Coenzyme Q10 and Cardiovascular Diseases

Coenzyme Q10 (CoQ10), which plays a key role in the electron transport chain by providing an adequate, efficient supply of energy, has another relevant function as an antioxidant, acting in mitochondria, other cell compartments, and plasma lipoproteins. CoQ10 deficiency is present in chronic and age-related diseases. In particular, in cardiovascular diseases (CVDs), there is a reduced bioavailability of CoQ10 since statins, one of the most common lipid-lowering drugs, inhibit the common pathway shared by CoQ10 endogenous biosynthesis and cholesterol biosynthesis. Different clinical trials have analyzed the effect of CoQ10 supplementation as a treatment to ameliorate these deficiencies in the context of CVDs. In this review, we focus on recent advances in CoQ10 supplementation and the clinical implications in the reduction of cardiovascular risk factors (such as lipid and lipoprotein levels, blood pressure, or endothelial function) as well as in a therapeutic approach for the reduction of the clinical complications of CVD.

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One-year outcome of coenzyme Q10 supplementation in ADCK3 ataxia (ARCA2)

Cerebellum & Ataxias ◽

10.1186/s40673-019-0109-2 ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 3

Author(s):

Tommaso Schirinzi ◽

Martina Favetta ◽

Alberto Romano ◽

Andrea Sancesario ◽

Susanna Summa ◽

...

Keyword(s):

Coenzyme Q10 ◽

Rating Scales ◽

Clinical Effects ◽

Short Treatment ◽

Oral Supplementation ◽

Coq10 Deficiency ◽

Pathophysiological Role ◽

Coq10 Supplementation ◽

One Year ◽

Biallelic Mutations

Abstract Background The recessive ataxia ARCA2 is a rare disorder characterized by Coenzyme Q10 (CoQ10) deficiency due to biallelic mutations in ADCK3 gene. Despite the pathophysiological role, available data are not univocal on clinical efficacy of CoQ10 supplementation in ARCA2. Here we described the long-term motor outcome of 4 untreated ARCA2 patients prospectively followed-up for one year after starting CoQ10 oral supplementation (15 mg/kg/day). Methods Clinical rating scales (SARA; 9 holes peg test; 6 min walking test; Timed 25-Foot Walk) and videoelectronic gait analysis were performed at baseline and every 6 months (T0, T1, T2) to evaluate the motor performances. Since two patients discontinued the treatment at the 7th month, we could provide comparative analysis between longer and shorter supplementation. Results At T2, the gait speed (Timed 25-Foot Walk test) significantly differed between patients with long and short treatment; overall, the clinical condition tended to be better in patients continuing CoQ10. Conclusions Although preliminarily, this observation suggests that only prolonged and continuous CoQ10 supplementation may induce mild clinical effects on general motor features of ARCA2. Dedicated trials are now necessary to extend and validate such observation.

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Coenzyme Q10: Clinical Applications in Cardiovascular Diseases

Antioxidants ◽

10.3390/antiox9040341 ◽

2020 ◽

Vol 9 (4) ◽

pp. 341 ◽

Cited By ~ 6

Author(s):

Alma Martelli ◽

Lara Testai ◽

Alessandro Colletti ◽

Arrigo F. G. Cicero

Keyword(s):

Cardiovascular Diseases ◽

Coenzyme Q10 ◽

Randomized Clinical Trials ◽

Substantial Reduction ◽

Muscle Disorders ◽

Stress Markers ◽

Pathway Activation ◽

Number Of Patients ◽

Coq10 Supplementation ◽

Associated Risk Factors

Coenzyme Q10 (CoQ10) is a ubiquitous factor present in cell membranes and mitochondria, both in its reduced (ubiquinol) and oxidized (ubiquinone) forms. Its levels are high in organs with high metabolism such as the heart, kidneys, and liver because it acts as an energy transfer molecule but could be reduced by aging, genetic factors, drugs (e.g., statins), cardiovascular (CV) diseases, degenerative muscle disorders, and neurodegenerative diseases. As CoQ10 is endowed with significant antioxidant and anti-inflammatory features, useful to prevent free radical-induced damage and inflammatory signaling pathway activation, its depletion results in exacerbation of inflammatory processes. Therefore, exogenous CoQ10 supplementation might be useful as an adjuvant in the treatment of cardiovascular diseases such as heart failure, atrial fibrillation, and myocardial infarction and in associated risk factors such as hypertension, insulin resistance, dyslipidemias, and obesity. This review aims to summarize the current evidences on the use of CoQ10 supplementation as a therapeutic approach in cardiovascular diseases through the analysis of its clinical impact on patients’ health and quality of life. A substantial reduction of inflammatory and oxidative stress markers has been observed in several randomized clinical trials (RCTs) focused on several of the abovementioned diseases, even if more RCTs, involving a larger number of patients, will be necessary to strengthen these interesting findings.

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Coenzyme Q10 modulates sulfide metabolism and links the mitochondrial respiratory chain to pathways associated to one carbon metabolism

Human Molecular Genetics ◽

10.1093/hmg/ddaa214 ◽

2020 ◽

Vol 29 (19) ◽

pp. 3296-3311

Author(s):

Pilar González-García ◽

Agustín Hidalgo-Gutiérrez ◽

Cristina Mascaraque ◽

Eliana Barriocanal-Casado ◽

Mohammed Bakkali ◽

...

Keyword(s):

Mitochondrial Dysfunction ◽

Coenzyme Q10 ◽

Carbon Metabolism ◽

Sulfide Oxidation ◽

Metabolic Effects ◽

Therapeutic Effects ◽

Coq10 Deficiency ◽

Transsulfuration Pathway ◽

One Carbon Metabolism ◽

Coq10 Supplementation

Abstract Abnormalities of one carbon, glutathione and sulfide metabolisms have recently emerged as novel pathomechanisms in diseases with mitochondrial dysfunction. However, the mechanisms underlying these abnormalities are not clear. Also, we recently showed that sulfide oxidation is impaired in Coenzyme Q10 (CoQ10) deficiency. This finding leads us to hypothesize that the therapeutic effects of CoQ10, frequently administered to patients with primary or secondary mitochondrial dysfunction, might be due to its function as cofactor for sulfide:quinone oxidoreductase (SQOR), the first enzyme in the sulfide oxidation pathway. Here, using biased and unbiased approaches, we show that supraphysiological levels of CoQ10 induces an increase in the expression of SQOR in skin fibroblasts from control subjects and patients with mutations in Complex I subunits genes or CoQ biosynthetic genes. This increase of SQOR induces the downregulation of the cystathionine β-synthase and cystathionine γ-lyase, two enzymes of the transsulfuration pathway, the subsequent downregulation of serine biosynthesis and the adaptation of other sulfide linked pathways, such as folate cycle, nucleotides metabolism and glutathione system. These metabolic changes are independent of the presence of sulfur aminoacids, are confirmed in mouse models, and are recapitulated by overexpression of SQOR, further proving that the metabolic effects of CoQ10 supplementation are mediated by the overexpression of SQOR. Our results contribute to a better understanding of how sulfide metabolism is integrated in one carbon metabolism and may explain some of the benefits of CoQ10 supplementation observed in mitochondrial diseases.

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Cellular Consequences of Coenzyme Q10 Deficiency in Neurodegeneration of the Retina and Brain

International Journal of Molecular Sciences ◽

10.3390/ijms21239299 ◽

2020 ◽

Vol 21 (23) ◽

pp. 9299

Author(s):

Haider Manzar ◽

Dalia Abdulhussein ◽

Timothy E. Yap ◽

M. Francesca Cordeiro

Keyword(s):

Coenzyme Q10 ◽

Cellular Level ◽

Vital Role ◽

The Body ◽

Age Related Macular Degeneration ◽

Inner Mitochondrial Membrane ◽

Waste Products ◽

Age Related ◽

Coq10 Deficiency ◽

The Central Nervous System

Coenzyme Q10 (CoQ10) is a ubiquitous cofactor in the body, operating in the inner mitochondrial membrane, where it plays a vital role in the generation of adenosine triphosphate (ATP) through the electron transport chain (ETC). In addition to this, CoQ10 serves as an antioxidant, protecting the cell from oxidative stress by reactive oxygen species (ROS) as well as maintaining a proton (H+) gradient across lysosome membranes to facilitate the breakdown of cellular waste products. Through the process of ageing, the body becomes deficient in CoQ10, resulting in several systemic manifestations. On a cellular level, one of the consequences of CoQ10 deficiency is apoptosis, which can be visualised in tissues of the central nervous system (CNS). Diseases affecting the retina and brain such as age-related macular degeneration (AMD), glaucoma, Alzheimer’s disease (AD) and Parkinson’s disease (PD) have shown defects in cellular biochemical reactions attributed to reduced levels of CoQ10. Through further research into the pathogenesis of such conditions, the effects of CoQ10 deficiency can be counteracted through supplementation, early detection and intervention.

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Disorders of Human Coenzyme Q10 Metabolism: An Overview

International Journal of Molecular Sciences ◽

10.3390/ijms21186695 ◽

2020 ◽

Vol 21 (18) ◽

pp. 6695 ◽

Cited By ~ 1

Author(s):

Iain Hargreaves ◽

Robert A. Heaton ◽

David Mantle

Keyword(s):

Coenzyme Q10 ◽

Biochemical Pathway ◽

Mitochondrial Oxidative Phosphorylation ◽

Vital Functions ◽

Coq10 Deficiency ◽

Number Of Genes ◽

Clinical Consequences ◽

Coq10 Supplementation ◽

Lipid Soluble Antioxidant

Coenzyme Q10 (CoQ10) has a number of vital functions in all cells, both mitochondrial and extramitochondrial. In addition to its key role in mitochondrial oxidative phosphorylation, CoQ10 serves as a lipid soluble antioxidant, plays an important role in fatty acid, pyrimidine and lysosomal metabolism, as well as directly mediating the expression of a number of genes, including those involved in inflammation. In view of the central role of CoQ10 in cellular metabolism, it is unsurprising that a CoQ10 deficiency is linked to the pathogenesis of a range of disorders. CoQ10 deficiency is broadly classified into primary or secondary deficiencies. Primary deficiencies result from genetic defects in the multi-step biochemical pathway of CoQ10 synthesis, whereas secondary deficiencies can occur as result of other diseases or certain pharmacotherapies. In this article we have reviewed the clinical consequences of primary and secondary CoQ10 deficiencies, as well as providing some examples of the successful use of CoQ10 supplementation in the treatment of disease.

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The Effects of Coenzyme Q10 Supplementation on Lipid Profiles Among Patients with Metabolic Diseases: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Current Pharmaceutical Design ◽

10.2174/1381612824666180406104516 ◽

2018 ◽

Vol 24 (23) ◽

pp. 2729-2742 ◽

Cited By ~ 6

Author(s):

Nasrin Sharifi ◽

Reza Tabrizi ◽

Mahmood Moosazadeh ◽

Naghmeh Mirhosseini ◽

Kamran B. Lankarani ◽

...

Keyword(s):

Systematic Review ◽

Lipid Profile ◽

Coenzyme Q10 ◽

Metabolic Disorders ◽

Metabolic Diseases ◽

Meta Analysis ◽

Lipid Profiles ◽

Controlled Trials ◽

Serum Triglycerides ◽

Coq10 Supplementation

Background and objective: Oxidative stress and inflammation are key parameters in developing metabolic disorders. Hence, antioxidant intake might be an appropriate approach. Several studies have evaluated the effect of coenzyme Q10 (CoQ10) supplementation on lipid profile among patients with metabolic diseases, though findings are controversial. The aim of this systematic review and meta-analysis was to determine the effects of CoQ10 supplementation on lipid profile in patients with metabolic disorders. Methods: We searched PubMed, EMBASE, Web of Science and Cochrane Library databases until July 2017. Prospective clinical trials were selected assessing the effect of CoQ10 supplementation on different biomarkers. Two reviewers independently assessed the eligibility of studies, extracted data, and evaluated the risk of bias of included studies. A fixed- or random-effects model was used to pool the data, which expressed as a standardized mean difference with 95% confidence interval. Heterogeneity was measured using a Q-test and with I2 statistics. Results: A total of twenty-one controlled trials (514 patients and 525 controls) were included. The meta-analysis indicated a significant reduction in serum triglycerides levels (SMD -0.28; 95% CI, -0.56, -0.005). CoQ10 supplementation also decreased total-cholesterol (SMD -0.07; 95% CI, -0.45, 0.31), increased LDL- (SMD 0.04; 95% CI, -0.27, 0.36), and HDL-cholesterol levels (SMD 0.10; 95% CI, -0.32, 0.51), not statistically significant. Conclusion: CoQ10 supplementation may significantly reduce serum triglycerides levels, and help to improve lipid profiles in patients with metabolic disorders. Additional prospective studies are recommended using higher supplementation doses and longer intervention period.

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The Use of Coenzyme Q10 in Cardiovascular Diseases

Antioxidants ◽

10.3390/antiox10050755 ◽

2021 ◽

Vol 10 (5) ◽

pp. 755

Author(s):

Yoana Rabanal-Ruiz ◽

Emilio Llanos-González ◽

Francisco J. Alcain

Keyword(s):

Oxidative Stress ◽

Cardiovascular Diseases ◽

Endothelial Dysfunction ◽

Vascular System ◽

Contractile Function ◽

Artery Bypass ◽

Bypass Graft ◽

No Bioavailability ◽

Coq10 Supplementation ◽

Endogenous Antioxidant

CoQ10 is an endogenous antioxidant produced in all cells that plays an essential role in energy metabolism and antioxidant protection. CoQ10 distribution is not uniform among different organs, and the highest concentration is observed in the heart, though its levels decrease with age. Advanced age is the major risk factor for cardiovascular disease and endothelial dysfunction triggered by oxidative stress that impairs mitochondrial bioenergetic and reduces NO bioavailability, thus affecting vasodilatation. The rationale of the use of CoQ10 in cardiovascular diseases is that the loss of contractile function due to an energy depletion status in the mitochondria and reduced levels of NO for vasodilatation has been associated with low endogenous CoQ10 levels. Clinical evidence shows that CoQ10 supplementation for prolonged periods is safe, well-tolerated and significantly increases the concentration of CoQ10 in plasma up to 3–5 µg/mL. CoQ10 supplementation reduces oxidative stress and mortality from cardiovascular causes and improves clinical outcome in patients undergoing coronary artery bypass graft surgery, prevents the accumulation of oxLDL in arteries, decreases vascular stiffness and hypertension, improves endothelial dysfunction by reducing the source of ROS in the vascular system and increases the NO levels for vasodilation.

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Coenzyme Q10 and Immune Function: An Overview

Antioxidants ◽

10.3390/antiox10050759 ◽

2021 ◽

Vol 10 (5) ◽

pp. 759

Author(s):

David Mantle ◽

Robert A. Heaton ◽

Iain P. Hargreaves

Keyword(s):

Immune System ◽

Immune Function ◽

Coenzyme Q10 ◽

Mitochondrial Respiratory Chain ◽

Inflammatory Gene Expression ◽

Optimal Functioning ◽

Human Immune ◽

Coq10 Supplementation ◽

Lipid Soluble Antioxidant

Coenzyme Q10 (CoQ10) has a number of important roles in the cell that are required for optimal functioning of the immune system. These include its essential role as an electron carrier in the mitochondrial respiratory chain, enabling the process of oxidative phosphorylation to occur with the concomitant production of ATP, together with its role as a potential lipid-soluble antioxidant, protecting the cell against free radical-induced oxidation. Furthermore, CoQ10 has also been reported to have an anti-inflammatory role via its ability to repress inflammatory gene expression. Recently, CoQ10 has also been reported to play an important function within the lysosome, an organelle central to the immune response. In view of the differing roles CoQ10 plays in the immune system, together with the reported ability of CoQ10 supplementation to improve the functioning of this system, the aim of this article is to review the current literature available on both the role of CoQ10 in human immune function and the effect of CoQ10 supplementation on this system.

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Nursing Teleconsultation for the Outpatient Management of Patients with Cardiovascular Disease during COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042087 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2087

Author(s):

Vincenzo Russo ◽

Roberta Cassini ◽

Valentina Caso ◽

Chiara Donno ◽

Annunziata Laezza ◽

...

Keyword(s):

Cardiovascular Diseases ◽

Continuity Of Care ◽

Medical Intervention ◽

Lipid Lowering ◽

Outpatient Management ◽

Medical Interventions ◽

Artery Disease ◽

Clinical Conditions ◽

Mean Time

Introduction: During the COVID-19 outbreak, non-urgent clinic visits or cardiac interventional procedures were postponed to a later date, and the implementation of telemedicine has guaranteed continuity of care for patients with chronic diseases. The aim of our study was to describe the medical interventions following nursing teleconsultation for the outpatient management of patients with cardiovascular diseases during the COVID-19 pandemic. Materials and Methods: All patients who did not attend the follow-up visit from 4 to 15 April 2020 at our institution and who were re-scheduled due to the COVID-19 lockdown were selected to be enrolled in the study. Each patient was followed by a semi-structured telephonic interview performed by a nurse. The outcomes of our study were to assess the patients’ adherence to nursing teleconsultation and the usefulness of nursing teleconsultation to detect clinical conditions in need of medical intervention. Results: In total, 203 patients (81%) underwent nursing teleconsultation in a mean time of 7 ± 3 days from the outpatient visit lost due to the COVID-19 lockdown. Furthermore, 53 patients (26%) showed poor adherence to nursing teleconsultation. Among the 150 patients (mean age 67 ± 10 years; 68% male) who completed the telephonic interview, the nursing teleconsultation revealed the need of medical intervention in 69 patients (46%), who were more likely at very high cardiovascular risk (77% vs. 48%; p < 0.0003) and who showed a higher prevalence of dyslipidemia (97% vs. 64%; p < 0.0001) and coronary artery disease (75% vs. 48%, p < 0.0008) compared to those not in need of any intervention. The up-titration of the lipid-lowering drugs (n: 32, 74%) was the most frequent medical intervention following the nursing teleconsultation. The mean time between the nursing teleconsultation and the date of the rescheduled in-person follow-up visit was 164 ± 36 days. Conclusions: Nursing teleconsultation is a simple and well-tolerated strategy that ensures the continuity of care and outpatient management for patients with cardiovascular diseases during the COVID-19 pandemic.

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Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine—a meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-039358 ◽

2021 ◽

Vol 11 (1) ◽

pp. e039358

Author(s):

Suhairul Sazali ◽

Salziyan Badrin ◽

Mohd Noor Norhayati ◽

Nur Suhaila Idris

Keyword(s):

Random Effects ◽

Coenzyme Q10 ◽

Migraine Headache ◽

Meta Analysis ◽

Adult Patients ◽

Control Group ◽

Cochrane Central Register ◽

Statistical Heterogeneity ◽

Coq10 Supplementation ◽

The Impact

ObjectiveTo determine the effects of coenzyme Q10 (CoQ10) for reduction in the severity, frequency of migraine attacks and duration of headache in adult patients with migraine.DesignSystematic review and meta-analysis.Data sourcesCochrane Central Register of Controlled Trials, CENTRAL, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Psychological Information Database (PsycINFO) from inception till December 2019.Study selectionAll randomised control trials comparing CoQ10 with placebo or used as an adjunct treatment included in this meta-analysis. Cross-over designs and controlled clinical trials were excluded.Data synthesisHeterogeneity at face value by comparing populations, settings, interventions and outcomes were measured and statistical heterogeneity was assessed by means of the I2 statistic. The treatment effect for dichotomous outcomes were using risk ratios and risk difference, and for continuous outcomes, mean differences (MDs) or standardised mean difference; both with 95% CIs were used. Subgroup analyses were carried out for dosage of CoQ10 and if CoQ10 combined with another supplementation. Sensitivity analysis was used to investigate the impact risk of bias for sequence generation and allocation concealment of included studies.ResultsSix studies with a total of 371 participants were included in the meta-analysis. There is no statistically significant reduction in severity of migraine headache with CoQ10 supplementation. CoQ10 supplementation reduced the duration of headache attacks compared with the control group (MD: −0.19; 95% CI: −0.27 to −0.11; random effects; I2 statistic=0%; p<0.00001). CoQ10 usage reduced the frequency of migraine headache compared with the control group (MD: −1.52; 95% CI: −2.40 to −0.65; random effects; I2 statistic=0%; p<0.001).ConclusionCoQ10 appears to have beneficial effects in reducing duration and frequency of migraine attack.PROSPERO registration numberCRD42019126127.

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