| خلاصه مقاله | Background: Multiple sclerosis (MS) is an inflammatory neurodegenerative disease characterized by immune-mediated damage to myelin and axons in the central nervous system. Oxidative stress also contributes to tissue injury in MS. As an antioxidant and electron carrier in mitochondria, coenzyme Q10 (CoQ10) may have therapeutic potential in MS. This systematic review synthesized evidence on the efficacy and safety of CoQ10 supplementation in MS patients.
Methods: A comprehensive literature search was conducted in PubMed, Scopus, Embase and Web of Science in May 2023. Randomized controlled trials (RCTs) and retrospective analyses of CoQ10 supplementation in MS patients were included. Risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Outcomes evaluated were effects on oxidative stress, inflammation, fatigue, depression, disability progression, cognition, neural growth factors, and adverse events.
Results: The preliminary literature search identified 237 potentially relevant articles. After screening, 8 studies met the inclusion criteria - 7 randomized controlled trials (RCTs) and 1 retrospective analysis. The results showed that taking 200mg/day of coQ10 supplement for 2-3 months did not significantly affect levels of neuronal growth factors in the blood. However, there were inconsistent findings on whether this dose impacted inflammatory markers, antioxidant enzymes, and lipid peroxidation. In contrast, taking 500mg/day of coQ10 supplement for the same duration appeared to reduce oxidative stress and inflammation. This higher dose also seemed to lessen symptoms of depression and fatigue in multiple sclerosis patients. These findings imply that coQ10 may have dose-dependent effects, with higher doses of 500mg/day potentially improving outcomes related to inflammation, oxidative stress, depression and fatigue.
Conclusions: CoQ10 supplementation displays antioxidant and potential anti-inflammatory effects in MS patients. Preliminary evidence indicates possible benefits for fatigue and depression. However, current research does not demonstrate an impact on disability outcomes. Effects may depend on adequate dosing and treatment duration. Larger RCTs with clinical endpoints are needed to establish efficacy. Safety appears favorable but systematic adverse event monitoring is lacking. Overall, CoQ10 is a promising supplement for MS warranting further study. Determining optimal dosage and treatment length should be a priority. |