COENZYME Q10: ANTIOXIDANT AS USEFUL
A REVIEW: Part II
In this part we will review the interactions
of Co enyme10 and clincical use in various systemic disease and conditions.
CoQ10 has when administered with other drugs
have few drug interactions and caution should be exercised with those
The concomitant administration of CoQ10 with
HMG-CoA reductase inhibitors has shown to interfere with the endogenous
synthesis of CoQ10. HMG-Co A reductase inhibitors block the synthesis of
melvalonic acid, a precursor to cholesterol and to CoQ10. Beta-blockers have
shown to decrease endogenous serum coQ10 levels by inhibiting
coQ10-dependent enzymes. CoQ10 also reduces insulin requirement in diabetes
mellitus. Oral hypoglycemic agents like glyburide, acetohexamide, and
tolazaide have been shown to decrease endogenous CoQ10 levels. In patients
on warfarin care should be maintained with concomitant use of CoQ10 because
of the structural similarity to vitamin K.
Table 3 Drug Interactions
Mechanism of Action
Blocks pathway to produce CoQ10
Inhibits enzymes to produce CoQ10
CoQ10 structurally similar to vitamin K
increasing clotting factors
Inhibits enzymes that
Various clinical trails have provided
evidence supporting the use of CoQ10 in prevention and treatment of various
disorders related to oxidative stress. It has been shown to be useful in
adjunct therapy for cardiovascular diseases, cancer, periodontal disease,
immuno-compromised systems, COPD and muscular dystrophy. Therefore,
healthcare professionals are advocating its use as a supplement.
Several open and controlled studies have
examined the efficacy of CoQ10 as adjunctive therapy or treating CHF. The
presence of increasing symptoms associated with CHF has been correlated to
the severity of CoQ10 deficiency. Patients exhibiting a significantly lower
serum free cholesterol-related CoQ10 value had an increased risk of CHF,
severe myalgia, concomitant use of cytostatic and lipid-lowering drug
therapy, and /or death within a six month follow- up.
CoQ10's proposed mechanism on benefiting CHF
is through positive inotropic action. Such action increases the contractile
force of the heart to improve cardiac output. Many drugs of conventional CHF
therapy also possess this positive inotropic property, yet the increased
contractility requires an adequate supply of ATP. Failed hearts are believed
to lack ATP, thus this bioenergetic process is the reasoning behind
supplementing CHF therapy with CoQ10.
Despite its lack of effect on survival, CoQ10 may improve cardiac
function and quality of life in patients with severe CHF. Fewer
hospitalizations could reduce the cost of managing patients with NYHA Class
III or IV heart failure. It has been postulated that the mechanism for
improved exercise tolerance may be attributed to the ability of CoQ10 to
maintain oxidative phosphorylation, thereby acting as a direct membrane
protectant via the production of ATP.
CoQ10 may improve surgical recovery and
lessen the magnitude of surgical insult in heart surgery.CoQ10 plays a
protective role during cardiac valve replacement by directly scavenging
hydroxyl radicals, thus acting as an antioxidant and membrane stabilizer.
Since doxorubicin inhibits CoQ10-dependent enzymes, pretreatment with CoQ10
may mitigate its cardio toxic effects. Proposed mechanisms of cardio
protection involve the inhibition of doxorubicin-induced lipid peroxidation
and scavenging free radicals. Therefore, CoQ10 may have a potential role in
the prevention of doxorubicin-induced cardio toxicity.
Several studies involving small numbers of people suggest that CoQ10 may
lower blood pressure. However, it may take 4 to 12 weeks before any
beneficial effect is observed. More research with greater numbers of people
is needed to assess the value of CoQ10 in the treatment of high blood
pressure. CoQ10 is not a typical antihypertensive drug; rather, it seems to
correct some metabolic abnormality that is involved in the pathogenesis of
Because of its role in enhancing immune function, CoQ10 has been
considered as a possible anti-cancer agent. Administration of CoQ10 reduced
tumor size and increased survival in mice exposed to a chemical carcinogen.
Preliminary studies in humans, though uncontrolled, are promising. CoQ10
prevents metastasis and enhances remission in breast cancer. Mechanisms in
cancer include immune system enhancement and antioxidant activity.
The electron transport chain, of which CoQ10
is a component, plays a major role in carbohydrate. CoQ10 was found at
decreased level when measured in rats with experimentally induced diabetes.
Another study done in humans found that daily dose of 120mg of Coq7 for 2-18
weeks reduced fasting blood sugar by at least 30% in 31% of patients and
ketone bodies declined by at least 30% in 59% of the patients.
Cells and tissues that play a role in immune
function are highly energy-dependent and therefore require an adequate
supply of CoQ10 for optimal function. Several studies have demonstrated
immune-enhancing effects of CoQ10 or its analogues. These effects included
increased phagocytic activity of macrophages; increased proliferation of
granulocytes in response to experimental infections; and prolonged survival
in mice infected with Pseudomonas aeruginosa, Staphylococcus aureus,
Escherichia coli, Klebsiella pneumonia, or Candida albicans. Studies have
demonstrated that the degree of CoQ10 deficiency is correlated with the
severity of immune compromised diseases. Patients with acquired immune
deficiency syndrome (AIDS) showed statistically significant lower CoQ10
serum concentrations than AIDS-related complex (ARC) patients, who in turn
had lower levels than healthy subjects. Its antioxidant activity helps
prevent AIDS-related diseases caused by oxidative stress. Blood levels of
CoQ10 are lower in AIDS patients and 200 mg/day increased
Research suggests a strong correlation
between human myotonic dystrophic conditions and defects in mitochondrial
functions, energy metabolism, and oxidative damage. CoQ10 is found in
cardiac and skeletal muscle i animals and humans with hereditary muscular
dystrophy. In addition, treatment with CoQ10 or its analogues increased
survival and improved the performance of dystrophic mice, rabbits, and
monkeys, as determined by a reduction of creatinuria, regaining of righting
reflex, and weight gain.
Susceptibility to gastric ulceration is
related to the balance between ulcer promoting factors (such as excessive
gastric acidity and infection with Helicobacter pylori), and resistance
factors (such as tissue integrity, production of protective mucus, and
repair mechanisms). Free-radical damage is believed to be one of the primary
mechanisms by which external factors induce gastric injury and peptic
ulceration. Since CoQ10 possesses antioxidant activity, it might be capable
of preventing ulceration by reducing the amount of free-radical damage. In
addition, the production of protective mucus and the rapid cell turnover of
gastric mucosa are highly energy-dependent processes, which require the
presence of adequate amounts of CoQ10.
Individuals with a family history of obesity
have a 50% reduction in thermogenic response to a meal and are often found
to have low CoQ10 levels. Since CoQ10 is an essential cofactor for energy
production, it is conceivable that CoQ10 deficiency is a contributing factor
in some cases of obesity. However one of the studies found other metabolic
abnormalities related to CoQ10 deficiency and therefore it may an effect
rather than a cause.
Supplementation with CoQ10 may enhance
aerobic capacity and muscle performance, especially in sedentary
individuals. The effect of CoQ10 on the performance of trained athletes has
not been studied.
CoQ10 inhibits release of histamines and
SRSA in antigen-challenged animal models. This has not yet been proved in
CoQ7 (CoQ10 analog) at 10mg/day resulted in
significant increase in sperm count and motility.
Dr Vinayak M. Joshi M.D.S ( perio)
With This Issue we have a New person to
provide you more information! I am sure if you are a member of any
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I am sure you have guessed the person , its Dr.RASHA SERAGELDEN
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new feature on Dental Follicle , RASHA RECOMMENDS! Where you will find the
Links specific to specialty are recommended by Dr.Rasha Seragelden!In case
you are looking for some information on a specific topic/case , just
mail us at
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Follicle! ---- Editor!