Alpha lipoic acid attenuates inflammatory response during extracorporeal circulation

Abstract

Aim: Extracorporeal circulation (ECC) of blood during cardiopulmonary surgery has been shown to stimulate various proinflammatory molecules such as cytokines and chemokines. The biochemical oxidation/reduction pathways of α-lipoic acid suggest that it may have antioxidant properties.

Methods: In this study we aimed to evaluate only patients with coronary heart disease and those planned for coronary artery bypass graft operation. Blood samples were obtained from the patients before the operation (P1) and one (P2), four (P3), 24 (P4) and 48 hours (P5) after administration of α-lipoic acid (LA). The patients were divided into two groups, control and LA treatment group. Levels of interleukin- 6 (IL-6) and -8 (IL-8), complement 3 (C3) and 4 (C4), anti-streptolysin (ASO), C-reactive protein (CRP) and haptoglobin were assessed in the blood samples.

Results: Cytokine IL-6 and IL-8 levels were significantly higher after surgery. Compared with the control groups, LA significantly decreased IL-6 and IL-8 levels in a time-dependent manner. CRP levels did not show significant variation in the first three time periods. CRP levels were higher after surgery, especially in the later periods. These results demonstrate that CRP formation depends on cytokine release. C3 and C4 levels were significantly higher after surgery than in the pre-operative period. LA treatment decreased C3 and C4 levels. Therefore, LA administration may be useful for the treatment of diseases and processes where excessive cytokine release could cause oxidative damage.

Conclusion: Our findings suggest a possible benefit of using LA during cardiac surgery to reduce cytokine levels.

Fig. 1.

ECC with LA administration had a significant effect on Il-6 (A) and Il-8 (B) release. Mean values of all baseline samples were transformed to 100% and data measured during ECC are given in relation to the adjusted baseline value in each treatment group. *p < 0.05 indicates statistical significance versus the respective baseline value in each group. ^#p < 0.05 indicates statistical significance between the two groups at each time point.

Fig. 2.

ECC with LA treatment had a significant effect on activation of C3 (A) and C4 (B) release. *p < 0.05 indicates statistical significance versus the respective baseline value in each group. ^#p < 0.05 indicates statistical significance between the two groups at each time point.

Fig. 3.

C-reactive protein (CRP) in serum analysed using a turbidimetric method. *p < 0.05 indicates statistical significance versus the respective baseline value in each group. ^#p < 0.05 indicates statistical significance between the two groups at each time point.

Fig. 4.

Haptogloubulin levels in the serum were analysed using a turbidimetric method. *p < 0.05 indicates statistical significance versus the respective baseline value in each group. ^#p < 0.05 indicates statistical significance between the two groups at each time point.

Fig. 5.

Anti-streptolysin (ASO) levels in serum were analysed using a turbidimetric method. *p < 0.05 indicates statistical significance versus the respective baseline value in each group. ^#p < 0.05 indicates statistical significance between the two groups at each time point.