Background/objective

Systemic inflammation and oxidative stress (OS) are associated with breast cancer. CoQ10 as an adjuvant treatment with conventional anti-cancer chemotherapy has been demonstrated to help in the inflammatory process and OS. This systematic review and meta-analysis of randomized clinical trials (RCTs) aimed to evaluate the efficacy of CoQ10 supplementation on levels of inflammatory markers, OS parameters, and matrix metalloproteinases/tissue inhibitor of metalloproteinases (MMPs/TIMPs) in patients with breast cancer.

Methods

A systematic literature search was carried out using electronic databases, including PubMed, Web of Science, Scopus, Google Scholar, and Embase, up to December 2020 to identify eligible RCTs evaluating the effect of CoQ10 supplementation on OS biomarkers, inflammatory cytokines, and MMPs/TIMPs. From 827 potential reports, 5 eligible studies consisting of 9 trials were finally included in the current meta-analysis. Quality assessment and heterogeneity tests of the selected trials were performed using the PRISMA checklist protocol and the I² statistic, respectively. Fixed and random-effects models were assessed based on the heterogeneity tests, and pooled data were determined as the standardized mean difference (SMD) with a 95% confidence interval (CI).

Results

Our meta-analysis of the pooled findings for inflammatory biomarkers of OS and MMPs showed that CoQ10 supplementation (100 mg/day for 45–90 days) significantly decreased the levels of VEGF [SMD: − 1.88, 95% CI: (− 2. 62 to − 1.13); I² = 93.1%, p < 0.001], IL-8 [SMD: − 2.24, 95% CI: (− 2.68 to − 1.8); I² = 79.6%, p = 0.001], MMP-2 [SMD: − 1.49, 95% CI: (− 1.85 to − 1.14); I² = 76.3%, p = 0.005] and MMP-9 [SMD: − 1.58, 95% CI: (− 1.97 to − 1.19); I² = 79.6%, p = 0.002], but no significant difference was observed between CoQ10 supplementation and control group on TNF-α [SMD: − 2.30, 95% CI: (− 2.50 to − 2.11); I² = 21.8%, p = 0.280], IL-6 [SMD: − 1.56, 95% CI: (− 1.73 to − 1.39); I² = 0.0%, p = 0.683], IL-1β [SMD: − 3.34, 95% CI: (− 3.58 to − 3.11); I² = 0.0%, p = 0.561], catalase (CAT) [SMD: 1.40, 95% CI: (1.15 to 1.65); I² = 0.0%, p = 0.598], superoxide dismutase (SOD) [SMD: 2.42, 95% CI: (2.12 to 2.71); I² = 0.0%, p = 0.986], glutathione peroxidase (GPx) [SMD: 2.80, 95% CI: (2.49 to 3.11); I² = 0.0%, p = 0.543]], glutathione (GSH) [SMD: 4.71, 95% CI: (4.26 to 5.16); I² = 6.1%, p = 0.302] and thiobarbituric acid reactive substances (TBARS) [SMD: − 3.20, 95% CI: (− 3.53 to − 2.86); I² = 29.7%, p = 0.233].

Conclusion

Overall, the findings showed that CoQ10 supplementation reduced some of the important markers of inflammation and MMPs in patients with breast cancer. However, further studies with controlled trials for other types of cancer are needed to better understand and confirm the effect of CoQ10 on tumor therapy.

中文翻译：

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补充辅酶 Q10 对乳腺癌患者炎症、血管生成和氧化应激的影响：随机对照试验的系统评价和荟萃分析

背景/目标

全身炎症和氧化应激 (OS) 与乳腺癌有关。CoQ10 作为常规抗癌化疗的辅助治疗已被证明有助于炎症过程和 OS。这项随机临床试验 (RCT) 的系统评价和荟萃分析旨在评估补充辅酶 Q10 对乳腺癌患者炎症标志物、OS 参数和基质金属蛋白酶/金属蛋白酶组织抑制剂 (MMPs/TIMPs) 水平的疗效。

方法

使用电子数据库（包括 PubMed、Web of Science、Scopus、Google Scholar 和 Embase）对截至 2020 年 12 月的电子数据库进行了系统的文献检索，以确定评估 CoQ10 补充剂对 OS 生物标志物、炎症细胞因子和 MMP 影响的合格 RCT/ TIMP。从 827 份潜在报告中，5 项符合条件的研究（包括 9 项试验）最终被纳入当前的荟萃分析。所选试验的质量评估和异质性测试分别使用 PRISMA 检查表协议和I ²统计量进行。基于异质性检验评估固定和随机效应模型，并将汇总数据确定为具有 95% 置信区间 (CI) 的标准化平均差 (SMD)。

结果

我们对 OS 和 MMP 炎症生物标志物汇总结果的荟萃分析表明，辅酶 Q10 补充剂（100 毫克/天，持续 45-90 天）显着降低了 VEGF 水平 [SMD：- 1.88，95% CI：(- 2. 62 至 − 1.13)；I ²  = 93.1%, p  < 0.001], IL-8 [SMD: - 2.24, 95% CI: (- 2.68 to - 1.8); I ²  = 79.6%, p  = 0.001], MMP-2 [SMD: - 1.49, 95% CI: (- 1.85 to - 1.14); I ²  = 76.3%, p  = 0.005] 和 MMP-9 [SMD: − 1.58, 95% CI: (− 1.97 to − 1.19); I ²  = 79.6%，p = 0.002]，但在补充辅酶 Q10 和对照组之间没有观察到 TNF-α 的显着差异 [SMD：- 2.30，95% CI：（- 2.50 至 - 2.11）；I ²  = 21.8%, p  = 0.280], IL-6 [SMD: - 1.56, 95% CI: (- 1.73 to - 1.39); I ²  = 0.0%, p  = 0.683], IL-1β [SMD: - 3.34, 95% CI: (- 3.58 to - 3.11); I ²  = 0.0%, p  = 0.561], 过氧化氢酶 (CAT) [SMD: 1.40, 95% CI: (1.15 to 1.65); I ²  = 0.0%, p  = 0.598]，超氧化物歧化酶 (SOD) [SMD: 2.42, 95% CI: (2.12 to 2.71); I ²  = 0.0%, p = 0.986]，谷胱甘肽过氧化物酶 (GPx) [SMD: 2.80, 95% CI: (2.49 to 3.11); I ²  = 0.0%, p  = 0.543]]，谷胱甘肽 (GSH) [SMD: 4.71, 95% CI: (4.26 to 5.16); I ²  = 6.1%, p  = 0.302] 和硫代巴比妥酸反应性物质 (TBARS) [SMD: - 3.20, 95% CI: (- 3.53 to - 2.86); I ²  = 29.7%，p  = 0.233]。

结论

总体而言，研究结果表明，辅酶 Q10 补充剂减少了乳腺癌患者炎症和 MMP 的一些重要标志物。然而，还需要对其他类型癌症的对照试验进行进一步研究，以更好地了解和确认辅酶 Q10 对肿瘤治疗的影响。