Α-lipoic acid (ALA) is a potent antioxidant. ALA is proposed to mitigate the development of diabetic polyneuropathy by addressing reactive oxygen and nitrogen species. ALA administration is approved for treatment of diabetic sensorimotor polyneuropathy in some countries. Patients that received kidney-pancreas transplantation in order to ameliorate polyneuropathy, may be treated with ALA. Therefore, the aim of the present work was to evaluate the effect of ALA in patients undergoing kidney-pancreatic transplant evaluating functional recovery of graft and biochemical markers of ischemia reperfusion injury (IRI).

The study included 18 kidney-pancreas transplant patients. ALA (600 mg, i.v.) was administered to the deceased donor at the time of ablation and to the recipients during the surgical procedure. Blood samples were obtained at the beginning, the end, 12 h after surgery and every one or two day after transplant for at least 10 days. Cytokines were measured by using a Cytometric Bead Array and serum amylase, lipase, glycemia and creatinine levels were meassured as markers of organ function. Also, kidney and pancreas biopsies were taken at the end of the surgery to perform a Real-time PCR analysis for inflammatory gene expression.

HMOX and C3 gene expression were upregulated and IL-10 was downregulated in pancreas and kidney biopsies of ALA treated patients. The serum levels of TNF-Α, IL-1Β, IL-6 and IL-12p70 were undetectable. An increase in serum IL-8 and IL-10 was observed in untreated patients immediately after the surgery. This was not observed in ALA treated patients. The mean serum lipase and amylase values of ALA treated patients were lower than untreted patients (P< 0.001 and P< 0.05, respectively). AUC analyses of lipase and amylase serum levels were 8747 and 1205 for untreated patients and 4373 and 713 for ALA treated patients respectively. The difference between the groups was not statistically significant for glycemia but a slight increased for serum creatinine was observed in ALA treated patients.

The treatment with ALA to donors and kidney-pancreas transplant patients decreased serum IL-8 and IL-10, increased the expression of HMOX in the graft and decreased the postoperative amylase and lipase values in blood therefore protects from the IRI.

Incardona, C.: Employee, GADOR.

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