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J Am Soc Nephrol 12:124-133, 2001
© 2001 American Society of Nephrology

Effects of Dietary Supplementation of {alpha}-Lipoic Acid on Early Glomerular Injury in Diabetes Mellitus

MONA F. MELHEM*, PATRICIA A. CRAVEN{dagger} and FREDERICK R. DERUBERTIS{dagger}

* Department of Medicine, Veterans Affairs Medical Center and University of Pittsburgh, Pittsburgh, Pennsylvania.
{dagger} Department of Pathology, Veterans Affairs Medical Center and University of Pittsburgh, Pittsburgh, Pennsylvania.

Correspondence to Dr. Frederick R. DeRubertis, Department of Veterans Affairs Medical Center, University Drive C, Pittsburgh, PA 15240. Phone: 412-688-6000 x4690; Fax: 412-688-6947; E-mail: frederick.derubertis{at}med.va.gov

Abstract. Antioxidants, in particular vitamin E (VE), have been reported to protect against diabetic renal injury. {alpha}-Lipoic acid (LA) has been found to attenuate diabetic peripheral neuropathy, but its effects on nephropathy have not been examined. In the present study, parameters of glomerular injury were examined in streptozotocin diabetic rats after 2 mo on unsupplemented diets and in diabetic rats that received the lowest daily dose of dietary LA (30 mg/kg body wt), VE (100 IU/kg body wt), or vitamin C (VC; 1 g/kg body wt), which detectably increased the renal cortical content of each antioxidant. Blood glucose values did not differ among the diabetic groups. At 2 mo, inulin clearance, urinary albumin excretion, fractional albumin clearance, glomerular volume, and glomerular content of immunoreactive transforming growth factor-ß (TGF-ß) and collagen {alpha}1 (IV) all were significantly increased in unsupplemented D compared with age-matched nondiabetic controls. With the exception of inulin clearance, LA prevented or significantly attenuated the increase in all of these glomerular parameters in D, as well as the increases in renal tubular cell TGF-ß seen in D. At the dose used, VE reduced inulin clearance in D to control levels but failed to alter any of the other indices of glomerular injury or to suppress renal tubular cell TGF-ß in D. VC suppressed urinary albumin excretion, fractional albumin clearance, and glomerular volume but not glomerular or tubular TGF-ß or glomerular collagen {alpha}1 (IV) content. LA but not VE or VC significantly increased renal cortical glutathione content in D. These data indicate that LA is effective in the prevention of early diabetic glomerular injury and suggest that this agent may have advantages over high doses of either VE or VC.




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