Alpha-lipoic acid may be a clinically useful therapy in interstitial cystitis. - GreenMedInfo Summary

It has been recently observed that the urothelial expression of the chemokine fractalkine (CX3CL1) and its receptor (CX3CR1) is markedly increased in a mouse model of chronic cystitis . In this regard, Yuridullah et al. demonstrated a robust upregulation of both CXCL1 and CXCR1 in the urothelium following chronic cyclophosphamide (CYP)-induced cystitis in the rat . Because CYP-induced cystitis closely resembles the features of interstitial cystitis in humans , these observations establish down regulation of fractalkine as a potential target for the therapy of this common clinical entity. We hypothesize that such a therapeutic effect could be achieved via administration of alpha-lipoic acid (ALA), a naturally occurring disulfide compound . There are two major lines of evidence supporting this hypothesis: first, ALA has been demonstrated to act as an effective agent to reduce fractalkine mRNA and protein expression as well as fractalkine-mediated inflammatory processes ; second, ALA has the capacity to inhibit TNF-alpha-induced expression of fractalkine . Intriguingly, a recent study has also shown a significant reduction in antioxidant defense parameters in a rat model of chronic cystitis . Accordingly, ALA could reverse the detrimental effects of high levels of oxidative stress in bladder inflamed tissue due to its potent antioxidant activity . Finally, ALA has been shown to prevent the contractile dysfunction in rat urinary bladder strips . Since bladder inflammation may significantly influence regulation of detrusor activity , we speculate that ALA could prevent bladder hyperreflexia induced by chronic bladder inflammation.