Cardioprotective effect of alpha-lipoic acid and its mechanisms

Alpha-lipoic acid (ALA), a sulfur-containing fatty acid ubiquitously present in living organisms, is a cofactor that covalently binds to mitochondrial enzymes, such as pyruvate dehydrogenase (PDH) and oxoglutarate dehydrogenase (OGDH). ALA is not only crucial to the function of major enzymes that provide carbon to the tricarboxylic acid cycle but also has strong antioxidant properties. Indeed, ALA has a variety of properties under physiological and pathological conditions. In particular, ALA has been shown to have a protective effect on the cardiovascular system. The specific mechanisms may involve an anti-oxidative stress role by scavenging reactive oxygen species (an antioxidant property), regulation of aldehyde dehydrogenase-2 (ALDH2), and anti-inflammatory properties. The present review discusses the endogenous disulfide compound ALA, with a focus on its roles in cardioprotection and the underlying mechanisms.