Clinical Trials for the Use of CoQ10 in Pre-eclampsia 辅酶Q10在先兆子痫患者中的应用试验

分类:医学文献 54 0

Pre-eclampsia (PE) is a complex pathology diagnosed during the second part of the pregnancy. The clinical features of PE are hypertension and proteinuria. This syndrome occurs in 3-8% of all pregnancies. The only cure for PE is delivery, and this syndrome is a leading cause of maternal and neonatal mortality and morbidity. The cause of PE is thought to originate from the placenta through the release of circulating factors that lead to a generalized systemic vascular endothelial dysfunction. The factors suspected include reactive oxygen species (ROS). It is strongly believed that ROS are major contributors of endothelial cell dysfunction leading to PE, since women affected by this syndrome show imbalanced ROS production, abnormal levels of antioxidant defenses, and increased blood and placental lipid peroxidation. Here, we discussed the rationale for the use of coenzyme Q10 (CoQ10), a vitamin-like antioxidant, during pregnancy to prevent PE.


The coenzyme Q10 is an essential component of the mitochondrial respiratory chain and a very efficient antioxidant under its reduced form, the ubiquinol-10. Indeed, ubiquinol-10 is more efficient than β–carotene, α-tocopherol, and lycopene in inhibiting low density oxidation in vivo (1). The CQ10 has also the ability to protect vitamin E from superoxide anion (O2-) attack (2). The oxidized (ubiquinone-10)/reduced (ubiquinol-10) ratio of CQ10 can be used as an oxidative stress marker in human plasma (3).


In pre-eclampsia, the total CoQ10 level was shown to be decreased in serum and was associated with the severity of the syndrome (4). The total CoQ10 level was also reported to be decreased in pre-eclampsia plasma (5). However, CoQ10 level was shown to be increased in pre-eclampsia cord blood and placentas when compared to normotensive pregnancies. Interestingly, our group reported no increase of total CoQ10 level in plasma, but rather an increase in the ratio of oxidized to reduced form of CoQ10 in the blood of pre-eclampsia mothers (6). Also, our study showed that ubiquinol-10 was correlated with α-tocopherol in pre-eclampsia pregnancies only (6). The positive correlation between ubiquinol-10 and α-tocopherol could thus represent a coordinated defense mechanism against oxidative stress in pre-eclampsia.

在先兆子痫患者的血清中,辅酶Q10总量降低,降低程度与病症的严重程度相关(4)。有研究发现患者血浆中的辅酶Q10总量也有所降低(5)。不过,先兆子痫患者脐带血和胎盘中的辅酶Q10水平升高。有意思的是,我们研究小组发现先兆子痫母亲血液中血浆的辅酶Q10总量水平没有增加,但是辅酶Q10氧化型/还原型比值却增加了(6)。 另外,先兆子痫患者的泛醇10水平仅与α-生育酚水平正相关。这种相关性可能表示它们在抗氧化应激反应过程中具有协同防御机制。

Besides its efficient antioxidant properties, CoQ10 may have unsuspected roles on immune functions and the control of blood pressure in pre-eclampsia. Indeed, we discovered that plasmatic IL-18 level, a cytokine known to induce tumor necrosis factor-α (TNF-α), was positively correlated with the ubiquinol-10 in pre-eclampsia pregnancies only (7). Though, the exact impact of the latter on immune function remains to be determined. We also observed that CoQ10 (oxidized/reduced ratio) positively correlates with the prostacyclin (vasodilator) to thromboxane (vasoconstrictor) ratio (6). This ratio may partly explain the hypertension in pre-eclampsia. More work still need to be done to understand the impact of the redox state on immune and vasoactive mediators.


A recent study indicated that CoQ10 supplementation at a dose of 200 mg/day from 20 weeks of pregnancy until birth can prevent pre-eclampsia (8). In this randomized cohort, the placebo group was constituted of 74 women and the CoQ10 treated group of 80 women. The 25.6% incidence of pre-eclampsia in the placebo group was significantly reduced to 14.4% in the CoQ10-treated group. This encouraging study was performed in Quito, Ecuador at 2,800 m of altitude, a factor know to increase the incidence of pre-eclampsia.




1. Stocker R, Bowry VW, Frei B (1991) Ubiquinol-10 protects human low density lipoprotein more efficiently against lipid peroxidation than does alpha-tocopherol. Proc Natl Acad Sci U S A 88:1646-1650

2. Stoyanovsky DA, Osipov AN, Quinn PJ, Kagan VE (1995) Ubiquinone-dependent recycling of vitamin E radicals by superoxide. Arch Biochem Biophys 323:343-351

3. Yamashita S, Yamamoto Y (1997) Simultaneous detection of ubiquinol and ubiquinone in human plasma as a marker of oxidative stress. Anal Biochem 250:66-73

4. Palan PR, Shaban DW, Martino T, Mikhail MS (2004) Lipid-soluble antioxidants and pregnancy: maternal serum levels of coenzyme Q10, alpha-tocopherol and gamma-tocopherol in preeclampsia and normal pregnancy. Gynecol Obstet Invest 58:8-13

5. Teran E, Racines-Orbe M, Vivero S, Escudero C, Molina G, Calle A (2003) Preeclampsia is associated with a decrease in plasma coenzyme Q10 levels. Free Radic Biol Med 35:1453-1456

6. Roland L, Gagne A, Belanger MC, Boutet M, Berthiaume L, Fraser WD, Julien P, Bilodeau JF (2010) Existence of compensatory defense mechanisms against oxidative stress and hypertension in preeclampsia. Hypertens Pregnancy 29:21-37

7. Roland L, Gagne A, Belanger MC, Boutet M, Julien P, Bilodeau JF (2010) Plasma interleukin-18 (IL-18) levels are correlated with antioxidant vitamin coenzyme Q(10) in preeclmpsia. Acta Obsete Gynecol Scand 89:360-366

8. Teran E, Hernandez I, Nieto B, Tavara R, Ocampo JE, Calle A (2009) Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. Int J Gynaecol Obstet 105:43-45

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