title: Does coenzyme-Q have a protective effect against atorvastatin induced myopathy? A histopathological and immunohistochemical study in albino rats.
abstract: In addition to their lipid-lowering effect, statins have pleiotropic effects that may extend their use to the treatment and prevention of various other diseases such as cancer, osteoporosis, multiple sclerosis, rheumatoid arthritis, type 2 diabetes, and Alzheimer's disease. Consequently, the number of patients taking statins is expected to increase. A side effect of statins, statin-induced myopathy, which may result from reduced muscular coenzyme Q10 levels, limits their use. The current study investigates if supplementing with CoQ10 could ameliorate statin induced myopathy.
  
  
  
  Forty adult male albino rats were randomized into 4 groups, with 10 rats per group. The following was administered to the rats using oral gavage for 4 weeks: Group 1: 2 ml of 0.5% carboxymethyl cellulose once daily. Group 2: 100 mg/kg/ day coenzyme Q10 dissolved in 2 ml of cotton seed oil. Group 3: 10 mg/kg once daily atorvastatin dissolved in 0.5% carboxymethyl cellulose. Group 4: concomitantly received CoQ10 and atorvastatin similar to groups 2 and 3 respectively. Plasma creatine kinase levels were measured by using spectrophotometer. The right extensor digitorum longus muscle sections were stained for histological (Haematoxylin & Eosin, Masson trichrome and Phosphotungstic acid haematoxylin) and immunohistochemical (cytochrome C and Bax) examinations. Quantitative measures of cytochrome C and Bax were carried out using image analyzer.
  
  
  
  Atorvastatin induced increased total creatine kinase, skeletal muscle variations in the sizes and shapes, necrosis, disorganization, nuclear pyknosis, karyorrhexis, karyolysis, dismantled plasma membrane, excess collagen fibers and lipid deposition in addition to loss of cross striation. Atorvastatin increased the intensity of the immune-positive reactions of cytochrome C and Bax. These changes were ameliorated by concomitantly giving coenzyme Q10.
  
  
  
  CoQ10 may ameliorate atorvastatin induced skeletal muscle injury.
authors.affiliation: Department of Histology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt and College of Medicine, King Saud University, Riyadh, KSA. msalah28@hotmail.com.
authors.forename: Mahmoud Salah
authors.initials: MS
authors.lastname: Khalil
authors.affiliation: Department of Pathology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt and College of Medicine, King Saud University, Riyadh, KSA.
authors.forename: Nehal
authors.initials: N
authors.lastname: Khamis
authors.affiliation: Department of Physiology, College of Medicine and vice deanship, Prince Sultan Ben Abdulaziz, College of EMS, King Saud University, Riyadh, KSA.
authors.forename: Abdulmajeed
authors.initials: A
authors.lastname: Al-Drees
authors.affiliation: Department of Medical Education, College of Medicine, King Saud University, Riyadh, KSA.
authors.forename: Hamza Mohammad
authors.initials: HM
authors.lastname: Abdulghani
mesh_terms: D000818:Animals; D000069059:Atorvastatin; D003402:Creatine Kinase / Q000097:blood; D045304:Cytochromes c / Q000378:metabolism; D006538:Heptanoic Acids / Q000037:antagonists & inhibitors* / Q000633:toxicity*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000633:toxicity*; D007150:Immunohistochemistry; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000473:pathology / Q000517:prevention & control*; D020011:Protective Agents / Q000494:pharmacology*; D011758:Pyrroles / Q000037:antagonists & inhibitors* / Q000633:toxicity*; D051381:Rats; D014451:Ubiquinone / Q000494:pharmacology*; D051028:bcl-2-Associated X Protein / Q000378:metabolism
chemical_list: C494828:Bax protein, rat; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020011:Protective Agents; D011758:Pyrroles; D051028:bcl-2-Associated X Protein; D014451:Ubiquinone; D045304:Cytochromes c; D000069059:Atorvastatin; D003402:Creatine Kinase