A randomized trial of coenzyme Q10 in mitochondrial disorders

Case reports and open‐label studies suggest that coenzyme Q10 (CoQ10) treatment may have beneficial effects in mitochondrial disease patients; however, controlled trials are warranted to clinically prove its effectiveness. Thirty patients with mitochondrial cytopathy received 1200 mg/day CoQ10 for 60 days in a randomized, double‐blind, cross‐over trial. Blood lactate, urinary markers of oxidative stress, body composition, activities of daily living, quality of life, forearm handgrip strength and oxygen desaturation, cycle exercise cardiorespiratory variables, and brain metabolites were measured. CoQ10 treatment attenuated the rise in lactate after cycle ergometry, increased (∽1.93 ml) VO2/kg lean mass after 5 minutes of cycling (P < 0.005), and decreased gray matter choline‐containing compounds (P < 0.05). Sixty days of moderate‐ to high‐dose CoQ10 treatment had minor effects on cycle exercise aerobic capacity and post‐exercise lactate but did not affect other clinically relevant variables such as strength or resting lactate. Muscle Nerve, 2010

[1]  N. Bresolin,et al.  Ubidecarenone in the treatment of mitochondrial myopathies: a multi-center double-blind trial , 1990, Journal of the Neurological Sciences.

[2]  M. Beal,et al.  A carbon column-based liquid chromatography electrochemical approach to routine 8-hydroxy-2'-deoxyguanosine measurements in urine and other biologic matrices: a one-year evaluation of methods. , 1999, Free radical biology & medicine.

[3]  M. V. Miles The uptake and distribution of coenzyme Q10. , 2007, Mitochondrion.

[4]  S. Di Giovanni,et al.  Coenzyme Q10 reverses pathological phenotype and reduces apoptosis in familial CoQ10 deficiency , 2001, Neurology.

[5]  R. Kreis,et al.  Peak assignment in localized 1H MR spectra of human muscle based on oral creatine supplementation , 1997, Magnetic resonance in medicine.

[6]  Chunfang Zhang,et al.  Cellular Redox Activity of Coenzyme Q 10 : Effect of CoQ 10 Supplementation on Human Skeletal Muscle , 2002, Free radical research.

[7]  R. Haas The evidence basis for coenzyme Q therapy in oxidative phosphorylation disease. , 2007, Mitochondrion.

[8]  M. Tarnopolsky,et al.  Metabolic Myopathies: Update 2009 , 2009, Journal of clinical neuromuscular disease.

[9]  S. Lalani,et al.  Isolated mitochondrial myopathy associated with muscle coenzyme Q10 deficiency. , 2005, Archives of neurology.

[10]  M. Tarnopolsky The mitochondrial cocktail: rationale for combined nutraceutical therapy in mitochondrial cytopathies. , 2008, Advanced drug delivery reviews.

[11]  H. Reichmann,et al.  Metabolic changes in patients with mitochondrial myopathies and effects of coenzyme Q10 therapy , 1998, Journal of Neurology.

[12]  A. Munnich,et al.  Quinone-responsive multiple respiratory-chain dysfunction due to widespread coenzyme Q10 deficiency , 2000, The Lancet.

[13]  S. Zierz,et al.  Coenzyme Q in serum and muscle of 5 patients with Kearns-Sayre syndrome and 12 patients with ophthalmoplegia plus , 1989, Journal of Neurology.

[14]  S. Friedman,et al.  Neuroimaging of mitochondrial disease. , 2008, Mitochondrion.

[15]  B. Rosen,et al.  Energy metabolism defects in Huntington's disease and effects of coenzyme Q10 , 1997, Annals of neurology.

[16]  G Cederblad,et al.  Muscle creatine loading in men. , 1996, Journal of applied physiology.

[17]  P. Matthews,et al.  Coenzyme Q10 with multiple vitamins is generally ineffective in treatment of mitochondrial disease , 1993, Neurology.

[18]  N. Nishitani,et al.  Marked reduction in CSF lactate and pyruvate levels after CoQ therapy in a patient with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke‐like episodes (MELAS) , 1991, Acta neurologica Scandinavica.

[19]  M. Tarnopolsky,et al.  A randomized, controlled trial of creatine monohydrate in patients with mitochondrial cytopathies , 1997, Muscle & nerve.

[20]  S. Kuroda,et al.  Mitochondrial encephalomyopathy (MELAS): Pathological study and successful therapy with coenzyme Q10 and idebenone , 1989, Journal of the Neurological Sciences.

[21]  M. V. Miles The uptake and distribution of coenzyme Q(10) , 2007 .

[22]  W. Colier,et al.  Quantitative near‐infrared spectroscopy discriminates between mitochondrial myopathies and normal muscle , 1999, Annals of neurology.

[23]  S. Dimauro,et al.  Familial cerebellar ataxia with muscle coenzyme Q10 deficiency , 2001, Neurology.

[24]  F. Rosenfeldt,et al.  Coenzyme Q10 therapy before cardiac surgery improves mitochondrial function and in vitro contractility of myocardial tissue. , 2005, The Journal of thoracic and cardiovascular surgery.

[25]  L. Vitetta,et al.  Coenzyme Q(10)--its role as a prooxidant in the formation of superoxide anion/hydrogen peroxide and the regulation of the metabolome. , 2007, Mitochondrion.

[26]  G Serratrice,et al.  31P NMR spectroscopy and ergometer exercise test as evidence for muscle oxidative performance improvement with coenzyme Q in mitochondrial myopathies , 1992, Neurology.

[27]  Y. Kuroiwa,et al.  Clinical improvement after administration of coenzyme Q10 in a patient with mitochondrial encephalomyopathy , 2004, Journal of Neurology.

[28]  Giovanni Cioni,et al.  Proton MR spectroscopy of mitochondrial diseases: analysis of brain metabolic abnormalities and their possible diagnostic relevance. , 2003, AJNR. American journal of neuroradiology.

[29]  S. Dimauro,et al.  Coenzyme Q10 deficiency and isolated myopathy , 2006, Neurology.

[30]  L. Morandi,et al.  Impaired oxygen extraction in metabolic myopathies: Detection and quantification by near‐infrared spectroscopy , 2007, Muscle & nerve.

[31]  M. V. Miles,et al.  Clinical laboratory monitoring of coenzyme Q10 use in neurologic and muscular diseases. , 2004, American journal of clinical pathology.

[32]  M. Febbraio,et al.  Effect of creatine supplementation on intramuscular TCr, metabolism and performance during intermittent, supramaximal exercise in humans. , 1995, Acta physiologica Scandinavica.

[33]  Joel S Perlmutter,et al.  Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. , 2002, Archives of neurology.

[34]  D. Graveron-Demilly,et al.  Java-based graphical user interface for the MRUI quantitation package , 2001, Magnetic Resonance Materials in Physics, Biology and Medicine.

[35]  S. Pulst,et al.  Identification of ataxia‐associated mtDNA mutations (m.4052T>C and m.9035T>C) and evaluation of their pathogenicity in transmitochondrial cybrids , 2009, Muscle & nerve.

[36]  S Yorifuji,et al.  Long‐term coenzyme Q10 therapy for a mitochondrial encephalomyopathy with cytochrome c oxidase deficiency , 1989, Neurology.

[37]  A. M. Salio,et al.  Coenzyme Q 10 Improves Lactic Acidosis, Strokelike Episodes, and Epilepsy in a Patient With MELAS (Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Strokelike episodes) , 2004, Clinical neuropharmacology.

[38]  A. Pestronk,et al.  Tolerance of high-dose (3,000 mg/day) coenzyme Q10 in ALS , 2005, Neurology.

[39]  N. Chu,et al.  Coenzyme Q10 treatment in mitochondrial encephalomyopathies. Short-term double-blind, crossover study. , 1997, European neurology.

[40]  R. Laaksonen,et al.  The effect of simvastatin treatment on natural antioxidants in low-density lipoproteins and high-energy phosphates and ubiquinone in skeletal muscle. , 1996, The American journal of cardiology.

[41]  D. Frens,et al.  Muscle coenzyme Q deficiency in familial mitochondrial encephalomyopathy. , 1989, Proceedings of the National Academy of Sciences of the United States of America.

[42]  P. Rustin,et al.  A case of mitochondrial encephalomyopathy associated with a muscle coenzyme Q10 deficiency , 1998, Journal of the Neurological Sciences.

[43]  M. Beal,et al.  Beneficial effects of creatine, CoQ10, and lipoic acid in mitochondrial disorders , 2007, Muscle & nerve.

[44]  T R Brown,et al.  In vivo phosphorus polarization transfer and decoupling from protons in three‐dimensional localized nuclear magnetic resonance spectroscopy of human brain , 1997, Magnetic resonance in medicine.

[45]  Vanhamme,et al.  Improved method for accurate and efficient quantification of MRS data with use of prior knowledge , 1997, Journal of magnetic resonance.

[46]  M. Takemoto,et al.  Mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes with recurrent abdominal symptoms and coenzyme Q10 administration. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[47]  Alessandro Bertolino,et al.  Reproducibility of Proton Magnetic Resonance Spectroscopic Imaging in Patients with Schizophrenia , 1998, Neuropsychopharmacology.

[48]  Robert W. Taylor,et al.  Endurance training and detraining in mitochondrial myopathies due to single large-scale mtDNA deletions. , 2006, Brain : a journal of neurology.

[49]  S. Dimauro,et al.  The spectrum of exercise tolerance in mitochondrial myopathies: a study of 40 patients. , 2003, Brain : a journal of neurology.

[50]  P. M. Matthews,et al.  Short‐term dichloroacetate treatment improves indices of cerebral metabolism in patients with mitochondrial disorders , 1995, Neurology.

[51]  M. Beal,et al.  Combination therapy with Coenzyme Q10 and creatine produces additive neuroprotective effects in models of Parkinson’s and Huntington’s Diseases , 2009, Journal of neurochemistry.

[52]  K. Abe,et al.  Effect of coenzyme Q10 in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS): Evaluation by noninvasive tissue oximetry , 1999, Journal of the Neurological Sciences.

[53]  S. Yorifuji,et al.  Improvement of abnormal pyruvate metabolism and cardiac conduction defect with coenzyme Ql0 in Kearns‐Sayre syndrome , 1985, Neurology.

[54]  S. Holtås,et al.  Proton MR spectroscopy in clinical routine , 2001, Journal of magnetic resonance imaging : JMRI.

[55]  P. Navas,et al.  Muscle coenzyme Q10 concentrations in patients with probable and definite diagnosis of respiratory chain disorders , 2005, BioFactors.

[56]  S. Yorifuji,et al.  Treatment of Kearns‐Sayre syndrome with coenzyme Q10 , 1986, Neurology.

[57]  M. Beal,et al.  Pilot trial of high dosages of coenzyme Q10 in patients with Parkinson's disease , 2004, Experimental Neurology.

[58]  N. Bresolin,et al.  Clinical and biochemical correlations in mitochondrial myopathies treated with coenzyme Q10 , 1988, Neurology.

[59]  M. Tarnopolsky,et al.  Mitochondrial myopathies: diagnosis, exercise intolerance, and treatment options. , 2005, Medicine and science in sports and exercise.

[60]  M. Schwartz,et al.  Aerobic training is safe and improves exercise capacity in patients with mitochondrial myopathy. , 2006, Brain : a journal of neurology.

[61]  R. Laaksonen,et al.  Serum and muscle tissue ubiquinone levels in healthy subjects. , 1995, The Journal of laboratory and clinical medicine.

[62]  M. Hanna,et al.  Mitochondrial Disease: Mutations and Mechanisms , 2004, Neurochemical Research.