Coenzyme Q10 and Parkinsonian Syndromes: A Systematic Review
Abstract
:1. Introduction
2. Methods
2.1. Search Strategy and Criteria for Eligibility of Studies
2.2. Selection of Studies and Methodology for the Meta-Analyses
3. Results
3.1. Studies Assessing Tissular CoQ10 Concentrations
3.1.1. Parkinson’s Disease
Serum/Plasma
Blood Cells
Cerebrospinal Fluid (CSF)
Brain
Skin Fibroblasts
3.1.2. Other Parkinsonian Syndromes
3.2. Studies Assessing Therapeutic Response to CoQ10 Administration
3.2.1. Parkinson’s Disease
3.2.2. Progressive Supranuclear Palsy
4. Discussion and Conclusions
- (a)
- (b)
- (c)
- (d)
- CoQ10 administration was also able to prevent iron-induced apoptosis in cultured human dopaminergic (SK-N-SH) neurons, in metallothionein gene-manipulated mice, and in alpha-synuclein knockout (alpha-synko) mice [56].
- (e)
- CoQ10 administration can prevent neurodegeneration and behavioral deterioration in rodents exposed to several toxins causing experimental parkinsonism, such as the pesticides paraquat [57,58], dichlorvos [59], and rotenone [60,61], and showed neuroprotective effects against rotenone in primary rat mesencephalic cultures [62] and human neuroblastoma cells [63]. Interestingly, the exposure of human neuroblastoma SH-SY5Y cells to commonly used organophosphate compounds, such as dichlorvos, methyl-parathion (parathion), and chlorpyrifos (CPF), induces an important decrease in CoQ10 levels and complex II + III activity—both related to a decrease in neuronal cell viability. In this model, CoQ10 supplementation can modestly although significantly increase complex II + III activity [64].
- (f)
- CoQ10 supplementation (with or without the concomitant treatment of levodopa) has shown a protective effect against chlorpromazine-induced parkinsonism in mice, including a reduction in mortality and catalepsy, an increase in dopamine levels, and a decrease in oxidative stress [65]. Similarly, CoQ10 improved the forced swimming test, locomotor activity test, catalepsy, muscle coordination, and akinesia test, and reduced the dopamine depletion in haloperidol-induced parkinsonism in rats [66].
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Tissue | Author, Year [Ref] | Parameter | PD N | PD Mean ± SD (Except % in *) | HC N | HC Mean ± SD | Difference in Means (95% C.I.), p |
---|---|---|---|---|---|---|---|
Serum/plasma | Jiménez-Jiménez et al., 2000 [9] | Total CoQ10 (nmol/L) | 33 | 1157 ± 344 | 31 | 1219 ± 424 | 62.00 (−130.39 to 254.39); 0.522 |
Buhmann et al., 2004 [10] | Total CoQ10 (nmol/L) | 40 | 990 ± 620 | 24 | 530 ± 290 | −460.00 (−729.67 to −190.32); 0.001 | |
Sohmiya et al., 2004 [11] | Total CoQ10 (nmol/L) | 36 | 613.3 ± 160 | 29 | 748.7 ± 224 | 135.40 (40.11 to 230.69); 0.006 | |
Bolner et al., 2006 [12] | Total CoQ10 (nmol/L) | 44 | 814.28 ± 750.57 | 21 | 1004.24 ± 772.58 | 189.96 (−211.60 to 591.52); 0.348 | |
Gorgone et al., 2012 [13] | Total CoQ10 (nmol/L) | 82 | 713.49 ± 187.64 | 60 | 871.01 ± 162.16 | 157.52 (97.95 to 217.09); <0.001 | |
Kasai et al. 2016 [14] | Total CoQ10 (nmol/L) | 20 | 740.8 ± 377.2 | 18 | 985.3 ± 939.4 | 244.50 (−217.59 to 706.59); 0.290 | |
Du et al., 2018 [15] | Total CoQ10 (nmol/L) | 30 | 1640.13 ± 419.80 | 30 | 1838.58 ± 481.41 | 198.45 (−34.98 to 431.88); 0.094 | |
TOTAL SERIES | Total CoQ10 (nmol/L) | 285 | 906.01 ± 531.19 | 213 | 1025.65 ± 592.90 | Random-effects model p = 0.234 | |
Jiménez-Jiménez et al., 2000 [9] | Total CoQ10/cholesterol | 33 | 5.03 ± 1.50 | 31 | 5.30 ± 1.84 | 02.7 (−0.57 to 1.11); 0.521 | |
Kasai et al. 2016 [14] | Total CoQ10/cholesterol | 20 | 4.07 ± 1.84 | 18 | 5.92 ± 5.88 | 1.85 (−0.47 to 4.17); 0.115 | |
TOTAL SERIES | Total CoQ10/cholesterol | 53 | 4.67 ± 1.69 | 49 | 5.53 ± 3.80 | Random-effects model p = 0.197 | |
Sohmiya et al., 2004 [11] | % Oxidized/total CoQ10 | 36 | 4.7 ± 1.8 | 29 | 3.4 ± 0.9 | −1.30 (−2.03 to −0.57); <0.001 | |
Gorgone et al., 2012 [13] | % Oxidized/total CoQ10 | 82 | 5.5 ± 0.9 | 60 | 3.8 ± 0.9 | −1.70 (−2.00 to −1.40); <0.001 | |
TOTAL SERIES | % Oxidized/total CoQ10 | 118 | 5.26 ± 1.29 | 89 | 3.67 ± 0.9 | Random-effects model p = 0.006 | |
Sohmiya et al., 2004 [11] | Oxidized CoQ10 (nmol/L) | 36 | 28.3 ± 10.5 | 29 | 24.7 ± 8.3 | −3.60 (−8.38 to 1.18); 0.137 | |
Kasai et al. 2016 [14] | Oxidized CoQ10 (nmol/L) | 20 | 644.2 ± 382.4 | 18 | 900.2 ± 890.6 | 256.00 (−186.86 to 698.86); 0.249 | |
Sohmiya et al., 2004 [11] | Reduced CoQ10 (nmol/L) | 36 | 585 ± 155 | 29 | 724 ± 219 | 139.00 (46.17 to 231.83); 0.004 | |
Kasai et al. 2016 [14] | Reduced CoQ10 (nmol/L) | 20 | 96.6 ± 118.2 | 18 | 85.2 ± 66.6 | −11.40 (−75.52 to 52.72); 0.721 | |
Platelets | Götz et al., 2000 [16] | Total CoQ10 (ng/109 platelets) | 20 | 80.6 ± 5.9 | 19 | 93.7 ± 5.1 | 13.10 (9.51 to 16.69); <0.001 |
Götz et al., 2000 [16] | Reduced CoQ10 (ng/109 platelets) | 20 | 10.3 ± 2.4 | 19 | 20.3 ± 3.2 | 10.00 (8.17 to 11.83); <0.001 | |
Götz et al., 2000 [16] | Oxidized CoQ10 (ng/109 platelets) | 20 | 70.3 ± 4.8 | 19 | 73.5 ± 4.7 | 3.20 (0.07 to 6.33); 0.045 | |
Götz et al., 2000 [16] | Reduced/oxidizedCoQ10 | 20 | 0.15 ± 0.04 | 19 | 0.32 ± 0.07 | 0.17 (0.13 to 0.21); <0.001 | |
Götz et al., 2000 [16] | Reduced/total CoQ10 | 20 | 0.11 ± 0.02 | 19 | 0.21 ± 0.03 | 0.10 (0.08 to 0.12); <0.001 | |
Lymphocytes | Mischley et al., 2012 [17] * | % of patients with CoQ10 deficiency * | 22 | 32–36% | 88 | 8–9% | p = 0.0012–0.006 (according to authors data) |
CSF | Isobe et al., 2007 [18] | Oxidized CoQ10 (nmol/L) | 20 | 5.2 ± 1.5 | 17 | 2.9 ± 1.3 | −2.30 (−3.25 to −1.35); <0.001 |
Isobe et al., 2007 [18] | Reduced CoQ10 (nmol/L) | 20 | 0.7 ± 0.6 | 17 | 0.8 ± 0.7 | 0.10 (−0.33 to 0.53); 0.643 | |
Isobe et al., 2007 [18] | Oxidized/total CoQ10 | 20 | 0.803 ± 0.179 | 17 | 0.682 ± 0.204 | −0.12 (−0.25 to 0.01); 0.063 | |
Compta et al., 2018 [19] | Total CoQ10 (nmol/L) | 15 | 54.39 ± 7.16 | 15 | 36.02 ± 7.20 | −18.37 (−23.74 to −13.00); < 0.001 | |
Brain | |||||||
Striatum | Hargreaves et al. 2008 [20] | Total CoQ10 (pmol/mg protein) | 20 | 188.6 ± 51.4 | 20 | 214.3 ± 64.3 | 25.70 (−11.56 to 62.96); 0.171 |
Substantia nigra | Hargreaves et al. 2008 [20] | Total CoQ10 (pmol/mg protein) | 8 | 102.9 ± 42.9 | 8 | 120.0 ± 4.3 | 17.10 (−15.59 to 49.79); 0.281 |
Cerebellum cortex | Hargreaves et al. 2008 [20] | Total CoQ10 (pmol/mg protein) | 25 | 107.1 ± 34.3 | 25 | 124.3 ± 47.1 | 17.20 (−6.23 to 40.63); 0.147 |
Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg protein) | 7 | 262.47 ± 28.84 | 37 | 241.87 ± 57.70 | −2.06 (−65.95 to 24.75); 0.365 | |
Barca et al., 2016 [22] | Total CoQ10 (pmol/mg protein) | 9 | 132.2 ± 8.47 | 12 | 113.1 ± 7.16 | −19.10 (−26.24 to −11.96); <0.001 | |
TOTAL SERIES | Total CoQ10 (pmol/mg protein) | 41 | 139.14 ± 64.49 | 74 | 181.27 ± 78.20 | Random-effects model p = 0.03358 | |
Cerebral cortex | Hargreaves et al. 2008 [20] | Total CoQ10 (pmol/mg protein) | 13 | 128.6 ± 61.4 | 13 | 218.6 ± 55.7 | 90.00 (42.55 to 137.45); 0.0007 |
Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 7 | 276.02 ± 71.37 | 37 | 259.39 ± 107.09 | −16.63 (−102.09 to 68.84); 0.697 | |
TOTAL SERIES | Total CoQ10 (pmol/mg) | 20 | 180.20 ± 99.89 | 50 | 248.78 ± 97.53 | Random-effects model p = 0.143 | |
Skin fibroblasts | Del Hoyo et al., 2010 [23] | Total CoQ10/CS | 20 | 1.16 ± 0.33 | 19 | 0.97 ± 0.25 | −0.19 (−0.38 to 0.00); 0.051 |
Del Hoyo et al., 2010 [23] | Reduced CoQ10/CS | 20 | 0.41 ± 0.16 | 19 | 0.34 ± 0.11 | −0.07 (−0.16 to 0.02); 0.122 | |
Del Hoyo et al., 2010 [23] | Oxidized CoQ10/CS | 20 | 0.75 ± 0.26 | 19 | 0.63 ± 0.23 | −0.12 (−0.28 to 0.04); 0.136 | |
Del Hoyo et al., 2010 [23] | Total CoQ10/mg protein | 20 | 86.27 ± 29.07 | 19 | 71.86 ± 26.38 | −14.41 (−32.45 to 3.63); 0.114 | |
Del Hoyo et al., 2010 [23] | Reduced CoQ10/mg protein | 20 | 24.50 ± 7.38 | 19 | 24.50 ± 7.38 | 0.00 (−4.79 to 4.79); 1.000 | |
Del Hoyo et al., 2010 [23] | Oxidized CoQ10/mg protein | 20 | 56.49 ± 25.20 | 19 | 47.31 ± 23.50 | −9.18 (−25.01 to 6.65); 0.248 | |
Del Hoyo et al., 2010 [23] | Oxidized CoQ10/Reduced CoQ10 | 20 | 0.60 ± 0.27 | 19 | 0.62 ± 0.27 | 0.02 (−0.16 to 0.20); 0.818 |
Tissue | Author, Year [Ref] | Parameter | MSA N | MSA Mean ± SD | HC N | HC Mean ± SD | Difference in Means (95% C.I.), p |
Serum/plasma | Kasai et al. 2016 [14] | Total CoQ10 (nmol/L) | 18 | 593.2 ± 222.6 | 18 | 985.3 ± 939.4 | 392.10 (−70.34 to 854.54); 0.094 |
Mitsui et al., 2016 [24] | Total CoQ10 (nmol/L) | 44 | 590.71 ± 254.82 | 39 | 833.95 ± 664.69 | 243.24 (28.09 to 458.39); 0.027 | |
Du et al., 2018 [15] | Total CoQ10 (nmol/L) | 30 | 1640.13 ± 419.80 | 30 | 1858.38 ± 481.41 | 218.25 (−15.18 to 451.68); 0.066 | |
TOTAL SERIES | Total CoQ10 (nmol/L) | 92 | 933.40 ± 583.47 | 87 | 1218.52 ± 817.98 | Random-effects model p = 0.001 | |
Kasai et al. 2016 [14] | Total CoQ10/cholesterol | 18 | 3.04 ± 1.23 | 18 | 5.92 ± 5.88 | 2.88 (0.00 to 5.76); 0.050 | |
Kasai et al. 2016 [14] | Oxidized CoQ10 (nmol/L) | 18 | 520.7 ± 202.8 | 18 | 900.2 ± 890.6 | 379.50 (−58.02 to 817.02); 0.087 | |
Kasai et al. 2016 [14] | Reduced CoQ10 (nmol/L) | 18 | 72.4 ± 34.1 | 18 | 85.2 ± 66.6 | 12.80 (17.64 to 48.64); 0.473 | |
CSF | Compta et al., 2018 [19] | Total CoQ10 (nmol/L) | 20 | 26.63 ± 3.70 | 15 | 36.02 ± 7.10 | 9.37 (5.61 to 13.13); <0.0001 |
Brain | |||||||
Cerebellum cortex | Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 20 | 169.30 ± 49.71 | 37 | 241.87 ± 57.70 | 72.57 (41.94 to 103.20); <0.001 |
Barca et al., 2016 [22] | Total CoQ10 (pmol/mg) | 12 | 68.1 ± 10.03 | 12 | 113.1 ± 7.16 | 45.00 (37.62 to 52.38); <0.001 | |
TOTAL SERIES | Total CoQ10 (pmol/mg) | 32 | 131.35 ± 63.47 | 49 | 210.33 ± 75.09 | Random-effects model p = 0.0977 | |
Cerebral cortex frontal | Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 20 | 260.44 ± 70.22 | 37 | 259.39 ± 107.09 | −1.05 (−54.43 to 52.33); 0.969 |
Cerebral cortex occipital | Barca et al., 2016 [22] | Total CoQ10 (nmol/mg protein) | 10 | 277.1 ± 29.73 | 9 | 267.3 ± 21.88 | −9.80 (−35.32 to 15.72); 0.429 |
Striatum | Barca et al., 2016 [22] | Total CoQ10 (nmol/mg protein) | 7 | 244.2 ± 27.16 | 7 | 230.8 ± 28.62 | −13.40 (−45.89 to 10.09); 0.387 |
Skin fibroblasts | Monzio Compagnoni et al., 2010 [25] | Total CoQ10 (pg/mg protein) | 14 | 27.83 ± 1.44 | 6 | 45.22 ± 3.48 | 17.39 (15.13 to 19.65); <0.001 |
Lewy Body Dementia (LBD) | |||||||
---|---|---|---|---|---|---|---|
Tissue | Author, Year [Ref] | Parameter | LBD N | LBD Mean ± SD | HC N | HC Mean ± SD | Difference in Means (95% C.I.), p |
Serum/plasma | Molina et al., 2002 [26] | Total CoQ10 (nmol/L) | 18 | 960.6 ± 359.1 | 20 | 1205.2 ± 362.2 | 244.60 (6.90 to 482.30); 0.044 |
Gironi et al. 2011 [27] | Total CoQ10 (nmol/L) | 7 | 645.17 ± 290 | 66 | 622.12 ± 227.14 | −23.05 (−207.81 to 161.71); 0.804 | |
TOTAL SERIES | Total CoQ10 (nmol/L) | 25 | 872.28 ± 365.05 | 86 | 757.72 ± 360.79 | Random-effects model: p = 0.409 | |
Molina et al., 2002 [7] | Total CoQ10/cholesterol | 18 | 4.67 ± 1.75 | 20 | 5.05 ± 1.52 | 0.38 (−0.70 to 1.46); 0.478 | |
Brain | |||||||
Cerebellum cortex | Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 20 | 169.30 ± 49.71 | 37 | 241.87 ± 57.70 | 72.57 (41.94 to 103.20); <0.001 |
Cerebral cortex frontal | Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 20 | 260.44 ± 70.22 | 37 | 259.39 ± 107.09 | −1.05 (−54.43 to 52.33); 0.969 |
Progressive Supranuclear Palsy (PSP) | |||||||
Tissue | Author, Year [Ref] | Parameter | PSP N | PSP Mean ± SD | HC N | HC Mean ± SD | Difference in Means (95% C.I.), p |
CSF | Compta et al., 2018 [19] | Total CoQ10 (nmol/L) | 10 | 47.67 ± 4.05 | 15 | 36.02 ± 7.10 | −11.65 (−16.79 to −6.51); 0.0001 |
Cortical Basal Degeneration (CBD) | |||||||
TISSUE | Author, Year [Ref] | Parameter | CBD N | CBD Mean ± SD | HC N | HC Mean ± SD | Difference in Means (95% C.I.), p |
Cerebellum cortex | Schottlaender et al., 2016 [21] | Total CoQ10 (pmol/mg) | 15 | 271.18 ± 76.21 | 37 | 241.87 ± 57.70 | −29.31 (−68.31 to 9.69); 0.137 |
Authors, Year [Ref] | Study Setting | Type of Study | Main Findings | Level of Evidence (Quality Score) |
---|---|---|---|---|
Strijks et al., 1997 [29] | 10 patients diagnosed with PD. Dosage of 200 mg/day. Assessment of motor performance with UPDRS and motor test. | 3 months open-label study |
| II (NA) |
Shults et al., 2002 [30] | Eighty subjects with early PD not requiring treatment for their disability. Dosages of 300, 600, or 1200 mg/day Evaluation with the UPDRS at the screening, baseline, and 1-, 4-, 8-, 12-, and 16-month visits. Follow-up of 16 months or until disability requiring treatment with levodopa. | Multicenter, randomized, parallel-group, placebo-controlled, double-blind, dosage-ranging trial. |
| I (>50%) |
Müller et al., 2003 [31] | Twenty-eight treated and stable PD patients. Dosage of 360 mg/day for 4 weeks. Scoring of PD symptoms, and visual function using the Farnsworth–Munsell 100 Hue test (FMT). | Monocenter, parallel-group, placebo-controlled, double-blind trial |
| I (>50%) |
NINDS NET-PD Investigators 2007 [32] | Seventy-one untreated early PD patients assigned to CoQ10 therapy (2400 mg/day), 71 to GPI-1485, and 71 to placebo. Measurement of change in total UPDRS scores and subscores, Hoehn & Yahr staging, and Schwabb & England scale scores, either at the time requiring symptomatic therapy or at 12 months. | Randomized, double-blind, calibrated futility clinical trial |
| I (>50%) |
Storch et al., 2007 [33] | One hundred thirty-one patients with PD without motor fluctuations and a stable antiparkinsonian treatment. Treatment with placebo or nanoparticular CoQ10 (100 mg 3 times a day, equivalent to 1200 mg/day of standard formulation) for 3 months. The stratification criterion was levodopa treatment. Evaluation with the UPDRS (sum score of parts II and III) at baseline, 1, 2, and 3 months at each visit monthly. | Multicenter, randomized, double-blind, placebo-controlled, stratified, parallel-group, single-dose trial. |
| I (>50%) |
Parkinson Study Group QE3 Investigators [34] | Six hundred patients diagnosed with PD (from 67 hospitals in the USA) in the previous 5 years, free of dopaminergic therapy in the previous 3 months, with Hoehn & Yahr stage of 2.5 or less. Two hundred were assigned to CoQ10 1200 mg/day, 200 to CoQ10 2400 mg/day and 200 to placebo. All patients were taking vitamin E 1200 IU/day. Evaluation at 16 months from baseline or until a disability requiring dopaminergic treatment. The study was powered to detect a 3-point difference between active treatment and placebo. | Phase III randomized, placebo-controlled, double-blind clinical trial |
| I (>50%) |
Jie et al., 2014 [35] | Eighty-eight patients diagnosed with PD and treated with levodopa. Forty-four were assigned to CoQ10 375–750 mg/day, and 44 to placebo Evaluation with the Webster Scale at baseline and 3 months | Monocenter, randomized, placebo-controlled, double-blind clinical trial |
| I (>50%) |
Wang et al., 2014 [36] | Thirty-nine patients diagnosed with PD under conventional therapy. Twenty-one were assigned to CoQ10 450 or 1200 mg/day, and 18 to placebo as add-on therapy Evaluation with the UPDRS III and Webster Scale at baseline and 36 weeks | Monocenter, randomized, placebo-controlled, double-blind clinical trial |
| I (>50%) |
Li et al., 2015 [37] | Seventy-five patients diagnosed with PD and MCI. Random assignation to treatment with CoQ10 100 mg b.i.d. and creatine 5 mg b.i.d. or to placebo. Evaluation with the UPDRS part III, and MoCa at 12 and 18 months. | Phase III randomized, placebo-controlled, double-blind clinical trial |
| I (>50%) |
Yoritaka et al., 2015 [38] | Twenty-six patients with PD experiencing wearing off (group A) and 22 early PD patients without levodopa (with or without a dopamine agonist, group B). Treatment with 300 mg/day of ubiquinol-10 or placebo for 48 weeks (Group A, 14 ubiquinol-10, 12 placeboes) or 96 weeks (Group B, 14 ubiquinol-10, 8 placeboes). | Randomized, double-blind, placebo-controlled, parallel-group pilot trial |
| I (>50%) |
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Jiménez-Jiménez, F.J.; Alonso-Navarro, H.; García-Martín, E.; Agúndez, J.A.G. Coenzyme Q10 and Parkinsonian Syndromes: A Systematic Review. J. Pers. Med. 2022, 12, 975. https://doi.org/10.3390/jpm12060975
Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Agúndez JAG. Coenzyme Q10 and Parkinsonian Syndromes: A Systematic Review. Journal of Personalized Medicine. 2022; 12(6):975. https://doi.org/10.3390/jpm12060975
Chicago/Turabian StyleJiménez-Jiménez, Félix Javier, Hortensia Alonso-Navarro, Elena García-Martín, and José A. G. Agúndez. 2022. "Coenzyme Q10 and Parkinsonian Syndromes: A Systematic Review" Journal of Personalized Medicine 12, no. 6: 975. https://doi.org/10.3390/jpm12060975