Effect of alpha-lipoic acid on asymmetric dimethylarginine and disability in multiple sclerosis patients: A randomized clinical trial Impact of therapy with alpha-lipoic acid (ALA) on the oxidative stress in the controlled NIDDM: a possible preventive way against the organ dysfunction? Effects of alpha lipoic acid supplementation on serum levels of IL-8 and TNF-α in patient with ESRD undergoing hemodialysis Effects of Alpha Lipoic Acid on Multiple Cytokines and Biomarkers and Recurrence of Atrial Fibrillation Within 1 Year of Catheter Ablation. The effect of alpha-lipoic acid (ALA) supplementation on cardiovascular risk factors in men with chronic spinal cord injury: a clinical trial Effects of alpha-lipoic acid supplementation on inflammation, oxidative stress, and serum lipid profile levels in patients with end-stage renal disease on hemodialysis. Alpha lipoic acid in burning mouth syndrome--a randomized double-blind placebo-controlled trial. Predictors of improvement and progression of diabetic polyneuropathy following treatment with α-lipoic acid for 4 years in the NATHAN 1 trial. Burning mouth syndrome (BMS): an open trial of comparative efficacy of alpha-lipoic acid (thioctic acid) with other therapies. A Randomized Placebo-Controlled Pilot Trial of Omega-3 Fatty Acids and Alpha Lipoic Acid in Alzheimer’s Disease Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Effect of alpha-lipoic acid and vitamin E supplementation on oxidative stress, inflammation, and malnutrition in hemodialysis patients. Randomized, triple-blind, placebo-controlled clinical trial examining the effects of alpha-lipoic acid supplement on the spermatogram and seminal oxidative stress in infertile men. Lipoic Acid Prevents High-Fat Diet-Induced Hepatic Steatosis in Goto Kakizaki Rats by Reducing Oxidative Stress Through Nrf2 Activation Efficacy of poly-unsaturated fatty acid therapy on patients with nonalcoholic steatohepatitis. A double-blind, randomized, placebo-controlled trial of n-3 versus n-6 fatty acid-based lipid infusion in atopic dermatitis. A randomized comparative 96-week trial of boosted atazanavir versus continued boosted protease inhibitor in HIV-1 patients with abdominal adiposity.
Background Multiple Sclerosis ( MS ) is an inflammatory and demyelinating disease of the central nervous system . Oxidative stress plays a major role in the onset and progression of MS . Asymmetric dimethylarginine ( ADMA ) formation is dependent on oxidative stress status . Objective We examined whether alpha-lipoic acid ( ALA ) as a potent antioxidant could improve the Exp and ed Disability Status Scale ( EDSS ) and decrease plasma level of ADMA in multiple sclerosis patients . Methods In a r and omized , double-blinded clinical trial conducted at Sina Hospital in Tehran , Iran , from September 2009 to July 2011 , 24 patients with relapsing-remitting MS were divided into a treatment group receiving ALA ( 1200mg/day ) for 12 weeks and a control group receiving placebo . Then patients ’ EDSS and Plasma levels of ADMA were measured at baseline and 12 weeks later . Statistical analysis was done by SPSS software version 16 using the K-S test , Chi square , Mann – Whitney U-test and Wilcoxon test . Results The plasma levels of ADMA in the intervention group were decreased significantly ( p=0.04 ) . Also , no patient had increased EDSS score in the supplement group , where 2 out of 12 patients in the placebo group experienced so . Comparing the serum level of ADMA between the two groups failed to show any significant change in the supplement group compared with the control group . Conclusion Considering that ADMA is produced by oxidative stress in MS patients and leads to increase of inflammation , ALA may have the potential of beneficial effects in them , in part , by decreasing the plasma level of ADMA and stopping progression . Trial registration The trial was registered at the Iranian Registry of Clinical Trials ( http://www.i rct .ir ) with the I rct ID : No. I RCT 138812222602N2 . Funding The authors received no financial support for the research , authors hip , and /or publication of this article There is a growing evidence that excess generation of highly reactive free radicals , largely due to hyperglycemia , causes oxidative stress , which further exacerbates the development and progression of diabetes and its complications . The purpose of this study was to evaluate the impact of ALA on lipid profile , oxidative pattern and inflammation in patients with controlled non-insulin dependent diabetes mellitus ( NIDDM ) .  ALA , 400mg/day was investigated in NIDDM patients over a period of 4 weeks using a r and omized , placebo-(PLA)-controlled study with two parallel groups . The marker of oxidative stress was the concentration of reactive oxygen metabolites , evaluated using a commercially available test , called d-ROMs  test  , and the  biological antioxidant potential ( BAP ) ; besides , the lipid profile ( total cholesterol = TC , high-density lipoprotein-cholesterol = HDL-C ; low-density lipoprotein-cholesterol = LDL-C , and triglycerides = TG ) and the C-reactive protein ( CRP ) , marker of inflammation were measured at the beginning and at the end of the treatment . A total of 14 patients were r and omly assigned to the two groups . ALA was safe and well tolerated in the only oral daily administration . The d-ROMs test ( p=0.03 ) and HDL-C ( p=0.04 ) showed a significant difference between the two groups . BAP ( p=0.06 ) tended to be higher in the treated patients , while LDL-C ( p=0.07 ) presented a moderate decline . There were no significant differences in TC ( p=0.65 ) , TG ( p=0.78 ) and CRP ( p=0.96 ) between the ALA and PLA groups . ALA therapy appears to reduce significantly d-ROMs and to improve HDL-C value , especially in men with metabolic syndrome treated with oral hypoglycemic drugs . These findings will be useful in patient selection in future clinical trials with ALA in long term studies Background Chronic renal failure is a progressive and irreversible loss of kidney function , and the hemodialysis ( HD ) is one of the most common modalities in this regard . Oxidative stresses [ like interleukin-8 ( IL-8 ) and tumor necrosis factor-alpha ( TNF-α ) ] and inflammation are the main risk factors associated with cardiovascular diseases and other complications in many organs in hemodialysis patients ; meanwhile , antioxidants like alpha lipoic acid ( ALA ) may reduce the oxidative stress markers and the levels of inflammatory cytokines , so can improve of the patient ’s quality of life . Methods In this r and omized clinical trial study , 60 HD patients were r and omly categorized in two case and control groups . Case group received a daily capsule of 600 mg of ALA supplementation for 8 weeks , and the control group received placebo capsules daily . The serum level of IL-8 and TNF-α was measured in both groups before and after the intervention . Results There were no significant differences in age , gender , duration of dialysis , and causative factor for dialysis between both groups ( P > 0.05 ) . The mean of IL-8 and TNF-α after the intervention in case group was 26.20 ± 15.34 and 21.25 ± 9.61 , respectively ; the difference between both groups was not statistically significant ( P > 0.05 ) . Conclusion Based on the better feeling and other beneficial effects of ALA were found in our study ; we can conclude that it is a beneficial and recommended supplement , especially , for diabetic and dialysis patients Catheter ablation ( CA ) is a procedure commonly used to restore sinus rhythm in patients with atrial fibrillation ( AF ) . However , AF recurrence after CA remains a relevant clinical issue . We tested the effects of an oral antioxidant treatment ( alpha lipoic acid [ ALA ] ) on AF recurrence post-CA . Patients with paroxysmal AF have been enrolled in a r and omized , prospect i ve , double-blind , controlled placebo trial . After CA , patients have been r and omly assigned to receive ALA oral supplementation ( ALA group ) or placebo ( control group ) and evaluated at baseline and after a 12-month follow-up : 73 patients completed the 12-month follow-up  ( ALA : 33 and control : 40 ) . No significant difference has been detected between the 2 groups at baseline . Strikingly , 1 year after CA , ALA therapy significantly reduced serum markers of inflammation . However , there was no significant difference in AF recurrence events at follow-up comparing ALA with placebo group . Multivariate analysis revealed that the only independent prognostic risk factor for AF recurrence after CA is age . In conclusion , ALA therapy reduces serum levels of common markers of inflammation in ablated patients . Nevertheless , ALA does not prevent AF recurrence after an ablative treatment Study design : A r and omized , double-blind , placebo-controlled clinical trial . Objective : To assess the effect of alpha-lipoic acid ( ALA ) supplementation on IL-6 , hs-CRP , FBS , anthropometric indices , food intake and blood pressure in male patients with chronic spinal cord injury ( SCI ) . Setting : Imam Khomeini Hospital , Tehran University of Medical Sciences , Tehran , Iran . Methods : Fifty-eight men with chronic SCI participated in the study . Participants were divided in two groups : one group received 600 mg of supplemental ALA ( n=28 ) and the other group received placebo ( n=30 ) for 12 weeks . At the beginning and end of the study , biochemical parameters , anthropometric indices , blood pressure and dietary intakes were measured . Dietary intake was measured using N4 software , and statistical analyses were carried out using SPSS16 . Results : No significant reduction was found in IL-6 ( P=0.97 ) and hs-CRP levels ( P=0.23 ) . There was significant reduction in fasting blood sugar ( P=0.001 ) , body weight ( P=0.001 ) , BMI ( P=0.001 ) , waist circumference ( P=0.001 ) and blood pressure ( P=0.001 ) . Dietary intake was significantly reduced , including fat ( P=0.001 ) , carbohydrate ( P=0.001 ) , protein ( P=0.002 ) and energy intakes ( P=0.001 ) . Conclusion : Lipoic acid supplementation had no significant effect on the measured inflammatory markers but it reduces fasting blood sugar , anthropometric parameters , food intake and blood pressure in men with chronic SCI OBJECTIVE We examined the effects of alpha-lipoic acid ( ALA ) supplementation on inflammation , oxidative stress , and serum lipid profile levels in hemodialysis ( HD ) patients . DESIGN This was a double-blinded , r and omized , placebo-controlled clinical trial . SETTING The present study involved HD centers in Tabriz , Iran . PATIENTS Participants included 63 patients with end-stage renal disease ( 43 men and 20 women ; age range : 22 - 79 years ) undergoing maintenance HD . INTERVENTION HD patients were r and omly assigned into the supplemented group ( n = 31 ) , receiving a daily dose of ALA ( 600 mg ) , or a control group ( n = 32 ) , receiving placebo for 8 weeks . MAIN OUTCOME MEASURES High sensitivity C-reactive protein ( hsCRP ) , malondialdehyde , total antioxidant status , total cholesterol , triglyceride , high-density lipoprotein cholesterol ( HDL-C ) , and low-density lipoprotein cholesterol ( LDL-C ) were measured at baseline and after 8 weeks of supplementation . RESULTS At the end of intervention , 11 patients were excluded from the study .  HsCRP levels decreased by 18.7 % in the supplemented group after 8 weeks of supplementation , and the reduction was significant in comparison with the placebo group ( P < .05 ) ; this finding was also significant after adjusting for baseline values of hsCRP . The mean malondialdehyde and total antioxidant status levels did not change significantly in the 2 groups during the study . The mean high-density lipoprotein cholesterol concentrations increased significantly in the supplemented group at the end of the study ( P < .05 ) ; however , this improvement was not statistically significant as compared with the placebo group . No significant alterations were observed in the other lipid profile parameters within each group during the study . CONCLUSION ALA supplementation significantly reduced hsCRP levels , which is a risk factor for cardiovascular disease in HD patients UNLABELLED The burning mouth syndrome ( BMS ) is a chronic condition characterized by oral burning pain in the absence of clinical abnormalities and without established therapy . OBJECTIVES The purpose of this study was to evaluate the effectiveness of alpha lipoic acid ( ALA ) in the management of BMS symptoms through a r and omized double-blind placebo-controlled trial . METHODS Thirty-eight patients ( 34 women and four men , median age 62.9 years , range 36 - 78 ) were included and 31 completed the study . The patients were r and omized into two cycles of treatment : one with alpha lipoic acid and one with placebo both administered in identical capsules . These cycles were separated by a washout period of 20 days . The oral symptoms and the treatment response were assessed using a 100-mm visual analog scale before and after each cycle and the global perceived effect score , using a 5-point scale after each treatment cycle . RESULTS The level of reduction on burning was significant for both treatments ( paired t-test : P < 0.05 ; rp = 0.011 ; ral < 0.001 ) . Considering the two cycles together , 22 patients reported at least some improvement after ALA use and 23 patients after placebo . CONCLUSIONS Comparison of the oral assessment scores of the two cycles failed to demonstrate the effectiveness of ALA over placebo ( t-test : P > 0.05 ; r = 0.75 ) AIMS We aim ed to analyze the impact of baseline factors on the efficacy of α-lipoic acid ( ALA ) over 4 years in the NATHAN 1 trial . METHODS This was a post-hoc analysis of the NATHAN 1 trial , a 4-year r and omized study including 460 diabetic patients with mild-to-moderate polyneuropathy using ALA 600 mg qd or placebo .  Amongst others , efficacy measures were the Neuropathy Impairment Score of the lower limbs ( NIS-LL ) and heart rate during deep breathing ( HRDB ) . RESULTS Improvement and prevention of progression of NIS-LL ( ΔNIS-LL≥2 points ) with ALA vs. placebo after 4 years was predicted by higher age , lower BMI , male sex , normal blood pressure , history of cardiovascular disease ( CVD ) , insulin treatment , longer duration of diabetes and neuropathy , and higher neuropathy stage . Participants treated with ALA who received ACE inhibitors showed a better outcome in HRDB after 4 years . CONCLUSIONS Better outcome in neuropathic impairments following 4-year treatment with α-lipoic acid was predicted by normal BMI and blood pressure and higher burden due to CVD , diabetes , and neuropathy , while improvement in cardiac autonomic function was predicted by ACE inhibitor treatment . Thus , optimal control of CVD risk factors could contribute to improved efficacy of α-lipoic acid in patients with higher disease burden BACKGROUND Alpha-lipoic acid ( ALA ) is a potent antioxidant mitochondrial coenzyme , trometamol salt of thioctic acid , shown in clinical studies to be neuroprotective and in a preliminary study to have an effect on the symptomatology of  Burning Mouth Syndrome ( BMS ) .  METHODS We were interested in extending our studies as to whether alpha-lipoic acid might improve the symptomatology in BMS and therefore carried out a larger open controlled clinical study on the effects of alpha-lipoic acid on BMS symptomatology . RESULTS We have examined the effects on 4 groups of 20 patients with BMS of ALA  , compared with bethanecol , Biotene and placebo , and found ALA of remarkable benefit with minimal adverse effects . CONCLUSIONS These results suggest that double-blind r and omized controlled multicenter studies of ALA are indicated Oxidative stress , inflammation , and increased cholesterol levels are all mechanisms that have been associated with Alzheimer ’s disease ( AD ) pathology . Several epidemiologic studies have reported a decreased risk of AD with fish consumption . This pilot study was design ed to evaluate the effects of supplementation with omega-3 fatty acids alone ( ω-3 ) or omega-3 plus alpha lipoic acid ( ω-3 + LA ) compared to placebo on oxidative stress biomarkers in AD . The primary outcome measure was peripheral F2-isoprostane levels ( oxidative stress measure ) . Secondary outcome measures included performance on : Mini-Mental State Examination ( MMSE ) , Activities of Daily Living/Instrumental Activities of Daily Living ( ADL/IADL ) , and Alzheimer Disease Assessment Scale-cognitive subscale ( ADAS-cog ) . Thirty-nine AD subjects were r and omized to one of three groups : 1 ) placebo , 2 ) ω-3 , or 3 ) ω-3 + LA for a treatment duration of 12 months . Eighty seven percent ( 34/39 ) of the subjects completed the 12-month intervention . There was no difference between groups at 12 months in peripheral F2-isoprostane levels ( p = 0.83 ) . The ω-3 + LA and ω-3 were not significantly different than the placebo group in ADAS-cog ( p = 0.98 , p = 0.86 ) and in ADL ( p = 0.15 , p = 0.82 ) . Compared to placebo , the ω-3+LA showed less decline in MMSE ( p < 0.01 ) and IADL ( p= 0.01 ) and the ω-3 group showed less decline in IADL ( p < 0.01 ) . The combination of ω-3+LA  slowed cognitive and functional decline in AD over 12 months . Because the results were generated from a small sample size , further evaluation of the combination of omega-3 fatty acids plus alpha-lipoic acid as a potential treatment in AD is warranted Alpha-lipoic acid ( ALA ) , a naturally occuring compound and a radical scavenger was shown to enhance glucose transport and utilization in different experimental and animal models . Clinical studies described an increase of insulin sensitivity after acute and short-term ( 10 d ) parenteral administration of ALA . The effects of a 4-week oral treatment with alpha-lipoic acid were evaluated in a placebo-controlled , multicenter pilot study to determine see whether oral treatment also improves insulin sensitivity . Seventy-four patients with type-2 diabetes were r and omized to either placebo ( n = 19 ) ; or active treatment in various doses of 600 mg once daily ( n = 19 ) , twice daily ( 1200 mg ; n = 18 ) , or thrice daily ( 1800 mg ; n = 18 ) alpha-lipoic acid . An isoglycemic glucose-clamp was done on days 0 ( pre ) and 29 ( post ) . In this explorative study , analysis was done according to the number of subjects showing an improvement of insulin sensitivity after treatment . Furthermore , the effects of active vs. placebo treatment on insulin sensitivity was compared . All four groups were comparable and had a similar degree of hyperglycemia and insulin sensitivity at baseline . When compared to placebo , significantly more subjects had an increase in insulin-stimulated glucose disposal ( MCR ) after ALA treatment in each group . As there was no dose effect seen in the three different alpha-lipoic acid groups , all subjects receiving ALA were combined in the " active " group and then compared to placebo . This revealed significantly different changes in MCR after treatment ( + 27 % vs. placebo ; p < .01 ) . This placebo-controlled explorative study confirms previous observations of an increase of insulin sensitivity in type-2 diabetes after acute and chronic intravenous administration of ALA . The results suggest that oral administration of alpha-lipoic acid can improve insulin sensitivity in patients with type-2 diabetes . The encouraging findings of this pilot trial need to be substantiated by further investigations INTRODUCTION Increased oxidative stress , inflammation , and malnutrition are present in hemodialysis patients and these factors exacerbate cardiovascular comorbidities . Vitamin E and alpha-lipoic acid ( ALA ) may have a protective role against cardiovascular disease risk factors via anti-oxidative and anti-inflammatory properties . The aim of this study was to evaluate the effect of ALA and vitamin E administration ( alone or combined ) on hemodialysis-induced stress oxidation , inflammation , and malnutrition . MATERIAL S AND METHODS In a r and omized placebo-controlled trial , we examined the effects of 2-month supplementation by vitamin E and ALA ( alone or combined ) on biomarkers of lipid peroxidation ( malondialdehyde ) , inflammation ( high-sensitivity C-Reactive protein and interleukin-6 ) , and malnutrition ( Subjective Global Assessment and body mass index ) in 85 hemodialysis patients receiving ALA ( 600 mg ) , vitamin E ( 400 IU ) , ALA and vitamin E , and placebo .  RESULTS After supplementation , no significant changes were observed in malondialdehyde level ; however , there was a decrease in the ALA and vitamin E group during the period of the study . Also , a nonsignificant decrease was seen in the high-sensitivity C-Reactive protein concentration of the interventional groups . Supplementation of vitamin E with and without ALA significantly reduced interleukin-6 concentration . A significant improvement was observed in malnutrition status of all groups . CONCLUSIONS Vitamin E and ALA supplementation , especially their combination , might improve inflammation and malnutrition status , which suggest it as a potential preventive strategy against CVD among end-stage renal disease patients OBJECTIVE To evaluate effects of supplementation with alpha-lipoic acid ( ALA ) on the spermatogram and seminal oxidative stress biomarkers . DESIGN R and omized , triple-blind , placebo-controlled clinical trial . SETTING Infertility clinic . PATIENT(S ) Infertile men . INTERVENTION(S ) ALA ( 600 mg ) or placebo for 12 weeks . MAIN OUTCOME MEASURE(S ) Semen analysis , anthropometric , dietary , and physical activity assessment s , total antioxidant capacity , and malondialdehyde . RESULT ( S ) At the end of study , the total sperm count , sperm concentration , and motility in the intervention group were significantly higher than in the control group . In the ALA group , the total sperm count , sperm concentration , and motility levels were also significantly increased at the end of study compared with baseline values . However , there were no significant differences in ejaculate volume , normal morphology percentage , and live sperm between groups . ALA supplementation also result ed in a significant improvement in seminal levels of total antioxidant capacity ( TAC ) and malondialdehyde compared with the placebo . CONCLUSION ( S ) According to the results , medical therapy of asthenoteratospermia with ALA supplement could improve quality of semen parameters . However , further investigation is suggested in this regard . CLINICAL TRIAL REGISTRATION NUMBER I RCT 2013111010181N3 Prevention of hepatic fat accumulation may be an important approach for liver diseases due to the increased relevance of hepatic steatosis in this field . This study was conducted to investigate the effects of the antioxidant α-lipoic acid ( α-LA ) on hepatic steatosis , hepatocellular function , and oxidative stress in a model of type 2 diabetes fed with a high fat diet ( HFD ) . Goto-Kakizaki rats were r and omly divided into four groups . The first group received only a st and ard rat diet ( control GK )  including groups 2 ( HFD ) , 3 ( vehicle group ) , and 4 ( α-LA group ) , which were given HFD , ad libitum during three months . Wistar rats are the non-diabetic control group . Carbohydrate and lipid metabolism , liver function , plasma and liver tissue malondialdehyde ( MDA ) , liver GSH , tumor necrosis factor-α ( TNF-α ) and nuclear factor E2 ( erythroid-derived 2)-related factor-2 ( Nrf2 ) levels were assessed in the different groups . Liver function was assessed using quantitative hepatobiliary scintigraphy , serum aspartate , and alanine aminotransferases ( AST , ALT ) , alkaline phosphatase , gamma-glutamyltranspeptidase , and bilirubin levels . Histopathologically steatosis and fibrosis were evaluated . Type 2 diabetic animals fed with HFD showed a marked hepatic steatosis and a diminished hepatic extraction fraction and both were fully prevented with α-LA  . Plasma and liver tissue MDA and hepatic TNF-α levels were significantly higher in the HFD group when compared with the control group and significantly lower in the α-LA  group . Systemic and hepatic cholesterol , triglycerides , and serum uric acid levels were higher in hyperlipidemic GK rats and fully prevented with α-LA . In addition , nuclear Nrf2 activity was significantly diminished in GK rats and significantly augmented after α-LA treatment . In conclusion , α-LA strikingly ameliorates steatosis in this animal model of diabetes fed with HFD by decrementing the inflammatory marker TNF-α and reducing oxidative stress . α-LA might be considered a useful therapeutic tool to prevent hepatic steatosis by incrementing antioxidant defense systems through Nrf2 and consequently decreasing oxidative stress and inflammation in type 2 diabetes AIM To examine whether poly-unsaturated fatty acid ( PUFA ) therapy is beneficial for improving  nonalcoholic steatohepatitis ( NASH ) . METHODS In total , 78 patients pathologically diagnosed with NASH were enrolled and were r and omly assigned into the control group and the PUFA therapy group ( added 50 mL PUFA with 1:1 ratio of EHA and DHA into daily diet ) . At the initial analysis and after 6 mo of PUFA therapy , parameters of interest including liver enzymes , lipid profiles , markers of inflammation and oxidation , and histological changes were evaluated and compared between these two groups . RESULTS At the initial analysis , in patients with NASH , serum levels of alanine aminotransferase ( ALT ) and aspartase aminotransferase ( AST ) were slightly elevated . Triglyceride ( TG ) , total cholesterol ( TC ) and low-density lipoprotein cholesterol levels , markers of systemic inflammation [ C-reactive protein ( CRP ) ] and oxidation [ malondialdehyde ( MDA ) ] , as well as fibrosis parameters of type IV collagen and pro-collagen type III pro-peptide were also increased beyond the normal range . Six months later , ALT and AST levels were significantly reduced in the PUFA group compared with the control group . In addition , serum levels of TG and TC , CRP and MDA , and type IV collagen and pro-collagen type III pro-peptide were also simultaneously and significantly reduced . Of note , histological evaluation showed that steatosis grade , necro-inflammatory grade , fibrosis stage , and ballooning score were all profoundly improved in comparison to the control group , strongly suggesting that increased PUFA consumption was a potential way to offset NASH progression . CONCLUSION Increased PUFA consumption is a potential promising approach for NASH prevention and reversal BACKGROUND In the involved epidermis of patients with atopic dermatitis , changes in the metabolism of eicosanoids with increased quantities of the arachidonic acid (AA)-derived lipoxygenase products have been observed . Free eicosapentaenoic acid ( EPA ) , a fish oil-derived alternative ( n-3 ) fatty acid , may compete with AA , result ing in an anti-inflammatory effect . METHODS In a 10-day double-blind , r and omized , placebo-controlled trial , 22 patients hospitalized for moderate-to-severe atopic dermatitis were r and omly assigned to receive daily infusions of either a n-3 fatty acid-based lipid emulsion ( fish oil , 10 % ; 200 mL/d ) or a conventional n-6-lipid emulsion ( soybean oil , 10 % ; 200 mL/d ) . Topical treatment was restricted to emollients . The severity of disease was evaluated daily with scoring of erythema , infiltration , and desquamation and by subjective patient scoring of clinical manifestations . In addition , plasma-free and total-bound fatty acids and the composition of membrane fatty acids in blood cells ( thrombocytes , granulocytes , and erythrocytes ) , lipid mediators from isolated neutrophils and platelets , and lymphocyte-activation parameters were determined . RESULTS Twenty patients completed the trial . Marked improvement from baseline was seen in both groups . On days 6 , 7 , 8 , and 10 , disease severity score-defined as the sum of all scores-was more pronounced ( p < .05 ) in the n-3 group compared with the n-6 group . Free arachidonic acid in plasma did not change substantially in both groups , whereas plasma-free EPA , total-bound EPA , and the membrane EPA/AA ratio markedly increased in response to n-3-lipid infusion . In parallel , EPA-derived lipid mediators appeared , whereas lymphocyte functions were unaffected . In the post-treatment period ( 2/4 weeks ) , relapse was observed in some patients after n-3 psoralene-ultraviolet A ( PUVA ) infusion , whereas there was a marked long-term improvement in the n-6 group . CONCLUSIONS IV n-3-fatty acid administration is effective in acutely improving the severity of atopic dermatitis , paralleled by changes in plasma and membrane fatty acid composition and lipid mediator synthesis . The long-term beneficial effects of IV n-6 fatty acids should be evaluated further BACKGROUND Abdominal adiposity in HIV-1 patients initiating antiretroviral therapy  may be part of a restoration-to-health phenomenon . Lipoatrophy is associated with long-term thymidine analogue therapy . Individual protease inhibitors ( PIs ) differ in their effects on lipids and insulin resistance . METHODS A r and omized open-label multicentre 96-week trial compared changes in fat distribution in patients with suppressed HIV-1 RNA and abdominal adiposity , who either continued on their current twice-daily ritonavir-boosted PI ( PI/r ) or switched to once-daily boosted atazanavir ( ATV/r ) .  Treatment with two nucleoside reverse transcriptase inhibitors was unchanged . Body composition was assessed by dual-energy x-ray absorptiometry ( DEXA ) and abdominal computerized tomography ( CT ) scanning . RESULTS In total , 201 patients were r and omized ; 131 switched to ATV/r .  Viral suppression ( < 50 copies/ml ) was similarly maintained ( 93 % ATV/r versus 89 % PI/r ) . Mean changes from baseline in trunk-to-limb fat ratio were similar ; difference estimates 0.03 ( 95 % CI -0.06 , 0.12 ; P=0.48 at week 48 ) and 0.02 ( 95 % CI -0.10 , 0.14 ; P=0.73 at week 96 ) . More patients in the PI/r arm had a decrease of ≥20 % in limb fat from baseline at week 96 . Significantly greater reductions in proatherogenic lipids occurred following switch to ATV/r . Both treatment regimens were generally well-tolerated ; the incidence of grade 3 - 4 treatment-related clinical adverse events was 34 % among ATV/r recipients versus 4 % of PI/r-treated patients . CONCLUSIONS Switching to ATV/r had no demonstrable benefit on abdominal adiposity . Maintenance of efficacy , less limb fat loss and marked reduction in proatherogenic lipids was observed with ATV/r compared with continuing a PI/r regimen
Conclusion In summary , the current meta- analysis demonstrated the promising impact of ALA administration on decreasing inflammatory markers such as CRP , IL-6 and TNF-α among patients with MetS and related disorders
Objective This systematic review and meta- analysis of r and omized controlled trials ( RCTs ) was conducted to determine the effect of alpha-lipoic acid ( ALA ) supplementation on the inflammatory markers among patients with metabolic syndrome ( MetS ) and related disorders .