mitoquinone and idebenone

Neurodegenerative movement disorders mainly include Parkinson's disease (PD), atypical parkinsonisms, Huntington's disease (HD), and Friedreich's ataxia (FA). With mitochondrial dysfunction observed in these diseases, mitochondrial enhancement such as creatine, coenzyme Q10 (CoQ10) and its analogues (idebenone and mitoquinone) has been regarded as a potential treatment.. In this paper, we systematically analysed and summarized the efficacy of mitochondrial enhancement in improving motor and other symptoms in neurodegenerative movement disorders.. We searched the electronic databases PubMed, EMBASE, CINAHL, Cochrane Library and China National Knowledge Infrastructure until September 2013 for eligible randomized controlled trials (RCTs), as well as unpublished and ongoing trials. We calculated the mean differences for continuous data with 95% confidence intervals and pooled the results using a fixed-effect model, if no significant statistical heterogeneity was found (I(2) < 50%).. We included 16 studies with 1,557 randomized patients, which compared creatine, CoQ10 or its analogues with placebo in motor and other symptoms. No significant improvements were found in the motor symptoms of PD, atypical parkinsonisms or HD patients, while only the high dose of idebenone seems to be promising for motor improvement in FA. Certain benefits are found in other symptoms.. There is insufficient evidence to support the use of mitochondrial enhancement in patients with neurodegenerative movement disorders. More well-designed RCTs with large samples are required for further confirmation.

Topics: Animals; Creatine; Dose-Response Relationship, Drug; Humans; Mitochondria; Mitochondrial Diseases; Neurodegenerative Diseases; Organophosphorus Compounds; Randomized Controlled Trials as Topic; Ubiquinone

Friedreich ataxia (FA) is a progressive genetic neurological disorder associated with degeneration of the dorsal columns, spinocerebellar tracts and other regions of the nervous system. The disorder results from mutations in the gene referred to as FXN. Almost all mutations are expansions of an intronic GAA repeat in this gene, which gives rise to decreased transcription of the gene product (called frataxin). Following these discoveries, drug discovery has moved at a rapid pace. Therapeutic trials in the next 5 years are expected to address amelioration of the effects of frataxin deficiency and methods for increasing frataxin expression. These therapies are directed at all levels of biochemical dysfunction in FA. Agents such as idebenone potentially improve mitochondrial function and decrease production of reactive oxygen species. Idebenone is presently in a phase III trial in the US and in Europe, with the primary outcome measure being neurological function. Deferiprone, an atypical iron chelator, may decrease build-up of toxic iron in the mitochondria in patients. It has entered a phase II trial in Europe, Australia and Canada directed toward improvement of neurological abilities. Finally, targeted histone deacetylase (HDAC) inhibitors and erythropoietin increase levels of frataxin when used in vitro, suggesting that they may provide methods for increasing frataxin levels in patients. Erythropoietin has been tested in a small phase II trial in Austria, while HDAC inhibitors are still at a preclinical stage. Symptomatic therapies are also in use for specific symptoms such as spasticity (baclofen). Thus, there is substantial optimism for development of new therapies for FA in the near future, and we suggest that one or several may be available over the next few years. However, continued development of new therapies will require creation of new, more sensitive measures for neurological dysfunction in FA, and clinically relevant measures of cardiac dysfunction.

Topics: Animals; Antioxidants; Deferiprone; Enzyme Inhibitors; Erythropoietin; Friedreich Ataxia; Histone Deacetylase Inhibitors; Humans; Iron Chelating Agents; Organophosphorus Compounds; Pyridones; Recombinant Proteins; Ubiquinone

Mitoquinone (MitoQ) attenuates aminoglycoside (AG)-induced upregulation of the proapoptotic molecules Bak and harakiri (Hrk) and decreases the percentage of apoptotic House Ear Institute Organ of Corti 1 (HEI-OC1) cells.. The primary mechanism of AG ototoxicity is the formation of reactive oxygen species, which leads to hair cell death via apoptotic and nonapoptotic pathways. Antioxidants have been shown to protect against AG ototoxicity. Mitoquinone is a mitochondria-targeted derivative of the antioxidant ubiquinone. Thus, MitoQ may be more effective in preventing AG ototoxicity compared with untargeted antioxidants.. Ribonucleic acid from untreated HEI-OC1 cells and cells exposed to gentamicin with and without preincubation with MitoQ, idebenone (IDB, an untargeted ubiquinone), or decylTPP (positive control) were used to assess gene expression of Bak and Hrk using real-time polymerase chain reaction. Protein expression of Bak and Hrk was determined by Western blotting. Annexin V assay using flow cytometry was performed to assess the percentage of apoptotic HEI-OC1 cells treated with gentamicin with and without preincubation with MitoQ, decylTPP, or IDB.. Preincubation of HEI-OC1 cells with MitoQ significantly decreased the gentamicin-induced upregulation of Bak gene (p = 0.03) but not preincubation with IDB (p = 0.87). Harakiri levels were very low that relative quantification could not be carried out. Protein levels of Bak and Hrk were not different between treatments. Annexin V assay showed that gentamicin increased the percentage of apoptotic cells (p < 0.05) compared with control. However, the percentages of apoptotic cells in gentamicin-treated and cells pretreated with the antioxidants MitoQ or IDB were not different.. Mitoquinone attenuated the gentamicin-induced upregulation of the Bak gene but not its product, the proapoptotic molecule Bak, and MitoQ did not significantly decrease the gentamicin-induced cell apoptosis in vitro. Further in vivo studies are needed to assess the clinical significance of these findings.

Topics: Antioxidants; Apoptosis; Apoptosis Regulatory Proteins; bcl-2-Associated X Protein; Cell Line; Gentamicins; Hair Cells, Auditory; Humans; Mitochondria; Organophosphorus Compounds; Reactive Oxygen Species; Real-Time Polymerase Chain Reaction; Ubiquinone

Antioxidants have been shown to protect against aminoglycoside-induced hearing loss. Mitoquinone (MitoQ) is a mitochondria-targeted derivative of the antioxidant ubiquinone. MitoQ is attached to a lipophilic triphenylphosphonium (TPP) cation, which enables its accumulation inside the mitochondria several hundred-fold over the untargeted antioxidant. The goals of this study were to determine if MitoQ attenuates gentamicin-induced activation of caspase-3/7 activity as a marker of apoptosis and to determine if MitoQ impacts aminoglycoside antimicrobial efficacy.. Prospective and controlled.. Antibiotic efficacy and minimum inhibitory concentrations (MICs) of gentamicin against three strains each of Staphylococcus aureus, Haemophilus influenzae, and Pseudomonas aeruginosa were evaluated with and without MitoQ using broth dilution methods. Apoptosis was assessed by caspase-3/7 activity in untreated HEI-OC1 cells and cells exposed to 2 mM gentamicin for 24 hours, with and without a 24-hour preincubation with 0.5 μM each of MitoQ, idebenone (an untargeted ubiquinone), or decylTPP (positive control).. Gentamicin MICs for P aeruginosa and H influenzae were not affected by MitoQ at pharmacological levels. MICs for S aureus were enhanced by MitoQ. Cell viability was significantly lower in the gentamicin-treated cells. A significant increase in caspase-3/7 activity was observed in cells treated with gentamicin or with idebenone + gentamicin (P = .005). Preincubation with MitoQ decreased the gentamicin-induced apoptosis of HEI-OC1 cells to a greater extent compared to idebenone (P = .002).. MitoQ attenuates gentamicin-induced apoptosis in HEI-OC1 cells and does not compromise gentamicin antibiotic efficacy. MitoQ holds promise as a means of preventing aminoglycoside ototoxicity.

Topics: Analysis of Variance; Apoptosis; Caspase 3; Cell Survival; Gentamicins; Haemophilus influenzae; Microbial Sensitivity Tests; Mitochondria; Organophosphorus Compounds; Prospective Studies; Pseudomonas aeruginosa; Staphylococcus aureus; Ubiquinone

Analogues of mitoQ and idebenone were synthesized to define the structural elements that support oxygen consumption in the mitochondrial respiratory chain. Eight analogues were prepared and fully characterized, then evaluated for their ability to support oxygen consumption in the mitochondrial respiratory chain. While oxygen consumption was strongly inhibited by mitoQ analogues 2-4 in a chain length-dependent manner, modification of idebenone by replacement of the quinone methoxy groups by methyl groups (analogues 6-8) reduced, but did not eliminate, oxygen consumption. Idebenone analogues 6-8 also displayed significant cytoprotective properties toward cultured mammalian cells in which glutathione had been depleted by treatment with diethyl maleate.

Topics: Antioxidants; Cytoprotection; Glutathione; Humans; Mitochondria; Organophosphorus Compounds; Oxygen Consumption; Ubiquinone

Friedreich Ataxia (FRDA), the most common inherited ataxia, arises from defective expression of the mitochondrial protein frataxin, which leads to increased mitochondrial oxidative damage. Therefore, antioxidants targeted to mitochondria should be particularly effective at slowing disease progression. To test this hypothesis, we compared the efficacy of mitochondria-targeted and untargeted antioxidants derived from coenzyme Q10 and from vitamin E at preventing cell death due to endogenous oxidative stress in cultured fibroblasts from FRDA patients in which glutathione synthesis was blocked. The mitochondria-targeted antioxidant MitoQ was several hundredfold more potent than the untargeted analog idebenone. The mitochondria-targeted antioxidant MitoVit E was 350-fold more potent than the water soluble analog Trolox. This is the first demonstration that mitochondria-targeted antioxidants prevent cell death that arises in response to endogenous oxidative damage. Targeted antioxidants may have therapeutic potential in FRDA and in other disorders involving mitochondrial oxidative damage.

Topics: Antioxidants; Benzoquinones; Cell Death; Drug Delivery Systems; Fibroblasts; Friedreich Ataxia; Humans; Mitochondria; Models, Biological; Organophosphorus Compounds; Oxidative Stress; Ubiquinone; Vitamin E