Effects of alpha lipoic acid and its R+ enantiomer supplemented to hyperbaric oxygen therapy on interleukin-6, TNF-α and EGF production in chronic leg wound healing.
BACKGROUND
Lipoic acid (LA) and hyperbaric oxygenation therapy (HBOT) improve chronic wound healing.


OBJECTIVE
We compared the effects of LA or its enantiomer R-(+)-lipoic acid (RLA) on wound healing.


METHODS
Groups LA + HBOT (L), RLA + HBOT (R) and placebo + HBOT (P). Lesion areas measured before treatment and on 20th and 40th day. The biopsies and plasma were harvested before treatment and on 7th and 14th (measurements of VEGF, vascular endothelial growth factor; EGF, epidermal growth factor, TNF-α and IL-6).


RESULTS
Ulcers improved more on RLA. In both L and R groups, EGF and VEFG increased in time. RLA decreased IL-6 on T7 and T14, which did not happen with LA. TNF-α levels decreased on T14 in both LA and RLA.


CONCLUSIONS
The improved wound healing is associated with increased EGF and VEGF and reduced plasma TNF-α and IL-6.


CONCLUSIONS
RLA may be more effective than LA in improving chronic wound healing in patients undergoing HBO therapy.
Istituto Iperbarico SpA, Diving and Hyperbaric Medicine Unit in Villafranca , Verona , Italy .
Emanuele
E
Nasole
Cristian
C
Nicoletti
Zhong-Jin
ZJ
Yang
Amelia
A
Girelli
Alessandro
A
Rubini
Francesca
F
Giuffreda
Andrea
A
Di Tano
Enrico
E
Camporesi
Gerardo
G
Bosco
D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D017719:Diabetic Foot / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*; D004311:Double-Blind Method; D004815:Epidermal Growth Factor / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013237:Stereoisomerism; D008063:Thioctic Acid / Q000008:administration & dosage / Q000737:chemistry / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000378:metabolism*; D014945:Wound Healing / Q000187:drug effects*
D000975:Antioxidants; C508600:IL6 protein, human; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D004815:Epidermal Growth Factor; D008063:Thioctic Acid