Influence of alpha lipoic acid on prostaglandin pathways: findings from systematic review of preclinical and clinical studies

Purpose Alpha-lipoic acid (ALA) is a naturally occurring antioxidant that has garnered attention for its potential therapeutic effects on various health conditions. Key outcomes assessed include changes in prostaglandin E2 (PGE2) and other related mediators in response to ALA treatment. Design/methodology/approach This systematic review aimed to comprehensively analyze the available evidence on drug interactions between ALA and prostaglandin pathways and highlight their potential therapeutic implications. A comprehensive search of multiple scientific databases, including Web of Science, Embase, PubMed, Scopus and Google Scholar, was conducted from database inception until 31 August 2025 using keywords related to ALA and prostaglandins. Findings The findings consistently show that ALA inhibits cyclooxygenase (COX) enzymes, particularly COX-2, leading to a reduction in prostaglandin production. This inhibition contributes to ALA’s anti-inflammatory, anticancer and antioxidant properties by modulating downstream signaling pathways such as MAPK, TNF and PI3K-Akt. ALA also reduces the expression of proinflammatory cytokines and markers, such as TNF-α, interleukin-6 and inducible nitric oxide synthase, in immune cells. Originality/value The findings underscore the need for more rigorous clinical trials to establish definitive conclusions regarding ALA’s efficacy and safety in this context.