Yoritaka Asako, Kawajiri Sumihiro, Yamamoto Yorihiro, Nakahara Toshiki, Ando Maya, Hashimoto Kazuhiko, Nagase Midori, Saito Yufuko, Hattori Nobutaka
Department of Neurology, Juntendo University School of Medicine, Japan; Department of Neurology, Juntendo University Koshigaya Hospital, Japan.
Department of Neurology, Juntendo University School of Medicine, Japan.
Parkinsonism Relat Disord. 2015 Aug;21(8):911-6. doi: 10.1016/j.parkreldis.2015.05.022. Epub 2015 May 29.
Mitochondrial complex I deficiencies have been found in post-mortem brains of patients with Parkinson's disease (PD). Coenzyme Q10 (CoQ10) is the electron acceptor found in complexes I and II, and is a potent antioxidant. A recent trial of the oxidized form of CoQ10 for PD failed to show benefits; however, the reduced form of CoQ10 (ubiquinol-10) has shown better neuroprotective effects in animal models.
Randomized, double-blind, placebo-controlled, parallel-group pilot trials were conducted to assess the efficacy of ubiquinol-10 in Japanese patients with PD. Participants were divided into two groups: PD experiencing wearing off (Group A), and early PD, without levodopa (with or without a dopamine agonist) (Group B). Participants took 300 mg of ubiquinol-10 or placebo per day for 48 weeks (Group A) or 96 weeks (Group B).
In Group A, total Unified Parkinson's Disease Rating Scale (UPDRS) scores decreased in the ubiquinol-10 group (n = 14; mean ± SD [-4.2 ± 8.2]), indicating improvement in symptoms. There was a statistically significant difference (p < 0.05) compared with the placebo group (n = 12; 2.9 ± 8.9). In Group B, UPDRS increased in the ubiquinol-10 group (n = 14; 3.9 ± 8.0), as well as in the placebo group (n = 8; 5.1 ± 10.3).
This is the first report showing that ubiquinol-10 may significantly improve PD with wearing off, as judged by total UPDRS scores, and that ubiquinol-10 is safe and well tolerated.
在帕金森病(PD)患者的尸检大脑中发现了线粒体复合物I缺陷。辅酶Q10(CoQ10)是在复合物I和II中发现的电子受体,并且是一种有效的抗氧化剂。最近一项针对PD的氧化形式CoQ10的试验未显示出益处;然而,CoQ10的还原形式(泛醇-10)在动物模型中显示出更好的神经保护作用。
进行了随机、双盲、安慰剂对照、平行组试点试验,以评估泛醇-10对日本PD患者的疗效。参与者分为两组:出现剂末现象的PD患者(A组)和未使用左旋多巴(使用或不使用多巴胺激动剂)的早期PD患者(B组)。参与者每天服用300毫克泛醇-10或安慰剂,持续48周(A组)或96周(B组)。
在A组中,泛醇-10组(n = 14;平均值±标准差[-4.2±8.2])的帕金森病统一评分量表(UPDRS)总分下降,表明症状有所改善。与安慰剂组(n = 12;2.9±8.9)相比,存在统计学显著差异(p < 0.05)。在B组中,泛醇-10组(n = 14;3.9±8.0)以及安慰剂组(n = 8;5.1±10.3)的UPDRS均升高。
这是第一份报告表明,根据UPDRS总分判断,泛醇-10可能显著改善出现剂末现象的PD,并且泛醇-10安全且耐受性良好。