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This article is part of the supplement: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012

Open Access Poster presentation

P02.183. Comparing the bioavailability of two forms of lipoic acid in multiple sclerosis

S Salinthone1*, V Yadav2, M Ganesh2, G Cherala2, L Shinto2, D Koop2, D Bourdette2 and D Carr1

  • * Corresponding author: S Salinthone

Author Affiliations

1 Portland VA Medical Center, Portland, USA

2 Oregon Health & Science University, Portland, USA

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BMC Complementary and Alternative Medicine 2012, 12(Suppl 1):P239  doi:10.1186/1472-6882-12-S1-P239

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6882/12/S1/P239


Published:12 June 2012

© 2012 Salinthone et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose

Lipoic acid (LA) stimulates production of an immunomodulatory molecule, cAMP, that may have therapeutic benefit in multiple sclerosis (MS). The study sought to determine the bioactivity of two forms of oral LA, racemic (R/S-LA) and R-LA, to identify factors that may improve the therapeutic effectiveness of LA in MS.

Methods

Participants met the following criteria: age 18-70 years and a definite multiple sclerosis diagnosis. Consenting participants were randomized to 2 groups: R/S-LA (n=20) or R-LA (n=8). Blood was collected at baseline, 5, 10, 15, 30, 60, 90, 120, 180, 240, and 300 minutes after ingestion of a single 1200 mg LA dose. Bioactivity was determined by measuring immune cell cAMP levels (pmol/mg) at baseline and 240 minutes post ingestion. Group differences were analyzed by repeated measures analysis of variance (cAMP) and t-test (pharmacokinetics).

Results

For R/S-LA, mean baseline cAMP levels were 8.6 (SE 0.83) pmol/mg protein, which increased to 14.1 (SE 1.7) 240 minutes post-ingestion. For R-LA, baseline cAMP levels were 5.7 (SE 0.54), which decreased to 4.7 (SE 0.41) 240 minutes post-ingestion. The mean change in cAMP levels were different between groups, p<0.01. The two groups showed no differences in serum LA levels at 240 minutes (p=0.29), but showed a difference in the mean AUC (min*mcg/ml): R/S-LA is 681.8 (SE 83.4) and R-LA is 389.5 (SE 43.9) (p<0.01). Tmax (minutes) between groups differed: R/S-LA was 81.0 (SE 8.9) and R-LA was 13.1 (SE 2.7); p<0.001.

Conclusion

At 1200 mg oral dose and comparable serum LA levels at T240, R/S-LA showed higher cAMP levels compared to R-LA. Since R-LA had an earlier Tmax, it is plausible that increases in cAMP may have occurred at earlier undetected time-points. This pilot study warrants further investigation as differences between R-LA and R/S-LA in bioactivity and pharmacokinetics would impact clinical trial design and patient care.