCT. [This study was supported by Wörwag Pharma, 1/016 NKFP and 002/2003 ETT Projects].