Pathogenetic mechanisms and clinical features of treatment of alcohol neuropathies

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Background. Alcoholic neuropathy is a dominant complication of acute and chronic intoxication due to alcohol abuse. It leads to sensory, motor and autonomic damage to the peripheral nervous system and quantitatively far outweighs da-mage to the central nervous system. The purpose of the work is to investigate the clinical and electrophysiological efficacy of alpha-lipoic acid (ALA) in the experiment and clinic during the comprehensive treatment of alcoholic polyneuropathies (APN). Materials and methods. Experimental alcoholic polyneuropathy (EAP) was reproduced for 10 weeks, during which male Wistar rats were fed alcohol (10 g/kg body weight). After 10 weeks, treatment was initiated with intraperitoneal administration of ALA at a dose of 100 mg/kg, 5 times a week for 8 weeks. Animal groups: 1) control (n = 6); 2) rats with EAP (n = 16); 3) rats with EAP who were administered ALA (n = 16). In the clinical part of the work, 51 patients with APN were examined. Results. The obtained data can be discussed in terms of developing a pathogenetically substantiated treatment regimen for APN. The positive results were evaluated as experimental evidence of the feasibi­lity of testing the clinical effects of ALA in patients with peri-pheral nerve damage. Rats with EAP showed normalization of the functioning of the sensory (from the 5th week, 31st day) and motor (from the 6th week, 40th day) components of the peri-pheral nerves. Based on the obtained experimental data, a series of clinical observations were conducted in which the clinical efficacy of ALA in APN was found. Conclusions. Considering the positive experimental and clinical effects of ALA proven using objective methods of neurophysiological and pathophysiological research, it is likely that the mechanism for achieving them is the restoration of the myelin sheath of the peripheral nerves, since the reverse process is of pathogenetic importance in the development of clinical symptoms of APN. The obtained positive results on the effectiveness of APN treatment using ALA require longer research, as a tendency towards progression of improvement in the condition of patients has been noted, especially with distal mixed (motor-sensory) forms of APN.