There are probably enough people on the list who don't have browser capability but who are interested in the San Diego Union-Tribune article on Coenzyme Q-10 that it is worth the bandwidth to retransmit it in regular e-mail format. Here goes.... (Page B-2 ) Queuing up hope for Q-10 | Parkinson's study looks at coenzyme to retard disease Cheryl Clark STAFF WRITER 18-Jan-1999 Monday A dietary supplement sold in health food stores is the subject of a $2 million federal grant to a UCSD researcher who thinks high doses of a purified form of the substance might keep patients in the early stages of Parkinson's disease from getting a lot worse. "Our hope is that we might be able to slow the progression, and someone who had the disease for 10 years would function as if they'd only had it for five," said Dr. Clifford Shults, UCSD professor of neurosciences and principal investigator of the study. "Their mobility would be better, and their response to medication better, too." The supplement, Coenzyme Q-10, occurs naturally in mitochondria, the so-called power plants that generate energy in cells. For more than 15 years, small doses have been synthesized in pill form and sold over the counter in health food stores and drugstores as an anti-oxidant and free-radical fighter, in hope that it can fight heart disease and cancer, although no studies have proved that it can. A bottle of 120 tablets of 30 milligrams each can cost between $15 and $40, and officials say its sales have slowly grown over the years. In patients with Parkinson's disease, mitochondrial function is impaired, leading to the decline and death of nerve cells that produce dopamine, a neurotransmitter lacking in patients with Parkinson's disease, researchers have found. Lack of dopamine leads to the tremors and stiffness that characterize Parkinson's. In 1997, Shults and fellow UCSD neuroscientist Dr. Richard Haas, along with Dr. Flint Beal, chief of neurology at Cornell University School of Medicine, measured levels of Coenzyme Q-10 in Parkinson's patients and found them significantly lower than levels in non-patients of the same age and sex. Beal and Shults then tried to see if they could mimic the disease in mice. In the 1980s, researchers discovered that MPTP, an ingredient in an intravenous drug used by addicts, caused the same tremors and rigidity seen in Parkinson's disease. MPTP also was found to be toxic to dopamine-producing nerve cells. First, Shults and Beal gave groups of mice either a standard diet or a diet laced with Coenzyme Q-10, then followed that with MPTP. They discovered that mice fed Coenzyme Q-10 had significantly greater levels of dopamine than mice that were fed the standard diet alone. If they could duplicate those results in humans with Parkinson's disease, they just might be onto something, the researchers thought. The question would be whether Parkinson's patients -- who sometimes have trouble absorbing medications -- could ingest enough of the high dose substance to make a difference. Shults gave a variety of high dose Coenzyme Q-10 to 15 Parkinson's patients and found no significant side effects except minor urinary changes. What is more, the researchers found comparable increases of the substance in the patients' blood and an increase in mitochondrial activity, the part governed by Coenzyme Q-10. In late 1997, Shults applied to the National Institute of Neurological Disorders and Stroke in Bethesda, Md., the arm of the federal government that allocates research money for Parkinson's disease. Last fall, he received $2 million and the go-ahead to recruit 80 early stage Parkinson's patients for a three-year study of Coenzyme Q-10. Protective treatments Shults, who directs San Diego's National Parkinson Foundation Center of Excellence at University of California San Diego, said considerable progress has been made in Parkinson's treatment. Medications such as levodopa can control some of the symptoms, such as the resting tremors, slowness and rigidity. A surgical procedure called pallidotomy shows promise for people suffering from severe forms of the disease. But nothing has been found to prevent further deterioration of nerve cells, Shults said. "The goal we've really started pursuing is to try to develop protective treatments," Shults said. "Our study is the first federally sponsored one to look at this compound in a systematic fashion." Dr. Dee Silver, a La Jolla neurologist and medical director of the Parkinson's Disease Information and Referral Center of San Diego County, applauded the effort, saying, "There's a lot of basic investigative evidence that this drug has a possibility of reducing progression." As word spreads among patients, some are already heading to the stores to buy the substance, Shults and Silver said. But in Shults' study, the doses will be 10 to 40 times the amount in most store-bought tablets, "much larger than one might be able to easily afford," Shults said. And the amount of Coenzyme Q-10 in the experimental doses, which Silver and others said can vary in the store-bought products, will be much more tightly controlled. Those enrolled will receive one of three doses, 300, 600 or 1,200 milligrams per day, or a placebo. They will be recruited at centers in Los Angeles; Chicago; Philadelphia; Baltimore; Atlanta; Portland, Ore.; St. Louis; Rochester, N.Y.; Kansas City, Mo.; Albany, N.Y.; West Bloomfield, Mich.; and Charlottesville, Va. Only patients with early stage Parkinson's will be enrolled to avoid interference with other drugs and cell deterioration in patients with severe diseases that could confuse results. Shults said patients will not be recruited in San Diego, but San Diegans may be able to participate through the University of Southern California in Los Angeles. Concern about hype Shults and others worry that because only 80 patients are being recruited and because of the potential for "holistic hype" on the Internet, other patients will rush to buy the drug, washing down hundreds of pills a day. "I've gotten zillions of calls from people about this, wanting to know if it works," said Gerry Graf, Costco's five-state regional pharmacy supervisor, who heard Coenzyme Q-10 discussed on a recent radio show about Parkinson's disease. "People need to understand that we don't know yet if this works or has side effects in these high doses," Graf said. "We really have no idea. Instead of doing a little study on their own, people could be killing themselves." Shults echoed Graf's concern. Kimberly Seidman, West Coast director of the National Parkinson Foundation in Los Angeles, said patients are calling her asking questions about Coenzyme Q-10. "They ask if they should take it, and my response is very clearly that there's no evidence that it can make a significant difference. We always tell people to talk with their doctors first." Seidman, whose late father had Parkinson's disease, has been taking small doses of Coenzyme Q-10 herself as a precaution since she met a San Fernando Valley physician and Parkinson's patient who took the compound after reading that it might help his heart murmurs. "He was pretty sick and getting ready to retire. His gait was slow and he was stooped over," and other symptoms of Parkinson's were starting to worsen, she said. "After he was on Coenzyme Q-10 for six months, he dramatically improved." While he never regained full function, he maintained an improvement for several years, she said. Seidman lost touch with him. But she is delighted that Coenzyme Q-10 is being subjected to a scientific trial. Parkinson's disease is diagnosed in 50,000 people annually in the United States and is estimated to affect between 500,000 and 1 million people at any time. Actor Michael J. Fox, U.S. Attorney General Janet Reno and boxer Muhammad Ali have been diagnosed with the disease. Federal officials estimate that the disease costs about $2 billion in direct and $4 billion in indirect medical costs each year. For more information, call (716) 275-7311. Copyright Union-Tribune Publishing Co. ________________________________________________________________ Arthur Hirsch {} [log in to unmask] {} Lewisville, TX {} 972-434-2377 (nickname on instant mail, ICQ, and chat programs is cutterson) ________________________________________________________________ PAN Forum, other photos, and my approach to links: http://www.fortunecity.com/meltingpot/farley/817/ ________________________________________________________________