Alpha-Lipoic Acid: Features of Molecular Mechanisms and Diabetic Complications

The purpose of our review was to characterize some features of the molecular mechanisms of action of alpha-lipoic acid (ALA) and its potential properties in the treatment of diabetic complications. Diabetes is a chronic metabolic disease with a high prevalence worldwide. Diabetes and insulin resistance are associated with the development of cardiovascular and nervous diseases. The endothelium-dependent vasodilation, protein kinase B phosphorylation in vascular endothelial cells, improvement in plasma redox status, protection against oxidative stress-induced apoptosis, and endothelium-dependent vasodilation are all effects of ALA. In skeletal muscle, ALA reduces triglyceride accumulation, enhances expression of the insulin receptor substrate 1 protein, and improves insulin sensitivity by activating 5'-AMP-activated protein kinase. It also recruits glucose transporter type 4 from its storage site in the Golgi to the sarcolemma. The prescription of ALA can have both detrimental and cytoprotective effects on pancreatic -cells. ALA has some important functions in AMPK expression and activity in the brain and peripheral tissues. AMPK is involved in many intracellular pathways related to the cell cycle, stress response, metabolism, and aging. However, further work with a better-designed protocol and appropriate selection of study population, doses, and duration may provide evidence for the hidden therapeutic potential of ALA and its potential properties for diabetic complications.