The Hepatoprotective Potential of Alpha-Lipoic Acid
Background: Liver diseases remain a major global health challenge with limited effective therapies. Alpha-lipoic acid (ALA), a mitochondrial cofactor, has gained attention for its antioxidant and anti inflammatory properties.Objective: To review the hepatoprotective potential of ALA based on preclinical and clinical evidence.Material and Methods: Studies were identified from PubMed, Scopus, Web of Science, and Google Scholar (2000–2025). Eligible preclinical and clinical studies reporting ALA dose and liver-related outcomes were included. Data were synthesized narratively.Results: Preclinical studies consistently show that ALA attenuates liver injury by improving liver enzymes, oxidative stress markers, inflammatory cytokines, and histopathological changes, typically at doses of 50–200 mg/kg in rodents. Clinical studies, mainly in MASLD and drug-induced liver injury, used doses of 300–1,200 mg/day and reported improvements in transaminases and insulin sensitivity. However, clinical evidence remains limited by small sample sizes and short durations.Conclusion: ALA demonstrates consistent hepatoprotective effects in preclinical models, while clinical evidence remains preliminary. Further well-designed clinical trials are required to confirm its therapeutic role.
- Front Matter
9
- 10.1016/j.jceh.2021.04.004
- Apr 27, 2021
- Journal of Clinical and Experimental Hepatology
Liver Injury Associated With Drugs and Complementary and Alternative Medicines in India
- Front Matter
101
- 10.1016/j.jhep.2011.02.024
- Mar 9, 2011
- Journal of Hepatology
Drug induced liver injury and its relationship to autoimmune hepatitis
- Front Matter
10
- 10.1016/j.cgh.2014.02.011
- Feb 12, 2014
- Clinical Gastroenterology and Hepatology
Drug-Induced Liver Injury, Dosage, and Drug Disposition: Is Idiosyncrasy Really Unpredictable?
- Front Matter
11
- 10.1016/j.jceh.2021.11.014
- Nov 29, 2021
- Journal of Clinical and Experimental Hepatology
Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH?
- Research Article
198
- 10.1016/j.jhep.2011.02.007
- Feb 22, 2011
- Journal of Hepatology
Causality assessment methods in drug induced liver injury: Strengths and weaknesses
- Front Matter
1
- 10.1053/j.gastro.2008.11.006
- Nov 8, 2008
- Gastroenterology
Do Hepatotoxicity Registries Have a Role in Health Care?
- Front Matter
7
- 10.1016/j.jhep.2010.08.002
- Aug 19, 2010
- Journal of Hepatology
Drug-induced liver injury: Is it time for genetics to change our clinical practice?
- Discussion
4
- 10.1016/j.jceh.2021.08.020
- Aug 26, 2021
- Journal of Clinical and Experimental Hepatology
Heart-leaved Moonseed- Innocuous or Baneful
- Research Article
398
- 10.1053/j.gastro.2006.05.054
- Sep 1, 2006
- Gastroenterology
Nonalcoholic fatty liver disease (NAFLD), the major reason for abnormal liver function in the Western world, is associated with obesity and diabetes and is characterized by insulin resistance (IR). IR is regulated by mediators released from cells of the immune system or adipocytes and proinflammatory cytokines such as tumor necrosis factor-α (TNFα). The importance of TNFα in human and animal fatty liver diseases, both caused by genetic manipulation and overnutrition, has been shown convincingly. Furthermore, neutralization of TNFα activity improves IR and fatty liver disease in animals. Adiponectin is a potent TNFα-neutralizing and anti-inflammatory adipokine and in vitro and experimental animal studies have proven the importance of this mediator in counteracting inflammation and IR. Anti-inflammatory effects of adiponectin are exerted both by suppressing TNFα synthesis and by induction of anti-inflammatory cytokines such as interleukin-10 or interleukin-1–receptor antagonist. Therefore, the balance between various mediators, either derived from the immune system or adipose tissue, appears to play an important role in hepatic and systemic insulin action and in the development of fatty liver disease.
- Research Article
13
- 10.3389/fphar.2021.607572
- Feb 24, 2021
- Frontiers in Pharmacology
Peripheral neuropathies, characterized by altered nociceptive and muscular functions, are related to oxidative stress. Thioctic acid is a natural antioxidant existing as two optical isomers, but most clinically used as racemic mixture. The present study investigated the central nervous system’s changes which followed loose-ligation-derived compression of sciatic nerve, the putative neuroprotective role of thioctic acid and the pain-alleviating effect on low-back pain suffering patients. Loose ligation of the right sciatic nerve was performed in spontaneously hypertensive rats (SHR), a model of increased oxidative stress, and in normotensive Wistar-Kyoto rats (WKY). Animals with sciatic nerve ligation were left untreated or were treated intraperitoneally for 15 days with 250 μmol·kg−1·die−1 of (+/−)-thioctic acid; 125 μmol·kg−1·die−1 of (+/−)-thioctic acid; 125 μmol·kg−1·die−1 of (+)-thioctic acid lysine salt; 125 μmol·kg−1·die−1 of (−)-thioctic acid; 300 μmol·kg−1·die−1 pregabalin. Control SHR and WKY rats received the same amounts of vehicle. The clinical trial NESTIORADE (Sensory-Motor Neuropathies of the Sciatic Nerve: Comparative evaluation of the effect of racemic and dextro-rotatory forms of thioctic acid) examined 100 patients (49 males and 51 females aged 53 ± 11 years) dividing them into two equal-numbered groups, each treated daily for 60 days with 600 mg of (+/−)-thioctic acid or (+)-thioctic acid, respectively. The trial was registered prior to patient enrollment at EudraCT website (OSSC Number: 2011-000964-81). In the preclinical study, (+)-thioctic acid was more active than (+/−)- or (−)-enantiomers in relieving pain and protecting peripheral nerve as well as in reducing oxidative stress and astrogliosis in the spinal cord. Main findings of NESTIORADE clinical trial showed a greater influence on painful symptomatology, a quicker recovery and a better impact on quality of life of (+)-thioctic acid vs. (+/−)-thioctic acid. These data may have a pharmacological and pharmacoeconomical relevance and suggest that thioctic acid, above all (+)-enantiomer, could be considered for treatment of low-back pain involving neuropathy.
- Front Matter
41
- 10.1016/j.jhep.2011.04.007
- May 8, 2011
- Journal of Hepatology
IL-1 cytokine family members and NAFLD: Neglected in metabolic liver inflammation
- Research Article
268
- 10.1074/jbc.r100026200
- Oct 1, 2001
- Journal of Biological Chemistry
A Trail of Research from Lipoic Acid to α-Keto Acid Dehydrogenase Complexes
- Research Article
2879
- 10.1053/j.gastro.2012.06.031
- Jun 20, 2012
- Gastroenterology
Transfer of Intestinal Microbiota From Lean Donors Increases Insulin Sensitivity in Individuals With Metabolic Syndrome
- Research Article
73
- 10.1016/j.cgh.2007.08.007
- Oct 29, 2007
- Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
Serum Apoptosis Markers in Acute Liver Failure: A Pilot Study
- Research Article
91
- 10.1016/j.jhepr.2020.100149
- Jul 21, 2020
- JHEP reports : innovation in hepatology
Approach to the patient with acute severe autoimmune hepatitis.