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Aldehyde dehydrogenase-2 (ALDH2) is the main enzyme responsible for acetaldehyde oxidation in ethanol metabolism and also provides protection against oxidative stress.  Alpha-lipoic acid (α-LA), a natural dithiol compound with antioxidant properties, has been reported to increase ALDH2 activity in cultured cells.  We analyzed the therapeutic efficacy of α-LA in 63 patients with confirmed acute coronary syndrome (ACS).  These patients (52 men and 11 women, with age range 49-72 years) were randomized into two groups: untreated group (n = 30) and α-LA group (n = 33).  Patients in the α-LA group were given an intravenous injection of 600 mg α-LA every day for 5 days while the patients in the untreated group were given saline.  An isoprostane, 8-iso-prostaglandin F2α (8-iso-PGF2α), one product of arachidonic acid metabolism, was measured as a marker for oxidative stress.  The serum levels of 8-iso-PGF2α and ALDH2 activity were determined at admission to the hospital (time 0), and at 24 hours and 1 week after treatment.  At 24 hours and 1 week after treatment, ALDH2 activity was significantly higher in the α-LA group than in the untreated group (P &lt; 0.05), whereas the levels of 8-iso-PGF2α were significantly lower in the α-LA group than in the untreated group (all P &lt; 0.05).  Importantly, the decrease of 8-iso-PGF2α levels correlated with the increased ALDH2 activity at both 24 hours (r = 0.6234, P &lt; 0.001) and 1 week after treatment (r = -0.3941, P = 0.0014).  α-LA may ameliorate oxidative stress through up-regulating ALDH2 activity in patients with ACS.

Alpha-Lipoic Acid Ameliorates Oxidative Stress by Increasing Aldehyde Dehydrogenase-2 Activity in Patients with Acute Coronary Syndrome