Alpha Lipoic Acid as a Potential Radioprotective Agent against Radiation-Induced Oral Mucositis through its antioxidant and anti-inflammatory effects

Purpose: The main aim of this review is to investigate the potential role of alpha-lipoic acid (ALA), which is a naturally occurring antioxidant in the prevention and management of radiation-induced oral mucositis (RIOM) in head and neck cancer patients undergoing radiotherapy sessions. It highlights the antioxidant, anti-inflammatory, and radioprotective effects of ALA found in preclinical and clinical studies.Methods: A comprehensive literature search was carried out using the Egyptian Knowledge Bank, PubMed, and Google Scholar databases by applying key terms such as “alpha-lipoic acid,” “oral mucositis,” “radiotherapy,” “antioxidants,” and “head and neck cancers“ to find important preclinical and clinical studies that were published in English. Findings: Numerous preclinical and clinical studies have demonstrated that the antioxidant and anti-inflammatory effects of ALA are beneficial in various diseases. Also, ALA showed protective effects against radiation-induced oral mucosal damage in three animal studies due to ALA’s ability to improve the activity of antioxidant enzymes, suppressing the pro-inflammatory signaling pathways, and reducing apoptosis in irradiated oral tissues.Implications: The potent anti-inflammatory and antioxidant properties demonstrated in clinical trials, as well as its radioprotective effects observed in animal studies, make alpha-lipoic acid (ALA) a promising supportive treatment for the management of RIOM in head and neck cancer patients. These effects also support its potential inclusion into clinical protocols in the future. However, this can only be applicable after performing further investigations and more extensive clinical trials in order to determine the ideal dose, effectiveness, and safety in RIOM patients.