Z Gastroenterol 2005; 43 - 136
DOI: 10.1055/s-2005-869783

Effect of alpha-lipoic acid on the porphyria cutanea tarda patients with type 2 diabetes mellitus and heavy drinkers

E Székely 1, K Szentmihályi 2, G Tasnádi 1, K Várnai 1, A Blázovics 3
  • 1Central Hospital of the Hungarian State Railways Budapest, Hungarian Porphyria Center
  • 2Chemical Research Center, Hungarian Academy of Sciense
  • 3Semmelweis University, 1st Department of Medicine Budapest, Hungary2

Introduction: PCT is a disorder of heme biosynthesis resulting from a decreased activity of uroporphyrinogen decarboxylase enzyme. Heme precursors, predominantly uroporphyrin accumulate in the blood, liver, urine, stool, and skin. Iron toxicity is associated with pathological free radical reactions. Alpha-lipoic acid is a coenzyme of pyruvate and alpha-ketoglutarate dehydrogenase. Alpha-lipoic acid showed protective effects against lipid peroxidation, protein carbonyl formation, NO and ONOO-.

Aim: We investigated the effect of alpha-lipoic acid on porphyrin concentration and iron metabolism in PCT patients with alcohol consumption and type 2 dibates mellitus. Patients were treated with alpha-lipoic acid (Thiogamma 600R) capsule for 8 weeks. We analysed the data of 18 PCT male patients (9 PCT with only PCT, 4 PCT with alcohol consumption, 5 PCT with alc. and type 2 DM).

Methods: The diagnosis of PCT was based on the result of blood, urine and faeces analyses. Rutin laboratory parameters were measured (AST, ALT, GGT, HDL-CHOL, LDL-CHOL, glucose, HbA1c, iron, transferrin and ferritin) with Roche/Hitachi MODULAR equipment. H-donor activity and reducing power was measured by spectrophotometry and chemiluminescent intensity of plasma and erythrocytes were measured with LB 9501 luminometer.

Results: Significant difference was found in urine-UP level after alpha-lipoic acid treatment in all patient groups. AST, ALP, GGT were changed more beneficial in alcohol consumers. HbA1c concentration and erythrocyte chemiluminescence were lowered, but the significant change was only in PCT with alcohol group in HbA1c. Iron concentration was decreased in all groups, whereas Cu, Zn P, and Mg concentration did not change.

Conclusion: Unexpected result: redox parameters were worse after antioxidant treatment in the plasma of alcohol consumers. Per os treatment with alpha-lipoic acid (600mg/day) over 8 weeks is safe and effective in reducing symptoms of PCT.

The study was supported by the ETT 002/2003 Ministry of Health, Social and Family Affairs and NKFP-1B 047/2004, NKFP-1/A/005/2004