Rationale for Correct Answer
The correct answer is: Lipoic acid is associated with reduced microglial activity in the central nervous system (CNS)
Lipoic acid reduces oxidative stress, T-cell adhesion to brain epithelium, T-cell penetration of the blood-brain barrier by inflammatory agents, and activity of CNS microglia and macrophages.1
In a phase 2, placebo-controlled trial of patients with nSPMS, lipoic acid was associated with significantly less brain volume loss; no other clinical or MRI endpoints showed a significant between-group difference.2 There were 6 serious adverse events (SAEs) each in the lipoic acid and placebo groups, none of which were considered treatment-related. Two of the SAEs in the lipoic acid group, however, were renal-related, suggesting that renal monitoring should be included in future clinical trials.2 In both cases, the renal SAE led to discontinuation. There were 5 discontinuations in the lipoic acid group and none in the placebo group.2
References:
1. Xie H et al. CNS Neurosci Ther. 2022;28:319-331.
2. Spain R et al. Neurol Neuroimmunol Neuroinflamm. 2017;4:e374.