Department of Internal Medicine, Ota&Jinemed Hospital, Istanbul, Turkey. Electronic address: https://orcid.org/0000-0001-7807-135X.
Department of Biochemistry, Private Practice, Istanbul, Turkey.
Med Hypotheses. 2020 Oct;143:110185. doi: 10.1016/j.mehy.2020.110185. Epub 2020 Aug 14.
COVID-19 pandemic is spreading rapidly worldwide, and drug selection can affect the morbidity and mortality of the disease positively or negatively. Alpha-lipoic acid (ALA) is a potent antioxidant and reduces oxidative stress and inhibits activation of nuclear factor-kappa B (NF-kB). ALA reduces ADAM17 activity and ACE2 upregulation. ALA is known to have antiviral effects against some viruses. ALA may show antiviral effect by reducing NF-kB activation and alleviating redox reactions. ALA increases the intracellular glutathione strengthens the human host defense. ALA activates ATP dependent K channels (Na, K-ATPase). Increased K in the cell raises the intracellular pH. As the intracellular pH increases, the entry of the virus into the cell decreases. ALA can increase human host defense against SARS-CoV-2 by increasing intracellular pH. ALA treatment increases antioxidant levels and reduces oxidative stress. Thus, ALA may strengthen the human host defense against SARS-CoV-2 and can play a vital role in the treatment of patients with critically ill COVID-19. It can prevent cell damage by decreasing lactate production in patients with COVID-19. Using ALA with insulin in patients with diabetes can show a synergistic effect against SARS-CoV-2. We think ALA treatment will be beneficial against COVID-19 in patients with diabetes.
新冠疫情在全球迅速蔓延，药物选择可能会对疾病的发病率和死亡率产生积极或消极的影响。α-硫辛酸（ALA）是一种有效的抗氧化剂，可以降低氧化应激并抑制核因子-κB（NF-κB）的激活。ALA 可以降低 ADAM17 的活性和 ACE2 的上调。ALA 已知对某些病毒具有抗病毒作用。ALA 可能通过抑制 NF-κB 激活和减轻氧化还原反应来显示抗病毒作用。ALA 增加细胞内谷胱甘肽，增强人体宿主防御。ALA 激活 ATP 依赖性 K 通道（Na、K-ATPase）。细胞内钾的增加会提高细胞内 pH 值。随着细胞内 pH 值的升高，病毒进入细胞的数量减少。ALA 通过增加细胞内 pH 值来增加人体对 SARS-CoV-2 的宿主防御。ALA 治疗可以增加抗氧化剂水平并减少氧化应激。因此，ALA 可能增强人体对 SARS-CoV-2 的宿主防御，并在治疗重症 COVID-19 患者方面发挥重要作用。它可以通过减少 COVID-19 患者的乳酸产生来防止细胞损伤。糖尿病患者联合使用胰岛素和 ALA 可能会对 SARS-CoV-2 产生协同作用。我们认为，ALA 治疗将对糖尿病患者的 COVID-19 有益。
