Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA.
Mol Cell Neurosci. 2012 Feb;49(2):149-57. doi: 10.1016/j.mcn.2011.10.007. Epub 2011 Oct 20.
Controversies surround the usefulness of Coenzyme Q10 (CoQ10) in Huntington's disease (HD), an autosomal dominant, fatal, neurodegenerative disease with no cure or disease modifying treatment. CoQ10, an endogenous substrate for electron transport and an anti-oxidant, has been shown in some but not all studies to improve symptoms and survival in mouse models of HD. Previous studies have been conducted in fast-progressing models that better mimic the juvenile forms of HD than the much more common middle-age onset form, possibly accounting for mixed results. Establishing the usefulness of CoQ10 to alter HD disease course in a model that better recapitulates the progressive features of the human disorder is important because clinical trials of CoQ10, which is safe and well tolerated, are being planned in patients. The CAG140 knock-in (KI) mouse model of HD in which an expanded (approximately 120) CAG repeat is inserted in the mouse gene provides a model of the mutation in the proper genomic and protein context. These mice display progressive motor, cognitive and emotional anomalies, transcriptional disturbances and late striatal degeneration. Homozygote mutant CAG140 KI mice and wild-type littermates were fed CoQ10 (0.2%, 0.6%) in chow, and behavioral and pathological markers of disease were examined. CoQ10 improved early behavioral deficits and normalized some transcriptional deficits without altering huntingtin aggregates in striatum. The lower dose (0.2%) was more beneficial than 0.6%. Similar to previous studies, this low dose also induced deleterious effects in open field and rotarod in WT mice, however these effects are of unclear clinical significance in view of the excellent safety profile of CoQ10 in humans. These data confirm that CoQ10 may be beneficial in HD but suggest that maximum benefit may be observed when treatment is begun at early stages of the disease and that dosage may be critical.
辅酶 Q10(CoQ10)在亨廷顿病(HD)中的作用存在争议,HD 是一种常染色体显性、致命的神经退行性疾病,目前尚无治愈方法或可改变病程的治疗方法。CoQ10 是电子传递的内源性底物和抗氧化剂,一些研究表明 CoQ10 可改善 HD 小鼠模型的症状和生存,但并非所有研究均得出阳性结果。之前的研究是在进展较快的模型中进行的,这些模型比更为常见的中年发病形式更能模拟青少年发病形式,这可能导致结果不一致。在更好地模拟人类疾病进行性特征的模型中确定 CoQ10 改变 HD 病程的作用非常重要,因为正在计划对患者进行 CoQ10 的临床试验,该药物安全且耐受良好。在将一个扩展的(约 120 个)CAG 重复插入小鼠基因的 CAG140 敲入(KI)HD 小鼠模型中,CoQ10 可提供适当基因组和蛋白背景下突变的模型。这些小鼠表现出进行性运动、认知和情感异常、转录失调和晚期纹状体变性。用含 0.2%或 0.6%CoQ10 的饲料喂养杂合子突变 CAG140 KI 小鼠和野生型同窝仔鼠,并检查疾病的行为和病理标志物。CoQ10 改善了早期行为缺陷,并使一些转录缺陷正常化,而不改变纹状体中的亨廷顿蛋白聚集物。低剂量(0.2%)比高剂量(0.6%)更有益。与之前的研究相似,该低剂量也会导致 WT 小鼠在旷场和旋转棒测试中出现有害作用,但鉴于 CoQ10 在人类中的安全性良好,这些作用的临床意义尚不清楚。这些数据证实 CoQ10 可能对 HD 有益,但提示在疾病早期开始治疗时可能观察到最大益处,并且剂量可能很关键。