Advances in micro- and nano- delivery systems for increasing the stability, bioavailability and bioactivity of coenzyme Q10

Coenzyme Q10 acts as a liposoluble quinone compound in mitochondrial oxidative phosphorylation, serving as an electron carrier and protecting the cell membrane structure as an antioxidant. Coenzyme Q10 has notable health benefits, including anti-aging, anti-inflammatory, prevention of cardiovascular diseases, and assistance in cancer treatment. However, its poor water solubility, unstable chemical properties, and low bioavailability significantly limit its application. This article reviewed the design and development processes of various delivery systems for coenzyme Q10, discussing the advantages and disadvantages of different delivery systems and their improvement strategies, including improvements in the stability and accessibility of emulsions, achieving higher penetration rates for oleogels, and reducing the use of toxic substances in the production process of liposomes. The mechanisms behind coenzyme Q10's low stability and bioavailability were analyzed, and the bioactivity and research prospects of coenzyme Q10 were also discussed. In summary, this review offered valuable insights into the design and application of delivery systems for coenzyme Q10, which may provide a reference for its development and application in pharmaceuticals, cosmetics, health products, and other industries in the future.

Bioavailability enhancement of coenzyme Q10: An update of novel approaches

Coenzyme Q10 (CoQ10) is an essential, lipid-soluble vitamin involved in electron transport in the oxidoreductive reactions of the mitochondrial respiratory chain. Structurally, the quinone ring is connected to an isoprenoid moiety, which has a high molecular weight. Over the years, coenzyme Q10 has become relevant in the treatment of several diseases, like neurodegenerative disorders, coronary diseases, diabetes, hypercholesterolemia, cancer, and others. According to studies, CoQ10 supplementation might be beneficial in the treatment of CoQ10 deficiencies and disorders associated with oxidative stress. However, the water-insoluble nature of CoQ10 is a major hindrance to successful supplementation. So far, many advancements in CoQ10 bioavailability enhancement have been developed using novel drug carriers such as solid dispersion, liposomes, micelles, nanoparticles, nanoemulsions, self-emulsifying drug systems, or various innovative approaches (CoQ10 complexation with proteins). This article aims to provide an update on methods to improve CoQ10 solubility and bioavailability.

Integrating supplementation in the management of patients with heart failure: an evidence-based review

INTRODUCTION

Complementary, alternative and integrative medicine includes a myriad of therapies including herbal medicines, vitamins, dietary interventions and more, that are taken alone or in adjunct to standard conventional treatment. Often the main goals are to slow progression of disease, increase effectiveness of a drug, reduce side effects and improve quality of life. The study of these therapies and their influence in heart failure is not new. However, even for an experienced clinician, a gap exists between the literature and the application of knowledge to make a confident recommendation.

AREAS COVERED

This review has a focus on specific supplements that are commonly used for individuals with HF. It discusses the mechanism of action, expected benefits, potential adverse effects, suggested doses, forms and drug interactions of these therapies. The literature search methodology included using medical subject headings terms to search in PubMed. Articles used were screened and critically appraised by the authors of this review.

EXPERT OPINION

There are promising outcomes pertaining to the use of CAM in patients with HF. Advances in large scale, randomized, placebo-controlled trials are necessary to support evidence-based decision making regarding the use of supplements in conjunction, and in comparison, to conventional therapies for heart failure.

Secondary coenzyme Q deficiency in neurological disorders

Coenzyme Q (CoQ) is a ubiquitous lipid serving essential cellular functions. It is the only component of the mitochondrial respiratory chain that can be exogenously absorbed. Here, we provide an overview of current knowledge, controversies, and open questions about CoQ intracellular and tissue distribution, in particular in brain and skeletal muscle. We discuss human neurological diseases and mouse models associated with secondary CoQ deficiency in these tissues and highlight pharmacokinetic and anatomical challenges in exogenous CoQ biodistribution, recent improvements in CoQ formulations and imaging, as well as alternative therapeutical strategies to CoQ supplementation. The last section proposes possible mechanisms underlying secondary CoQ deficiency in human diseases with emphasis on neurological and neuromuscular disorders.

Transport via Niemann-Pick C1 Like 1 contributes to the intestinal absorption of ubiquinone

Ubiquinone, which is a component in the electron-transport systems of mitochondria, is essential for various activities related to energy metabolism, but the detailed absorption mechanism of ubiquinone is not clear. On the other hand, Niemann-Pick C1 Like 1 (NPC1L1) is involved in the intestinal absorption of fat-soluble components such as cholesterol. In this study, we investigated whether the intestinal absorption of ubiquinone was transported by NPC1L1 as is cholesterol. In this study, coenzyme q10 (CoQ10) and coenzyme q9 (CoQ9) were used as models of ubiquinone. The transport activity of ubiquinone was increased significantly in NPC1L1-overexpressed Madin-Darby canine kidney (MDCK) cells compared with that in pMAM2-BSD vector-transfected MDCK cells and the uptake of ubiquinone was decreased in the presence of ezetimibe, an inhibitor of NPC1L1. These results indicate that NPC1L1 mediates the transport of ubiquinone. Furthermore, to clarify the effect of NPC1L1 on the intestinal absorption of CoQ10, emulsified CoQ10 was orally administered to Wistar rats, and the plasma concentration was measured. The plasma concentration of CoQ10 was significantly decreased by coadministration of ezetimibe and CoQ10 compared to that with administration of only CoQ10. This result indicates that the intestinal absorption of CoQ10 is mediated by NPC1L1.

Extrapulmonary Surfactant Therapy: Review of Available Data and Research/Development Issues

Since the discovery of surfactant, a large amount of knowledge has been accumulated about its biology and pharmacology. Surfactant is the cornerstone of neonatal respiratory critical care, but its proteins and phospholipids are produced in various tissues and organs, with possible roles only partially similar to that played in the alveoli. As surfactant research is focused mainly on its respiratory applications, knowledge about the possible role of surfactant in extrapulmonary disorders has never been summarized. Here we aim to comprehensively review the data about surfactant biology and pharmacology in organs other than the lung, especially focusing in the more promising surfactant extrapulmonary roles. We also review any preclinical or clinical data available about the therapeutic use of surfactant in these contexts. We offer a summary of knowledge and research/development milestones, as possible useful guidance for researchers of multidisciplinary background.

Miso Soup Consumption Enhances the Bioavailability of the Reduced Form of Supplemental Coenzyme Q10

Coenzyme Q₁₀ (CoQ₁₀) is an essential compound that is involved in energy production and is a lipid-soluble antioxidant. Although it has been proposed as an antiaging and a health-supporting supplement, its low bioavailability remains a significant issue. Concurrent food intake enhances the absorption of orally administered CoQ₁₀, but it has not been fully established whether specific food substances affect intestinal CoQ₁₀ absorption. Therefore, to determine whether the bioavailability of supplemental CoQ₁₀ is affected by diet, P30, a granulated and reduced form of CoQ₁₀, was dispersed in four different foods, clear soup, miso soup, milk soup, and raw egg sauce. Those foods which contained CoQ₁₀ were consumed on different occasions at intervals of 6–14 weeks by the same participants. Thirteen participants were recruited in the single-dose and repeated clinical study. When miso soup containing P30 was provided, the serum CoQ₁₀ concentration increased faster than when participants consumed other P30-containing soups or a P30-containing raw egg sauce. The area under the curve for serum CoQ₁₀ during the first 5 h after consumption of the P30-containing miso soup was approximately 1.5 times larger than those after the consumption of other P30-containing meals. These data imply that the absorption of CoQ₁₀ supplements can be enhanced by consuming them with food and in particular with specific food substances, such as miso soup.

Enhancement of intestinal absorption of coenzyme Q10 using emulsions containing oleyl polyethylene acetic acids

Emulsions have often been prepared to improve absorption of lipophilic compounds that have poor solubility. Coenzyme Q10 (CoQ10) is a lipophilic compound that has been used as an anti-aging supplement. We focused on oleyl polyethyleneoxy acetic acid, an oxa acid derivative, to prepare emulsions of CoQ10 with the expectation of application to oral pharmaceutics. Oxa acids were purified and classified into four groups based on the average length of the ethylene oxide chain. The emulsion that were prepared using the four oxa acid groups were administered to rats and the plasma concentration profiles of CoQ10 were analyzed. The absorption of CoQ10 was improved in all emulsion groups compared with that in the powder group. The emulsion using oxa acid (n = 9.0) greatly increased the plasma concentration of CoQ10. Absorption was also improved by using emulsions containing larger percentage of oxa acids (6%, 15% and 23%) to compared with the same oxa acid (n = 9.0). The effects of oxa acids on cell viability were almost the same as those of conventional surfactants such as polyoxyethylene (20) sorbitan monooleate (Tween 80). The results showed that oxa acids are useful to prepare emulsions for oral administration and that the absorption of CoQ10 using oxa acids is significantly improved by using our formulations.

[Study of Formulation Development Based on the Pharmacokinetic Properties of Functional Food Components]

Preventive medicine and anti-aging medicine have received much attention recently due to an increase in the proportion of elderly people in the population, and to an increase in patients with lifestyle diseases. Oxidative stress is involved in the onset of lifestyle diseases, and various antioxidant supplements and antioxidant-fortified functional foods have recently become available. Many epidemiological studies have shown relationships between the consumption of polyphenol and carotenoid-rich foods and the prevention of lifestyle diseases. We have focused on the absorption mechanism of these food components that show low bioavailability, and have made efforts to improve their poor absorption based on their pharmacokinetic properties. In this report, as examples, we describe the enhancement of the absorption of coenzyme Q10 (CoQ10) and lutein. To improve the absorption of CoQ10, we focused on the component of emulsion. We found that a higher plasma concentration of CoQ10 could be obtained by creating an emulsion containing a surfactant with a higher hydrophile-lipophile balance (HLB) value. For the improvement of lutein absorption, we prepared a solid dispersion and self-emulsifying drug delivery system. It was shown that the plasma concentrations of lutein in these two formulation groups were increased compared with that in the powder group. The absorption of lutein was also evaluated by its cumulative amount in the lymph system. Our data showed that lutein is transferred from the small intestine into the lymph stream, rather than into the blood stream. Further investigations to improve the absorption of these components are in progress.

Enhanced Stability and Oral Bioavailability of Folic Acid-Dextran-Coenzyme Q10 Nanopreparation by High-Pressure Homogenization

The preparation of folic acid-dextran-coenzyme Q₁₀ (FA-DEX-CoQ₁₀) nanopreparation was optimized by high-pressure homogenization to improve the dissolution and oral bioavailability of CoQ₁₀. The preparation conditions of FA-DEX-CoQ₁₀ nanopreparation were optimized by single-factor and orthogonal experimental design. The properties of CoQ₁₀ raw materials, CoQ₁₀ physical mixtures, and FA-DEX-CoQ₁₀ nanopreparation were characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and differential scanning calorimetry (DSC). The concentration of CoQ₁₀ in rat plasma was determined by high-performance liquid chromatography, and the corresponding pharmacokinetic parameters were calculated. The optimal preparation method is as follows: mass ratio of CoQ₁₀/FA-DEX of 1:18, mass ratio of stabilizer/CoQ₁₀ of 0.4:1, 6 homogenization cycles, and homogenization pressure of 800 bar. These conditions resulted in a mean particle size of 87.6 nm. SEM showed that the particles was spherical. DSC and XRD analyses showed that the crystallinity of FA-DEX-CoQ₁₀ nanopreparation decreased. FA-DEX-CoQ₁₀ possesses long-term stability. By single-factor and orthogonal experiments, the dissolution rate, C_max, and area under the curve (AUC) of the optimized FA-DEX-CoQ₁₀ nanopreparation were 3.95, 2.7, and 2.4 times as much as those of the raw materials. The results showed that FA-DEX-CoQ₁₀ nanopreparation had better oral bioavailability.

Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization

OBJECTIVES

Bioavailability of supplements with coenzyme Q10 (CoQ₁₀) in humans seems to depend on the excipients of formulations and on physiological characteristics of the individuals. The aim of this study was to determine which factors presented in CoQ₁₀ supplements affect the different response to CoQ₁₀ in humans.

METHODS

We tested seven different supplement formulations containing 100 mg of CoQ₁₀ in 14 young, healthy individuals. Bioavailability was measured as area under the curve of plasma CoQ₁₀ levels over 48 h after ingestion of a single dose. Measurements were repeated in the same group of 14 volunteers in a double-blind crossover design with a minimum of 4 wk washout between intakes.

RESULTS

Bioavailability of the formulations showed large differences that were statistically significant. The two best absorbable formulations were soft-gel capsules containing ubiquinone (oxidized CoQ₁₀) or ubiquinol (reduced CoQ₁₀). The matrix used to dissolve CoQ₁₀ and the proportion and addition of preservatives such as vitamin C affected the bioavailability of CoQ₁₀. Although control measurements documented that all formulations contained 100 mg of either CoQ₁₀ or ubiquinol, some of the participants showed high and others lower capacity to reach high increase of CoQ₁₀ in blood, indicating the participation of individual unknown physiological factors.

CONCLUSION

This study highlights the importance of individually adapted selection of best formulations to reach the highest bioavailability of CoQ₁₀ in humans.

Treatment options for lactic acidosis and metabolic crisis in children with mitochondrial disease

The mitochondrial pyruvate oxidation route is a tightly regulated process, which is essential for aerobic cellular energy production. Disruption of this pathway may lead to severe neurometabolic disorders with onset in early childhood. A frequent finding in these patients is acute and chronic lactic acidemia, which is caused by increased conversion of pyruvate via the enzyme lactate dehydrogenase. Under stable clinical conditions, this process may remain well compensated and does not require specific therapy. However, especially in situations with altered energy demands, such as febrile infections or longer periods of fasting, children with mitochondrial disorders have a high risk of metabolic decompensation with exacerbation of hyperlactatemia and severe metabolic acidosis. Unfortunately, no controlled studies regarding therapy of this critical condition are available and clinical outcome is often unfavorable. Therefore, the aim of this review was to formulate expert-based suggestions for treatment of these patients, including dietary recommendations, buffering strategies and specific drug therapy. However, it is important to keep in mind that a specific therapy for the underlying metabolic cause in children with mitochondrial diseases is usually not available and symptomatic therapy especially of severe lactic acidosis has its ethical limitations.

Strategies for oral delivery and mitochondrial targeting of CoQ10

Coenzyme Q10 (CoQ10), also known as ubiquinone or ubidecarenone, is a powerful, endogenously produced, intracellularly existing lipophilic antioxidant. It combats reactive oxygen species (ROS) known to be responsible for a variety of human pathological conditions. Its target site is the inner mitochondrial membrane (IMM) of each cell. In case of deficiency and/or aging, CoQ10 oral supplementation is warranted. However, CoQ10 has low oral bioavailability due to its lipophilic nature, large molecular weight, regional differences in its gastrointestinal permeability and involvement of multitransporters. Intracellular delivery and mitochondrial target ability issues pose additional hurdles. To maximize CoQ10 delivery to its biopharmaceutical target, numerous approaches have been undertaken. The review summaries the current research on CoQ10 bioavailability and highlights the headways to obtain a satisfactory intracellular and targeted mitochondrial delivery. Unresolved questions and research gaps were identified to bring this promising natural product to the forefront of therapeutic agents for treatment of different pathologies.