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辅酶Q10对溶酶体贮积症患儿的心脏保护作用。

Cardioprotective effects of CoQ10 in pediatric patients with lysosomal storage disorders.

作者信息

Abuzaid Yasmine, Suliman Ghada Abdul Moemn, Toulba Osama Abd Rab El Rasool, Elezz Ahmed Abd El Basset Abo, Badraldeen Alshimaa, Dawoud Heba

机构信息

Pediatrics Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

Ital J Pediatr. 2025 May 28;51(1):163. doi: 10.1186/s13052-025-02008-5.

Abstract

BACKGROUND

Lysosomal storage disorders (LSDs) result from an accumulation of specific substrates, due to the inability to break them down leading to cellular dysfunction in multiple organs, including the heart constituting an important and treatable cause of cardiomyopathy. Given the role of oxidative stress in many inborn errors of metabolism, many studies are evaluating oxidative stress and hence the role of antioxidants in patients with LSDs.

THE AIM OF THIS STUDY

was to study the possible effects of Coenzyme Q10 as a cardioprotective and an antioxidant drug in patients with LSDs.

METHODS

This study was a prospective case-control study conducted on 30 patients with LSDs and an equal number of healthy subjects of matched age and sex served as a control group at the unit of Medical Genetics and inborn errors of metabolism at the Pediatric Department of Tanta University Hospital. All subjects included were subjected to full history taking, complete physical examination, assessing serum level of N-terminal pro-brain natriuretic peptide (NT-proBNP) & serum malondialdehyde (MDA), along with comprehensive cardiac evaluation that was done using tissue doppler imaging and speckling tracking echo. Then the patient group was subdivided into two subgroups, half of the patients received Co enzyme Q10 (CoQ10) while the other half received a placebo for 24 weeks followed by cardiac evaluation and reassessment of serum MDA and NT-proBNP for both patient subgroups.

RESULTS

Patients with LSDs had significantly higher levels of serum MDA than controls denoting higher oxidative stress, P-value < 0.001. CoQ10 resulted in significant beneficial reduction of serum MDA (15%) &NT-proBNP (30%) in the group of patients who received CoQ10, P-value < 0.001 and improvement of cardiac functional parameters in patients with LSDs.

CONCLUSION

These findings suggest that CoQ10 may have a role in reducing oxidative stress and so may prevent the development of cardiomyopathy in patients with LSDs.

TRIAL REGISTRATION

This study was performed after approval from the Ethical Committee, Faculty of Medicine, Tanta University, Egypt (approval code 33255/07/19) and after obtaining written informed consent from children guardians. Also, this trial was registered on Pan African clinical trials registry with the number PACTR, 'PACTR202107466690046'. Registered 04 July 2021.

摘要

背景

溶酶体贮积症(LSDs)是由于特定底物无法分解而积累所致,导致多个器官细胞功能障碍,心脏受累是心肌病的一个重要且可治疗的病因。鉴于氧化应激在许多先天性代谢缺陷中的作用,许多研究正在评估氧化应激以及抗氧化剂在LSDs患者中的作用。

本研究的目的

是研究辅酶Q10作为一种心脏保护和抗氧化药物对LSDs患者可能产生的影响。

方法

本研究是一项前瞻性病例对照研究,对30例LSDs患者进行研究,并选取年龄和性别匹配的同等数量健康受试者作为对照组,研究在坦塔大学医院儿科医学遗传学和先天性代谢缺陷科进行。所有纳入的受试者均进行了全面的病史采集、完整的体格检查,评估血清N末端脑钠肽前体(NT-proBNP)和血清丙二醛(MDA)水平,同时使用组织多普勒成像和斑点追踪超声心动图进行全面的心脏评估。然后将患者组分为两个亚组,一半患者接受辅酶Q10(CoQ10)治疗,另一半患者接受安慰剂治疗24周,之后对两个患者亚组进行心脏评估,并重新评估血清MDA和NT-proBNP水平。

结果

LSDs患者的血清MDA水平显著高于对照组,表明氧化应激更高,P值<0.001。在接受CoQ10治疗的患者组中,CoQ10使血清MDA显著降低(15%),NT-proBNP显著降低(30%),P值<0.001,并改善了LSDs患者的心脏功能参数。

结论

这些发现表明,CoQ10可能在降低氧化应激方面发挥作用,从而可能预防LSDs患者心肌病的发生。

试验注册

本研究在获得埃及坦塔大学医学院伦理委员会批准(批准代码33255/07/19)并获得儿童监护人的书面知情同意后进行。此外,该试验在泛非临床试验注册中心注册,注册号为PACTR,“PACTR202107466690046”。于2021年7月4日注册。

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