Coenzyme Q10 is increased in placenta and cord blood during preeclampsia

Ferroptosis and Its Emerging Role in Pre-Eclampsia

Iron is essential for cell survival, and iron deficiency is a known risk factor for many reproductive diseases. Paradoxically, such disorders are also more common in cases of iron overload. Here, we evaluated the role of ferroptosis in women’s health, particularly focusing on pre-eclampsia (PE). PE is a multisystem disorder and is one of the leading causes of maternal and perinatal morbidity and mortality, especially when the condition is of early onset. Nevertheless, the exact etiological mechanism of PE remains unclear. Interestingly, ferroptosis, as a regulated iron-dependent cell death pathway, involves a lethal accumulation of lipid peroxides and shares some characteristics with PE pathophysiology. In this review, we comprehensively reviewed and summarized recent studies investigating the molecular mechanisms involved in the regulation and execution of ferroptosis, as well as ferroptosis mechanisms in the pathology of PE. We propose that ferroptosis not only plays an important role in PE, but may also become a novel therapeutic target for PE.

Fetal coenzyme Q10 deficiency in intrahepatic cholestasis of pregnancy

AIM

Intrahepatic cholestasis of pregnancy (ICP) is considered a high-risk condition because it may have serious consequences for the fetus health. ICP is characterized by the accumulation of bile acids in maternal serum which contribute to an imbalance between the production of reactive oxygen species and the antioxidant defenses increasing the oxidative stress experienced by the fetus. Previously, it was reported a significant decrease in plasma coenzyme Q10 (CoQ10) in women with ICP. CoQ10 is a redox substance integrated in the mitochondrial respiratory chain and is recognized as a potent antioxidant playing an intrinsic role against oxidative damage. The objective of the present study was to investigate the levels of CoQ10 in umbilical cord blood during normal pregnancy and in those complicated with ICP, all of them compared to the maternal ones.

METHODS

CoQ10 levels and bile acid levels in maternal and umbilical cord blood levels during normal pregnancies (n=23) and in those complicated with ICP (n=13), were investigated.

RESULTS

A significant decrease in neonate CoQ10 levels corrected by cholesterol (0.105±0.010 vs. 0.069±0.011, P<0.05, normal pregnancy vs. ICP, respectively), together with an increase of total serum bile acids (2.10±0.02 vs. 7.60±2.30, P<0.05, normal pregnancy vs. ICP, respectively) was observed.

CONCLUSIONS

A fetus from an ICP mother is exposed to a greater risk derived from oxidative damage. The recognition of CoQ10 deficiency is important since it could be the starting point for a new and safe intervention strategy which can establish CoQ10 as a promising candidate to prevent the risk of oxidative stress.

CoQ10 alleviate preeclampsia symptoms by enhancing the function of mitochondria in the placenta of pregnant rats with preeclampsia

Objective: To assess whether supplementation with Coenzyme Q10 (CoQ10) during pregnancy alleviate preeclampsia symptoms and the underlying mechanism in the rats with preeclampsia. Methods: Forty-five pregnant Wistar rats were equally divided into three groups randomly and received subcutaneous saline injection (control group, n = 15) or 200 mg/kg L-NAME injection to induce preeclampsia symptoms (PE group, n = 30). The PE rats were treated by distilled water (PE+DW group, n = 15) and CoQ10 (PE+CoQ10 group, n = 15) on day 15 to 21 of gestation randomly. Physiological characteristics such as urine volume, total urine protein, blood pressure, number and weight of pups were recorded. Fluorescent dye was used to detect mitochondrial membrane potential in placenta. Real-time fluorescent quantitative PCR was used to detect the expression of mitochondrial DNA(mtDNA) in placenta. Results: There was no statistic difference among all the three groups on day 10 of gestation in SBP and 24-h proteinuria (P > 0.05). Whereas, SBP and 24-h proteinuria were significantly higher in PE group than control group on day 15 and 21 of gestation (P < 0.05). SBP and 24-h proteinuria were significantly lower in PE+CoQ10 group than PE+DW group on day 21 of gestation (P < 0.05). The number and weight of normal pups were significantly lower in PE group than the control group (P < 0.05), which were most notably in distilled water group, and the number and weight of normal pups were markedly bigger in PE+CoQ10 group rats compared to PE+DW (P < 0.05). The PE+CoQ10 group showed a significantly higher in level of mitochondrial membrane potential than PE+DW group. The expression of mtDNA was significantly higher in the PE+CoQ10 group compared with PE+DW group (P < 0.05). Conclusions: CoQ10 can alleviate preeclampsia symptoms and enhance the function of mitochondria in the placenta.

Mitochondria and Coenzyme Q10 in the Pathogenesis of Preeclampsia

Hypertensive disorders during pregnancy constitute one of the main causes of maternal and perinatal morbidity and mortality across the world and particularly in developing countries such as Ecuador. However, despite its impact on public health, the primary pathophysiological processes involved are yet to be elucidated. It has been proposed, among other theories, that an abnormal placentation may induce an endothelial dysfunction, which is ultimately responsible for the final clinical manifestations. Mitochondria, particularly from trophoblastic cells, are responsible for the production of energy, which is extremely important for normal placentation. The malfunction in this supply of energy may produce higher levels of free radicals. In both production of energy and free radicals, coenzyme Q10 (CoQ10) plays a crucial role in electron transport. As such, the role of CoQ10 in the genesis and prevention of preeclampsia has become the focus of a number of research groups, including that of the authors. Developing an in-depth understanding of these mechanisms might allow us to design new and feasible strategies with which we can reduce preeclampsia, particularly in the Latin-American countries.

Maternal plasma and amniotic fluid coenzyme Q10 levels in preterm and term gestations: a pilot study

OBJECTIVE

To measure maternal plasma and amniotic fluid coenzyme Q10 (CoQ10) levels in preterm and term gestations.

STUDY DESIGN

This pilot study comprised a convenience sample of 72 women admitted for labor with singleton live gestations and intact membranes (preterm n = 27 and term n = 45).

RESULTS

Median [interquartile range] maternal plasma CoQ10 levels did not differ among the studied women (preterm, 0.47 [0.12] vs. term, 0.47 [0.23] mmol/L, p = 0.90). Overall CoQ10 amniotic fluid levels were nearly tenfold lower than those found in maternal plasma, with a significant lower level observed among those delivering preterm (0.050 [0.05] vs. 0.062 [0.04] mmol/L, p = 0.007). Multiple linear regression analysis controlling for several covariates determined a significant correlation between amniotic fluid CoQ10 levels and neonatal gestational age.

CONCLUSION

This is the first study to assess CoQ10 levels in amniotic fluid during pregnancy in which levels were significantly lower among those delivering preterm. More research is warranted in this regard.

Ubiquinol-10 and ubiquinone-10 levels in umbilical cord blood of healthy foetuses and the venous blood of their mothers

Despite their being good markers of oxidative stress for clinical use, little is known about ubiquinol-10 (reduced coenzyme Q10) and ubiquinone-10 (oxidized coenzyme Q10) levels in foetuses and their mothers. This study investigates oxidative stress in 10 healthy maternal venous, umbilical arterial and venous bloods after vaginal delivery by measuring ubiquinol-10 and ubiquinone-10 levels. Serum ubiquinol-10 and ubiquinone-10 levels were measured by HPLC with a highly sensitive electrochemical detector. Maternal venous ubiquinol-10 and ubiquinone-10 levels were significantly higher than umbilical arterial and venous levels (all p < 0.001). However, the ubiquinone-10/total coenzyme Q10 (CoQ10) ratio, which reflects the redox status, was significantly higher in umbilical arterial and umbilical venous blood compared to maternal venous blood (all p < 0.001). The ubiquinone-10/total CoQ10 ratio was higher in umbilical arterial than in umbilical venous blood (p < 0.01). The present study demonstrated that foetuses were under higher oxidative stress than their mothers.

Positive correlation between maternal serum coenzyme Q10 levels and infant birth weight

The purpose of this study was to examine the relationship between the level of maternal serum coenzyme Q10 (CoQ10), which is a lipid-soluble antioxidant, maternal body weight gain, fat mass gain, and infant birth weight. A longitudinal observational study was conducted with 50 healthy pregnant women (average age: 31.1 years, average body mass index (BMI): 21.3 kg/m(2) at prepregnancy) at each trimester. CoQ10 levels were measured by high performance liquid chromatography. Maternal weight and body composition were measured by a bioelectrical impedance analysis. The CoQ10 levels significantly increased throughout pregnancy from the first trimester to the third trimester (P < 0.001), and correlated with not only the serum cholesterol levels (P < 0.01) but also with the serum acetoacetic acid levels (P < 0.05) in the third trimester. The CoQ10 levels correlated with the maternal weight gain (P < 0.05) and fat mass gain (P < 0.05) from the second to the third trimester, after adjusting for lipid markers, age, and smoking habits. The level of CoQ10 during the third trimester was also significantly associated with the infant birth weight (P < 0.05) after adjusting for gestational age, maternal prepregnancy BMI, and smoking habits. Therefore, it is concluded that the level of maternal CoQ10 is positively associated with fetal growth, balancing rapid metabolic changes in the last half of a normal pregnancy.

Preeclampsia and HELLP syndrome: impaired mitochondrial function in umbilical endothelial cells

Preeclampsia (PE) and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome have been linked to congenital fetal disorders of mitochondrial fatty acid oxidation (FAO). Different incidences may argue for the association of noncongenital alterations of mitochondrial energy metabolism with PE/HELLP syndrome. We studied human umbilical vein endothelial cells [HUVEC] as selected part of the feto-placental unit from uncomplicated (n = 46) and diseased (n = 27; 17 PE and 10 HELLP) pregnancies by measuring the overall FAO, carnitine palmitoyltransferase 2 (CPT2), respiratory chain (RC) complexes I-V, citratesynthase (CS), lactatedehydrogenase (LDH), hexokinase (HK), phosphofructokinase (PFK), and energy rich phosphates. Maternal and infantile acylcarnitines in blood were investigated post partum. Overall FAO, RC complexes II-V, and CS were significantly compromised in HUVEC from complicated pregnancies; impairment of complexes I + III was not significant. CPT2 and energy charges were unaffected. Lactatedehydrogenase and PFK from complicated pregnancies were upregulated, and HK remained constant. In blood, carnitine was elevated in diseased women and their children, acylcarnitines were higher in affected infants. Impaired mitochondrial function in HUVEC is associated with PE/HELLP syndrome and may be involved in the pathophysiology of these diseases.

Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia

OBJECTIVE

To assess whether supplementation with Coenzyme Q10 (CoQ10) during pregnancy reduces the risk of pre-eclampsia.

METHODS

Women at increased risk of pre-eclampsia were enrolled in a randomized, double-blind, placebo-controlled trial. Women were assigned to receive 200 mg of CoQ10 or placebo daily from 20 weeks of pregnancy until delivery. The primary outcome was rate of pre-eclampsia. Statistical analyses were by intention-to-treat.

RESULTS

Of the 235 women enrolled in the trial, 118 were randomized to receive CoQ10 and 117 received a placebo. A total of 197 (83.8%) women were followed-up. The overall rate of pre-eclampsia was 20% (n=47). Thirty women (25.6%) in the placebo group developed pre-eclampsia compared with 17 women (14.4%) in the CoQ10 group, and this reduction was significant (P=0.035) (relative risk [RR] 0.56; 95% confidence interval [CI], 0.33-0.96).

CONCLUSION

Supplementation with CoQ10 reduces the risk of developing pre-eclampsia in women at risk for the condition.

Coenzyme Q10 levels in women with preeclampsia living at different altitudes

BACKGROUND

Preeclampsia is a common disorder of pregnancy exhibiting abnormal plasma and placental coenzyme Q10 (CoQ10) levels when compared to normal pregnancies.

OBJECTIVE

To evaluate CoQ10 levels both in plasma and placenta among normal pregnant (n = 60) and preeclamptic (n = 63) primigravid women and determine the effect of high or low altitude residency.

STUDY DESIGN

CoQ10 was determined using High Performance Liquid Chromatography (HPLC) technique and group comparisons were performed.

RESULTS

Preeclamptic women living at high altitude displayed significantly lower CoQ10 plasma levels (0.64 +/- 0.23 vs. 0.82 +/- 0.46 micromol/L, p = 0.05). No differences were found in CoQ10 plasma levels among women living at sea level. Interestingly, plasma CoQ10 levels at low altitude in normal pregnancies were significantly lower than high altitude normal pregnancies. Compared to normal pregnancies, preeclamptic women displayed higher placental CoQ10 content, which was only significant among those living at sea level (0.120 +/- 0.07 vs. 0.076 +/- 0.04 ng/mg protein, p < 0.005). Normal pregnant women living at high altitude displayed higher placental CoQ10 content when compared to those residing at sea level (p < 0.0005).

CONCLUSION

Women suffering from preeclampsia (high or low altitude) display high placental CoQ10 content, with significant low plasma CoQ10 levels among those residing in high altitude. More research is warranted to establish the cause-effect relationship between CoQ10 levels and preeclampsia.

The uptake and distribution of coenzyme Q(10)

This review describes recent advances in our understanding of the uptake and distribution of coenzyme Q10 (CoQ10) in cells, animals, and humans. These advances have provided evidence of important pharmacokinetic factors, such as non-linear absorption and enterohepatic recirculation, and may facilitate the development of new CoQ10 formulations. Studies providing data which support the claim of tissue uptake of exogenous CoQ10 are also discussed. Improved CoQ10 dosing and drug level monitoring guidelines are suggested for adult and pediatric patient populations. Future CoQ10 research should consider uptake and distribution factors to determine cost-benefit relationships.