Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.
CNS Neurosci Ther. 2022 Mar;28(3):319-331. doi: 10.1111/cns.13793. Epub 2021 Dec 28.
Lipoic acid (LA) is an endogenous antioxidant that exists widely in nature. Supplementation with LA is a promising approach to improve the outcomes of patients with multiple sclerosis (MS). This systematic review aimed to provide a comprehensive overview of both in vitro and in vivo studies describing the pharmacokinetics, efficacy, safety, and mechanism of LA in MS-related experiments and clinical trials. A total of 516 records were identified by searching five databases, including PubMed, Web of Science, Embase, Scopus, and Cochrane Library. Overall, we included 20 studies reporting LA effects in cell and mouse models of MS and 12 studies reporting LA effects in patients with MS. Briefly, cell experiments revealed that LA protected neurons by inhibiting the expression of inflammatory mediators and activities of immune cells. Experimental autoimmune encephalomyelitis mouse experiments demonstrated that LA consistently reduced the number of infiltrating immune cells in the central nervous system and decreased the clinical disability scores. Patients with MS showed relatively stable Expanded Disability Status Scale scores and better walking performance with few adverse events after the oral administration of LA. Notably, heterogeneity of this evidence existed among modeling methods, LA usage, MS stage, and trial duration. In conclusion, this review provides evidence for the anti-inflammatory and antioxidative effects of LA in both in vitro and in vivo experiments; therefore, patients with MS may benefit from LA administration. Whether LA can be a routine supplementary therapy warrants further study.
硫辛酸（LA）是一种内源性抗氧化剂，广泛存在于自然界中。补充 LA 是改善多发性硬化症（MS）患者预后的一种有前途的方法。本系统评价旨在全面概述描述 LA 在 MS 相关实验和临床试验中的药代动力学、疗效、安全性和作用机制的体内和体外研究。通过搜索五个数据库，包括 PubMed、Web of Science、Embase、Scopus 和 Cochrane Library，共确定了 516 条记录。总的来说，我们纳入了 20 项报告 LA 对 MS 细胞和小鼠模型影响的研究，以及 12 项报告 LA 对 MS 患者影响的研究。简要地说，细胞实验表明 LA 通过抑制炎症介质的表达和免疫细胞的活性来保护神经元。实验性自身免疫性脑脊髓炎小鼠实验表明，LA 一致减少了中枢神经系统中浸润的免疫细胞数量，并降低了临床残疾评分。MS 患者在口服 LA 后，扩展残疾状况量表评分相对稳定，行走能力更好，且不良事件较少。值得注意的是，证据存在建模方法、LA 使用、MS 阶段和试验持续时间的异质性。总之，本综述为 LA 在体内和体外实验中的抗炎和抗氧化作用提供了证据；因此，MS 患者可能受益于 LA 给药。LA 是否可以成为常规的补充治疗方法还需要进一步研究。
