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Alpha Lipoic Acid, A Novel Therapeutic Agent for Intervention of Childhood Allergies Print E-mail
by P.K.L. Lam, MBBS(H.K.), FAAP, FRCP(Edin), Suite 1023B Argyle Centre, Phase 1, 688 Nathan Road, Kowloon, Hong Kong, China

Summary

A spectrum of bizarre illnesses including chronic anorexia, poor growth, disturbed sleep, frequent infection and severe allergies were not well treated conventionally. Elevated heavy metals (Mercury, Lead, Cadmium, Antimony and Arsenic) could be identified in mineral hair analysis in these patients. Alpha Lipoic Acid, a potent antioxidant has been applied to treat these patients with remarkable result. A retrospective review from April, 2002 to December, 2003 of 416 consecutive infants and children so managed was carried out. Of these, 42 had severe allergic diseases including chronic tic- like cough, steroid dependent asthma with frequent exacerbation and intractable severe eczema. The excellent result could be explained by the potent antioxidant action of Alpha Lipoic Acid in chelating the heavy metals, thus breaking the allergic propagation.

Introduction

Like the rest of the world, Hong Kong has experienced an ever rising incidence of allergies in children.1) Environmental pollution has been incriminated as causative but the exact mechanism is obscure. In the quest of an alternative method of solving an emerging spectrum of bizarre illnesses including severe allergies, the patients¡¦ hair were subjected to mineral analysis by a U.S. based federally licensed laboratory (Trace Element). Patients with elevated heavy metal were treated by a regime including Alpha Lipoic Acid. Result of this novel treatment has been gratifying and seemed superior to conventional management.

copyright 2004 by MEDIMOND S.r.l. EX04C0011, The 6th Asia Pacific Congress of Allergology and Clinical Immunology

Material and Methods

A retrospective review of consecutive 416 infants and children who had undergone mineral hair analysis from April 2002 to December 2003 were carried out. Of these, 42 patients were noted to have severe allergies, classified into the following categories:

  • 13 (age range: 4 to 9 year): had chronic tic-like cough not responding to conventional anti-allergic treatment.
  • 18 (age range: 8 month to 5 year)): had severe asthma dependent on inhalational steroid yet experiencing frequent exacerbation.
  • 11 (age range: 10 month to 3 year): had intractable eczema involving large areas not responding well to topical steroid and frequently associated with disturbed sleep. All of these severely allergic patients showed elevation of one to multiple heavy metals in their hair. These were caused by ingestion of contaminated fish or from transplacental passage of heavy metal from asymptomatic mother during pregnancy.

These patients were treated by avoidance of the sources of heavy metals implying the abstinence of fish, and a regime of Alpha Lipoic Acid, supplementary zinc and magnesium, and vitamin B complex.

The mean duration of treatment was 79 days. The response of the severely allergic patients to this novel regime was good, with 78% having an excellent response. Apart from the complete eradication of the allergy, the overall health of the patients such as growth, sleep

History of Lipoic Acid

  • 1951 First isolated by Lester Reed in Texas, U.S.A..
  • 1960-70s First shown to be clinically effective in treating liver cirrhosis, diabetes, heavy metal toxicity and neuropathy in Europe. Also used successfully in treatment of Amanita mushroom poisoning.
  • 1988 Shown to be a potent antioxidant, able to regenerate & lengthen the life-span of other antioxidants: vitamin E & C, Co-enzyme Q10 & glutathione. It helps to maintain cell integrity in the face of biological insults.
  • 1990 Approved in Germany for the treatment of diabetic neuropathy, dosage up to 600 mg intravenous preparation without adverse side effects.

Results of Study

Quality of life, emotional balance and immune resistance to common infection also improved. From this review, the earlier the recognition and intervention, the higher the chance of a complete remission of the allergy.

Conclusion

As contrast to the predominant neurological damage reported from the mercury toxicity in Minamata Disease in 1953, this report described a spectrum of diseases with heavy metal overload affecting various systems amenable to therapy. Heavy metals induce an oxidative stress. They promote a Th-2 dominant immune response and down regulate a Th-1 immunity. Allergic reactions have been shown to be associated with oxidative stress. So it is rational to use anti-oxidant to intervene the allergy cascade. The potential role of Alpha Lipoic Acid in the management of chronic illnesses associated with oxidative stress has been cited. By nature of its high bioavailability, potent antioxidant capability and a brief half-life, it deserves to be studied further on its potential to treat early childhood allergies.

References

  • LEE S. L., WONG W. & LAU Y. L. Increasing prevalence of allergic rhinitis but not asthma among children in Hong Kong from 1995 to 2001 (Phase 3 International Study of Asthma and Allergies in Childhood). Pediatr Allergy Immunol. 15(1):72-8. 2004 Feb.
  • ETO K. Minamata disease. Neuropathology. Sep;20 Suppl:S14-9. 2000.
  • TIRMENSTEIN MA, PLEWS PI, WALKER CV, WOOLERY MD, WEY HE, TORAASON MA. Antimony-induced oxidative stress and toxicity in cultured cardiac myocytes. Toxicol Appl Pharmacol. 130(1):41-7. 1995 Jan.
  • STOHS S. J. & BAGCHI D. Oxidative mechanisms in the toxicity of metal ions. Free Radic Biol Med. 18(2):321-36. 1995.
  • GEBEL T. Arsenic and antimony: comparative approach on mechanistic toxicology. Chem Biol Interact. 28;107(3):131-44. 1997 Nov.
  • DIANNE R BALDWIN AND WILLIAM J MARSHALL. Heavy metal poisoning and its laboratory investigation. Ann Clin Biochem. 36(Pt 3): 267-300. 1999.
  • ERCAL N., GURER-ORHAN H. & AYKIN-BURNS N. Toxic metals and oxidative stress part I: mechanisms involved in metal-induced oxidative damage. Curr Top Med Chem. 1(6):529-39. 2001 Dec.
  • HUGHES MF. Arsenic toxicity and potential mechanisms of action. Toxicol Lett. 133(1):1-16. 2002 Jul.
  • CHEN CY, WANG YF, LIN YH, YEN SF. Nickel-induced oxidative stress and effect of antioxidants in human lymphocytes. Arch Toxicol. 77(3):123, 30. Epub 2003 Jan 25.
  • HENRICKS, P. A. & NIJKAMP, F. P. Reactive oxygen species as mediators in asthma. Pulm Pharmacol Ther. 14(6): 409-420. 2001.
  • BOWLER RP, CRAPO JD. Oxidative stress in allergic respiratory diseases. J Allergy Clin Immunol. 110(3):349-56. 2002 Sep.
  • RAHO G, CASSANO N, DARGENTO V, VENA GA, ZANOTTI F. Over- expression of Mn-superoxide dismutase as a marker of oxidative stress in lesional skin of chronic idiopathic urticaria. Clin Exp Dermatol. 28(3):318 2003 May.
  • KONGERUD J, CRISSMAN K, HATCH G, ALEXIS N. Ascorbic acid is decreased in induced sputum of mild asthmatics. Inhal Toxicol. 15(2):101 2003 Feb.
  • SMITH AR, SHENVI SV, WIDLANSKY M, SUH JH, HAGEN TM. Lipoic acid as a potential therapy for chronic diseases associated with oxidative stress. Curr Med Chem. 11(9):1135-46. 2004 May.


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