Alleviation of podocyte injury: the possible pathway implicated in anti-inflammation of alpha-lipoic acid in type 2 diabetics.

Background and aims: The objective of this study is to observe the effect of alpha-lipoic acid (ALA) on Pod injury by anti-inflammation and explore its possible renal protective mechanism. Methods: A total of 36 cases with type 2 diabetes with microalbuminuria and fasting plasma glucose (FPG) levels less than 9 mmol/L and glycated hemoglobin A1c (HbA1c) ≤9.0 % were recruited to be treated with ALA (600 mg, daily) for 6 months (group DA). Another 30 healthy individuals were chosen as normal controls (group NC). The levels of serum creatinine (Cr), FPG, and HbA1c were detected; blood pressure was recorded; and early morning urine samples (corrected for urinary Cr) were collected for the examination of urinary monocyte chemoattractant protein-1 (MCP-1), transforming growth factor-β1 (TGF-β1), podocalyxin (PCX), nephrin, albumin and Cr in group NC and group DA at the baseline and the sixth month. Results: The excretions of urinary MCP-1, TGF-β1, PCX, nephrin and albumin to Cr ratio (abbreviated as UMCR, UTCR, UPCR, UNCR and UACR respectively) were significantly increased in group DA compared with group NC (all P < 0.01), and after 6-month treatment, all indexes mentioned above decreased markedly ( P < 0.05), while FPG and HbA1c had no obvious changes. Additionally, there was a positive correlation between UMCR, UTCR with UPCR, UNCR and UACR, respectively (all P < 0.01). Conclusions: Anti-inflammation of ALA in vivo and local kidney is implicated in the protection of glomerular Pod injury in patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]