Clinical use of vaginal lipoic acid in pregnancy

Pregnancy is generally considered as an anti-inflammatory condition and a shift in the type of cytokines produced leads to the onset of an inflammation state that would lead to abortion or pregnancy complications. It is known that lipoic acid (ALA) and its reduced form dehydrolipoic acid (DHLA) constitute a powerful redox couple, that can directly scavenge reactive oxygen species and reactive nitrogen species and several mechanisms of action of ALA/DHLA seems to be associated to the modulation of NF-κB activity. Indeed, ALA acts on several inflammatory pathways involved in the onset of cervical ripening, uterine contractions and premature preterm rupture of membranes, and the specific anti-inflammatory actions exerted on pregnancy-related tissues such as amnion and cervix warrants its clinical application in this field. In particular, vaginal administration of ALA is a novel approach specifically directed to pregnacy-related tissue. As a local treatment, administration of vaginal ALA may exert more rapid and strong effects than a sistemic (i.e., oral) administration.