Modulation of mitogen- activated protein kinases (MAPK’s). Increased nerve lipid peroxidation (LPO). Accumulation of AGE’s and subsequent activation of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). Myeloperoxidase and NO affect the process of inflammation by molecular mechanisms and reaction between them is a sign of local inflammation and cardiovascular events initiation and progression in the body. Nitric oxide is a signaling molecule with cellular effects, cardiovascular and metabolic process involved in much biological regulation such as cell proliferation, neurotransmission, antimicrobial defence, vasodilatation and inflammatory response. Endoneurial microvascular damage and hypoxia due to NO inactivation. Fructose and sorbitol accumulation due to increased flux through the polyol pathway that is associated with compensatory depletion of other organic osmolytes such as taurine and myo-inositol. 7 In the development of DN are involved the following mechanisms: 1. Increased level of intracellular glucose leads to activation of polyol pathway and formation of advanced glycation end-products (AGE’s), resulting in the subsequent formation of ROS. OS is considered as a main pathophysiological pathway of diabetic neuropathy (DN) development. Keywords : alpha-lipoic acid, oxidative stress, inflammation, diabetes mellitus, diabetic neuropathy Introduction Prescription of ALA can have both detrimental and cytoprotective effects on pancreatic β-cells. In skeletal muscle ALA reduce triglyceride accumulation, enhances expression of the insulin receptor substrate 1 protein and improves insulin sensitivity by activating 5′-AMP-activated protein kinase, recruits glucose transporter type 4 from its storage site in the Golgi to the sarcolemma. ![]() ALA can protect albumin from glycation, improves the redox state of the plasma and endothelium-dependent vasodilation induces protein kinase B phosphorylation in vascular endothelial cells shows a protective effect on oxidative stress-induced apoptosis. ![]() ![]() ALA has many biochemical functions acting as a biological antioxidant, anti-inflammatory properties, metal chelators, reducing the oxidized forms of other antioxidant agents such as vitamin C and E and glutathione, and modulating the signaling transduction of several pathways, like insulin and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB). Alpha-lipoic acid (ALA) has been widely prescribed drug for treatment and prevention of diabetic complications since it affects the main pathogenesis links.
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