Coenzyme Q10 supplementation in multiple sclerosis; A systematic review.

BACKGROUND AND AIMS

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.

METHODS

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).

RESULTS

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.

DISCUSSION

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.

FUNDING AND REGISTRATION

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).