Salekzamani Shabnam, Pakkhesal Sina, Babaei Mohammad, Mirzaaghazadeh Ehsan, Mosaddeghi-Heris Reza, Talebi Mahnaz, Sanaie Sarvin, Naseri Amirreza
Department of Nutrition, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Mult Scler Relat Disord. 2025 Jan;93:106212. doi: 10.1016/j.msard.2024.106212. Epub 2024 Dec 3.
Multiple Sclerosis (MS) is a chronic and progressive inflammatory disease of the central nervous system (CNS). Oxidative stress is a crucial mediator in multiple conditions, including the MS. Coenzyme Q10 (CoQ10) is a potent antioxidant, present in enzyme complexes of mitochondria, and involved in oxidative phosphorylation to produce adenosine triphosphate (ATP). The objective of this systematic review was to investigate the outcomes of CoQ10 supplementation in oxidative stress, inflammatory, and clinical status of patients with MS.
Following the Cochrane and PRISMA methods, a comprehensive search was conducted in PubMed, Scopus, Embase, and Web of Science databases, and clinical studies that reported the outcomes of CoQ10 supplementation in MS patients, are included. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials (RoB2).
The initial search yielded 237 articles, of which eight reports from six studies (total n = 195), including three RCTs, two semi-experimental studies, and one retrospective analysis were included. The effects of 2-3 months of CoQ10 supplementation on inflammatory factors, antioxidant enzyme system, and lipid peroxidation remain controversial in 200mg/day dose; however, 500mg/day of CoQ10 supplement can improve oxidative stress and inflammation, along with depression and fatigue amelioration in MS patients.
This study concludes that CoQ10 might exert dose-dependent beneficial effects on ameliorating oxidative stress and inflammation in MS, and also sheds light on its possible utility in relieving clinical symptoms of MS; however, limitations of the evidence such as the small number of included studies, suggested future studies for clinical recommendations.
The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 71910). This study was registered in International prospective register of systematic reviews (PROSPERO ID: CRD42023461877).
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性进行性炎症性疾病。氧化应激是多种病症（包括MS）中的关键介质。辅酶Q10（CoQ10）是一种强效抗氧化剂，存在于线粒体的酶复合物中，并参与氧化磷酸化以产生三磷酸腺苷（ATP）。本系统评价的目的是研究补充CoQ10对MS患者氧化应激、炎症和临床状况的影响。
按照Cochrane和PRISMA方法，在PubMed、Scopus、Embase和Web of Science数据库中进行全面检索，并纳入报告了补充CoQ10对MS患者影响结果的临床研究。使用修订后的Cochrane随机试验偏倚风险工具（RoB2）评估偏倚风险。
初步检索得到237篇文章，其中纳入了来自6项研究的8份报告（共n = 195），包括3项随机对照试验、2项半实验研究和1项回顾性分析。每天200mg剂量的CoQ10补充2 - 3个月对炎症因子、抗氧化酶系统和脂质过氧化的影响仍存在争议；然而，每天500mg的CoQ10补充剂可以改善MS患者的氧化应激和炎症，并减轻抑郁和疲劳。
本研究得出结论，CoQ10可能对改善MS患者的氧化应激和炎症具有剂量依赖性的有益作用，并且也揭示了其在缓解MS临床症状方面的潜在效用；然而，证据存在局限性，如纳入研究数量较少，建议未来进行研究以提供临床建议。
本研究方案已获得大不里士医科大学学生研究委员会的批准和支持（批准号：71910）。本研究已在国际前瞻性系统评价注册库（PROSPERO编号：CRD42023461877）注册。
