Clinical aspects of coenzyme Q₁₀: An update

Abstract 

The fundamental role of coenzyme Q₁₀ (CoQ₁₀) in mitochondrial bioenergetics and its well-acknowledged antioxidant properties constitute the basis for its clinical applications, although some of its effects may be related to a gene induction mechanism. Cardiovascular disease is still the main field of study and the latest findings confirm a role of CoQ₁₀ in improving endothelial function. The possible relation between CoQ₁₀ deficiency and statin side effects is highly debated, particularly the key issue of whether CoQ₁₀ supplementation counteracts statin myalgias. Furthermore, in cardiac patients, plasma CoQ₁₀ was found to be an independent predictor of mortality. Studies on CoQ₁₀ and physical exercise have confirmed its effect in improving subjective fatigue sensation and physical performance and in opposing exercise-related damage. In the field of mitochondrial myopathies, primary CoQ₁₀ deficiencies have been identified, involving different genes of the CoQ₁₀ biosynthetic pathway; some of these conditions were found to be highly responsive to CoQ₁₀ administration. The initial observations of CoQ₁₀ effects in Parkinson's and Huntington's diseases have been extended to Friedreich's ataxia, where CoQ₁₀ and other quinones have been tested. CoQ₁₀ is presently being used in a large phase III trial in Parkinson's disease. CoQ₁₀ has been found to improve sperm count and motility on asthenozoospermia. Moreover, for the first time CoQ₁₀ was found to decrease the incidence of preeclampsia in pregnancy. The ability of CoQ₁₀ to mitigate headache symptoms in adults was also verified in pediatric and adolescent populations.

Keywords: Coenzyme Q₁₀, Cardiovascular disease, Mitochondrial myopathies, Reproductive medicine