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Innovative Research and Applications for CoQ10

August 2004

By Kurt J. Samson

In 1983, the Life Extension Foundation introduced coenzyme Q10 (CoQ10) to the United States. Over the past 21 years, hundreds of studies have confirmed the safety and effectiveness of CoQ10 supplementation for health disorders ranging from neurological aging to heart disease.

Yet the US medical establishment and federal drug regulators have been hesitant to embrace these indings,
reserving opinion until more large-scale trials are completed. With several major studies under way, CoQ10 could be on the cusp of broader acceptance across a range of medical disciplines.

Understanding CoQ10
Ubiquinone, commonly referred to as coenzyme Q10, was originally so named because of its omnipresence in virtually every cell of the human body. According to Dr. Karl Folkers, a pioneer in the CoQ10 fermentation synthesis, CoQ10 should be properly renamed “vitamin Q,” and thus take its rightful place in the pantheon of essential nutrients.

Two main theories have been set forth as to how CoQ10 assists in achieving optimal health and regeneration from illness. First is its ability to increase the amount of energy available to those parts of the body whose cells most require it, including the heart, brain, kidneys, and skeletal muscles, among others. Second, many of the benefits derived from CoQ10 are thought to be a result of its potent antioxidant effects, as it scavenges dangerous free radical oxygen species that normally harm the body.

A cell showing the nucleus (with DNA) and the cytoplasm with organelles, including smooth and rough endoplasmic reticulum, ribosomes, Golgi complex, mitochondria, lysosomes, and centrioles. Endocytotic and exocytotic vesicles are included in the cell's plasma membrane.

Dr. Folkers’ quest and legacy are being carried on by dozens of researchers whose efforts are continuing to bring information about CoQ10 to the forefront of academic medicine. A number of encouraging studies were published by respected medical and scientific journals in 2003 and early 2004. Life Extension surveyed the literature and herein presents some of the most significant highlights.

CoQ10 and Kidney Failure
In the Journal of Nutritional and Environmental Medicine, CoQ10 research pioneers Drs. Ram Singh and Adarsh Kumar reported the results of a very well-designed trial indicating CoQ10 might have a powerful role as adjunctive therapy in patients with end-stage kidney disease—in some cases even reducing or averting the need for dialysis.1

In a randomized, double-blind, placebo-controlled trial, the researchers found CoQ10 treatment decreased progression and reversed renal dysfunction in a majority of patients with end-stage disease, many of whom were able to discontinue dialysis over the course of the 12-week trial. The report followed up on a pilot study the scientists published in 2000 involving a smaller number of subjects.

End-stage kidney disease produces marked organ contraction and progressive dysfunction, with corresponding increases in levels of serum creatinine and blood urea nitrogen. Levels of toxic waste products accumulate in the blood because the kidneys cannot clear them from the body.

A patient undergoing hemodialysis.

Dr. Singh and his colleagues documented significantly lower levels of serum creatinine and blood urea nitrogen in the CoQ10-treated patients, with increases in creatinine clearance and urine output regardless of patient dialysis or baseline status. More significantly, only half the number of CoQ10 patients required dialysis at the end of the study when compared to subjects receiving placebo.

The researchers also reported considerable increases in the antioxidant vitamins E and C and beta-carotene in treated subjects, while plasma levels of oxidative stress such as thiobarbituric acid reactive substances, diene conjugates, and malondialdehyde all fell dramatically.

Although one in five patients did not respond, the researchers concluded that CoQ10 supplementation improves renal function in end-stage patients regardless of dialysis status, and can delay or avert the need for dialysis. They suggested that higher doses than those used in their study (180 mg per day) might result in even greater improvement and response in others.

Cardiovascular Advances
CoQ10 has been shown to be effective against chronic inflammation of the arteries and heart muscle tissue resulting in cardiac myopathy. In addition, studies by Japanese and Australian re-searchers, as well as by scientists in the US and elsewhere, have consistently shown the supplement’s effectiveness against congestive heart failure and in preventing secondary cardiac events after patients have suffered an initial heart attack.

In Molecular Cell Biology, Drs. Singh and Kumar published the results of another randomized, double-blind, placebo-controlled study showing CoQ10’s benefits in combating atherosclerosis, increasing survival, and reducing the risk of subsequent cardiac events in heart attack patients, including those taking lipid-lowering drugs.2

The scientists reported that among 73 patients receiving 120 mg per day of oral CoQ10 for one year after a first heart attack, the treated subjects suffered significantly fewer cardiac events than their untreated counterparts (24.6% vs. 45%). The CoQ10 group had a nearly 50% lower incidence of non-fatal heart attacks (13.7% vs. 25.3%) and significantly fewer deaths than the untreated patients.

Further, the researchers found plasma levels of vitamin E and protective high-density lipoprotein (HDL) were significantly higher in CoQ10 patients, and thiobar-bituric acid reactive substances, malondialdehyde, and diene con-jugates were lower than in the control group. According to Dr. Singh, it is important to note, with respect to concern over statin therapy and CoQ10 supplements, that half of the patients in each group were taking lovastatin.

Last year, Danish scientists at Copenhagen University Hospital’s Heart Center, led by noted re-searcher Dr. Svende Aage Mort-ensen, announced the launch of a large, two-year multinational trial to “establish the future role of CoQ10 as part of a maintenance therapy in patients with chronic heart failure.”3

The double-blind, multi-center trial will review morbidity and mortality data on patients with chronic heart failure taking supplemental CoQ10. In announcing the study design and endpoints in the journal Biofactors, which dedicated an issue to papers presented at the Third Conference of the International CoQ10 Association, Dr. Mortensen noted that double-blind, placebo-controlled trials have demonstrated the benefits of the bioenergetic antioxidant in more than 1,000 patients. Imp-roved exercise capacity, reduced hospitalizations, and significant improvements in various hemodynamic parameters have been the “overwhelming experience,” he writes, with only three of 13 studies showing neutral results.

“Thus, based on the available con-trolled data, CoQ10 is a promising, effective, and safe approach to chronic heart failure,” Dr. Mortensen concluded.

Dr. Mortensen also participated in a study examining serum concentrations of CoQ10 in 99 healthy male subjects taking daily 30-mg or 100-mg supplements for one month, compared with matched controls receiving placebo.

In this randomized, double-blind trial, he and Czech scientists at the Medical Faculty Hospital in Prague ascertained the median baseline serum level of CoQ10. Supplementation with 30 mg of CoQ10 resulted in an increase in the baseline concentration of CoQ10 of 44%, while an increase of 108% was noted in the group that received 100 mg of CoQ10. These changes were significantly higher in both groups of subjects supplemented with CoQ10 compared to the group that received placebo, regardless of baseline CoQ10 levels, age, or body weight.

Late last year, Japanese scientists at the University of Kyoto’s Graduate School of Medicine add-ed further evidence that CoQ10 protects the heart muscle against acute viral myocarditis, a life-threatening infection of the heart walls.4

Dr. Chiharu Kishimoto and colleagues infected mice with a strain of encephalomyocarditis virus in order to measure the degree of oxidative damage and DNA injury, using thioredoxin expression and 8-hydroxy-2’-deoxyguanosine in the myocardium to measure CoQ10’s benefits. The scientists found survival was about three times higher in treated mice, with significantly increased levels of CoQ10 in the heart muscles and a marked decrease in serum creatine kinase (a marker of heart muscle damage). Further, the up-regulation of myocardial thioredoxin indicating DNA damage was considerably lower in treated mice. The researchers concluded that pretreatment with CoQ10 (supplementation) can reduce the severity of viral myocarditis as well as oxidative stress and DNA damage in the myocardium.