Weber Cynthia A, Ernst Michael E
Family Medicine, College of Pharmacy, The University of Iowa, Iowa City, IA 52242-1097, USA.
Ann Pharmacother. 2006 May;40(5):935-8. doi: 10.1345/aph.1G551. Epub 2006 Apr 18.
To review the use of antioxidants and other supplements for the prevention and treatment of Parkinson's disease (PD).
Biomedical literature was accessed through MEDLINE (1996-June 2005); key search terms included Parkinson's disease, coenzyme Q10 (CoQ10), antioxidants, supplements, and glutathione. Pertinent references cited in those articles were also evaluated for inclusion in this review.
Three main antioxidants or supplements have been studied for use in the prevention or treatment of PD: tocopherol, CoQ10, and glutathione. These agents have been studied because of their potential to alter the course of 2 common theories of PD pathogenesis: free radical generation and mitochondrial complex-1 deficiency. The literature search revealed 3 large clinical studies of tocopherol (2 observational, 1 prospective randomized), 4 trials of CoQ10, and 1 study of glutathione. With the exception of the large observational studies with tocopherol and one study of CoQ10 that enrolled 80 patients, each of the other studies retrieved included fewer than 30 patients and were conducted for 3 months or less. Antioxidant supplementation, in particular tocopherol, did not appear to alter the course of PD. However, in 2 of the studies of CoQ10 and in the study of glutathione, a small but statistically significant improvement in PD symptoms was observed.
At present, antioxidants and supplements appear to have a limited role in the prevention or treatment of PD. Of those reviewed here, CoQ10 appears to provide some minor treatment benefits. More study is necessary to determine whether CoQ10 has a significant role as primary or adjunctive therapy in PD.
综述抗氧化剂及其他补充剂在帕金森病(PD)预防和治疗中的应用。
通过MEDLINE(1996年 - 2005年6月)检索生物医学文献;关键检索词包括帕金森病、辅酶Q10(CoQ10)、抗氧化剂、补充剂和谷胱甘肽。对这些文章中引用的相关参考文献也进行了评估以纳入本综述。
已对三种主要的抗氧化剂或补充剂用于PD的预防或治疗进行了研究:生育酚、CoQ10和谷胱甘肽。研究这些药物是因为它们有可能改变PD发病机制的两种常见理论进程:自由基生成和线粒体复合物I缺乏。文献检索发现了3项关于生育酚的大型临床研究(2项观察性研究,1项前瞻性随机研究)、4项CoQ10试验和1项谷胱甘肽研究。除了关于生育酚的大型观察性研究和一项纳入80例患者的CoQ10研究外,其他检索到的研究每项纳入患者均少于30例,且研究持续时间为3个月或更短。补充抗氧化剂,尤其是生育酚,似乎并未改变PD的病程。然而,在2项CoQ10研究和谷胱甘肽研究中,观察到PD症状有轻微但具有统计学意义的改善。
目前,抗氧化剂和补充剂在PD的预防或治疗中作用似乎有限。在此综述的这些物质中,CoQ10似乎能提供一些轻微的治疗益处。需要更多研究来确定CoQ10在PD中作为主要治疗或辅助治疗是否具有重要作用。