Coenzyme Q10

thumb|Coenzyme Q10 powder

Coenzyme Q (CoQ ), also known as ubiquinone, is a naturally occurring biochemical cofactor (coenzyme) and an antioxidant produced by the human body. The human body mainly produces the form known as coenzyme Q10 (CoQ10, ubidecarenone), but other forms exist. CoQ is used by and found in many organisms, including animals and bacteria. As a result, it can also be obtained from dietary sources, such as meat, fish, seed oils, vegetables, and dietary supplements.

Although a ubiquitous molecule in human tissues, CoQ10 is not a dietary nutrient and does not have a recommended intake level, and its use as a supplement is not approved in the United States for any health or anti-disease effect.

CoQ10 is a lipophilic molecule that is located in all biological membranes of the human body and serves as a component for the synthesis of ATP and is a life-sustaining cofactor for the three complexes (complex I, complex II, and complex III) of the ETC in the mitochondria.

antioxidant activity as a lipid-soluble antioxidant together with vitamin E, scavenging reactive oxygen species and protecting cells against oxidative stress,

Biochemistry

Coenzyme Q (CoQ) is a quinone and functions as an electron carrier in the mitochondrial electron transport chain (ETC) of eukaryotes and many bacteria. The other name for CoQ is ubiquinone which was assigned by the IUPAC-IUB Commission on Biochemical Nomenclature in 1975 due to its ubiquitous presence from bacteria to humans. a group of gram-negative bacteria. The fact that the coenzyme is ubiquitous gives the origin of its other name, ubiquinone. In humans, the most common form of coenzyme Q is coenzyme Q10, also called CoQ10 () or ubiquinone-10. Organs with the highest energy requirements—such as the heart, liver, and kidney—have the highest CoQ10 concentrations.

There are three redox states of CoQ: fully oxidized (ubiquinone), semiquinone (ubisemiquinone), and fully reduced (ubiquinol). Biosynthesis is the major source of CoQ10. Biosynthesis requires at least 15 genes, and mutations in any of them can cause CoQ deficiency.

Assessment

Although CoQ10 may be measured in blood plasma, these measurements reflect dietary intake rather than tissue status. Currently, most clinical centers measure CoQ10 levels in cultured skin fibroblasts, muscle biopsies, and blood mononuclear cells. Culture fibroblasts can be used also to evaluate the rate of endogenous CoQ10 biosynthesis, by measuring the uptake of 14C-labeled p-hydroxybenzoate.

CoQ10 is studied as an adjunctive therapy to reduce inflammation in periodontitis.

Statins

Although statins may reduce CoQ10 in the blood it is unclear if they reduce CoQ10 in muscle.

Chemical properties

The oxidized structure of CoQ10 is shown below. The various kinds of coenzyme Q may be distinguished by the number of isoprenoid subunits in their side-chains. The most common coenzyme Q in human mitochondria is CoQ10.

An important enzyme in this pathway is HMG-CoA reductase, usually a target for intervention in cardiovascular complications. The "statin" family of cholesterol-reducing medications inhibits HMG-CoA reductase. One possible side effect of statins is decreased production of CoQ10, which may be connected to the development of myopathy and rhabdomyolysis. However, the role statins play in CoQ deficiency is controversial. Although statins reduce blood levels of CoQ, studies on the effects of muscle levels of CoQ are yet to come.

Genes involved include PDSS1, PDSS2, COQ2, and ADCK3 (COQ8, CABC1).

Organisms other than humans produce the benzoquinone and isoprene structures from somewhat different source chemicals. For example, the bacteria E. coli produces the former from chorismate and the latter from a non-mevalonate source. The common yeast S. cerevisiae, however, derives the former from either chorismate or tyrosine and the latter from mevalonate. Most organisms share the common 4-hydroxybenzoate intermediate, yet again uses different steps to arrive at the "Q" structure.

Dietary supplement

Although neither a prescription drug nor an essential nutrient, CoQ10 is commonly used as a dietary supplement with the intent to prevent or improve disease conditions, such as cardiovascular disorders. Despite its significant role in the body, it is not used as a drug to treat any specific disease.

Regulation and composition

CoQ10 is not approved by the U.S. Food and Drug Administration (FDA) for the treatment of any medical condition. However, it is sold as a dietary supplement not subject to the same regulations as medicinal drugs, and is an ingredient in some cosmetics and energy drinks. The manufacture of CoQ10 is not regulated, and different batches and brands may vary significantly. A 2016 Cochrane review concluded that CoQ10 had no effect on blood pressure. A 2021 Cochrane review found "no convincing evidence to support or refute" the use of CoQ10 for the treatment of heart failure.

A 2017 meta-analysis of people with heart failure taking 30–100 mg/d of CoQ10 found a 31% lower mortality and increased exercise capacity, with no significant difference in the endpoints of left heart ejection fraction. A 2021 meta-analysis found that CoQ10 was associated with a 31% lower all-cause mortality in HF patients. In a 2023 meta-analysis of older people, ubiquinone had evidence of a cardiovascular effect, but ubiquinol (the reduced form) did not.

Although CoQ10 has been studied as a potential remedy to treat purported muscle-related side effects of statin medications, the results were mixed. Although a 2018 meta-analysis concluded that there was preliminary evidence for oral CoQ10 reducing statin-associated muscle symptoms, including muscle pain, muscle weakness, muscle cramps, and muscle tiredness, 2015 Food intake (and the presence of lipids) stimulates bodily biliary excretion of bile acids and greatly enhances absorption of CoQ10. Exogenous CoQ10 is absorbed from the small intestine and is best absorbed if taken with a meal. Serum concentration of CoQ10 in fed condition is higher than in fasting conditions.

Metabolism

CoQ10 is metabolized in all tissues, with the metabolites phosphorylated in cells.

Bioavailability

In contrast to the intake of CoQ10 as a constituent of food, such as nuts or meat, from which CoQ10 is normally absorbed, there is a concern about CoQ10 bioavailability when it is taken as a dietary supplement. Bioavailability of CoQ10 supplements may be reduced due to the lipophilic nature of its molecule and large molecular weight. However, this has not proved successful with CoQ10, although reports have differed widely. The use of aqueous suspension of finely powdered CoQ10 in pure water also reveals only a minor effect.

Water-solubility

Facilitating drug absorption by increasing its solubility in water is a common pharmaceutical strategy and also is successful for CoQ10. Various approaches have been developed to achieve this goal, with many of them producing significantly better results over oil-based soft gel capsules despite the many attempts to optimize their composition. formulations based on various solubilising agents, such as hydrogenated lecithin, and complexation with cyclodextrins; among the latter, the complex with β-cyclodextrin has been found to have highly increased bioavailability and also is used in pharmaceutical and food industries for CoQ10-fortification. Some adverse effects, largely gastrointestinal, are reported with intakes.

Caution should be observed in the use of CoQ10 supplementation in people with bile duct obstruction and during pregnancy or breastfeeding. The structure of CoQ10 is similar to that of vitamin K, which competes with and counteracts warfarin's anticoagulation effects. CoQ10 is not recommended in people taking warfarin due to the increased risk of clotting. Besides the endogenous synthesis within organisms, CoQ10 also is supplied by various foods.

Effect of heat and processing

Cooking by frying reduces CoQ10 content by 14–32%.

History

In 1950, a small amount of CoQ10 was isolated from the lining of a horse's gut, a compound initially called substance SA, but later deemed to be quinone found in many animal tissues. In 1957, the same compound was isolated from mitochondrial membranes of beef heart, with research showing that it transported electrons within mitochondria. It was called Q-275 as a quinone. The Q-275/substance SA was later renamed ubiquinone as it was a ubiquitous quinone found in all animal tissues. Ubiquinone was later called either mitoquinone or coenzyme Q due to its participation to the mitochondrial electron transport chain.