Effects of alpha lipoic acid and its R+ enantiomer supplemented to hyperbaric oxygen therapy on interleukin-6, TNF-α and EGF production in chronic leg wound healing

Context: Lipoic acid (LA) and hyperbaric oxygenation therapy (HBOT) improve chronic wound healing.

Objective: We compared the effects of LA or its enantiomer R-(+)-lipoic acid (RLA) on wound healing.

Materials and methods: Groups LA + HBOT (L), RLA + HBOT (R) and placebo + HBOT (P). Lesion areas measured before treatment and on 20th and 40th day. The biopsies and plasma were harvested before treatment and on 7th and 14th (measurements of VEGF, vascular endothelial growth factor; EGF, epidermal growth factor, TNF-α and IL-6).

Results: Ulcers improved more on RLA. In both L and R groups, EGF and VEFG increased in time. RLA decreased IL-6 on T7 and T14, which did not happen with LA. TNF-α levels decreased on T14 in both LA and RLA.

Discussion: The improved wound healing is associated with increased EGF and VEGF and reduced plasma TNF-α and IL-6.

Conclusion: RLA may be more effective than LA in improving chronic wound healing in patients undergoing HBO therapy.