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5th International CoQ10

J11-028.doc

ANTIANGIOGENIC AND HYPOLIPIDEMIC ACTIVITY


OF COENZYME Q10 SUPPLEMENTATION TO BREAST
CANCER PATIENTS UNDERGOING TAMOXIFEN
THERAPY
P Sachdanandam
Department of Medical Biochemistry, University of Madras, Taramani
Campus, India
*Correspondence: psachdanandam2000@yahoo.co.in

Introduction:
Tamoxifen, a non-steroidal anti-estrogen is now widely used and has
led to an increase in both disease-free and overall survival of women after
primary surgery. A complicating factor is the relapse in breast cancer
patients during tamoxifen therapy and in this subset of patients treatment is
only palliative and recurrent breast cancer is incurable. TAM therapy is
found to cause hypertriglyceridemia by reduced activity of lipolytic
enzymes on triglycerides, and thereby increasing the risk of cardiovascular
disease. Angiogenesis promotes local tumour progression and invasion and
enables tumour cell dissemination and metastasis formation. Our study has
found that co-administration of CoenzymeQ10 (100 mg) along with
tamoxifen (10 mg, twice a day) to breast cancer patients reduced the level of
angiogenesis markers and lipid levels.

Materials and Methods:


Group I: Forty-two socio-economically and age matched disease free,
healthy controls.
Group II: Eighty-four untreated breast cancer patients.
Group III: Eighty-four breast cancer patients treated for more than 1 year
with tamoxifen.
Group IV and V: Group III patients followed up for 45 days (group IV) and
90 days (group V) after supplementation with Coenzyme Q10 (CoQ10)100
mg (Kaneka Q10, Kaneka Corporation, Japan) one dosage per day along
with tamoxifen (10 mg twice a day).
Serum angiogenic markers such as Interleukin (IL) -1β, IL-6, IL-8,
Tumour Necrosis Factor (TNF-α), Vascular Endothelial Growth Factor
(VEGF), Matrix metalloproteinase (MMP) – 2, MMP-9, Tissue inhibitors of
metalloproteinase (TIMP) -1, TIMP-2, Angiogenin and breast cancer
markers such as Carcinoembryonic antigen (CEA) and Carbohydrate
antigen 15-3 (CA 15-3) were determined using the Enzyme Linked
Immunosorbent Assay (ELISA) kit according to instructions provided by
the manufacturer. The standard curves were prepared by using a group of
serially diluted standards. The Plasma Total cholesterol and Triglycerides
were measured enzymatically at 520 nm by using a commercial kit (Agappe

1/1
Diagnostics, India). Plasma free cholesterol, Plasma FFA and Plasma
Phospholipids were estimated by standard laboratory protocol. The
difference between total cholesterol and free cholesterol is the ester
cholesterol content of plasma. Plasma HDL was determined by precipitating
VLDL and LDL with heparin and manganese at pH 5.04 (Agappe,
Diagnostics, India). The HDL remaining in the supernatant was determined
enzymatically as described for the measurement of the total cholesterol.
Concentration of the plasma LDL was calculated by the standard
Friedewald equation.

Result and Discussion:


The levels of lipids, cytokines, angiogenesis markers and breast
cancer markers in the different study groups were tabulated in the table. In
the current study, it has been observed that the CoQ10 reduces the TG and
VLDL levels and increases the HDL cholesterol levels, thereby counteracts
the tamoxifen induced hypertriglyceridemia to normal levels offering
anticancer effect and protection from cardiovascular risk. CoQ10
supplementation was found to reduce the levels of serum IL-1β, IL-6, IL-8,
TNF-α, MMP-2, MMP-9, Angiogenin and VEGF levels, which are
stimulators of angiogenesis as well as factors for cancer cell proliferation
and growth. There was a significant reduction in tumour marker levels of
CEA and CA15-3 levels and the number of patients with tumour marker
levels higher than the cut off value also reduced. In conclusion, this study
suggests that supplementation of CoQ10 to tamoxifen therapy may provide
good prognosis by reducing the risk of cancer recurrence and metastases by
decreasing the levels of angiogenic and tumour markers and importantly, the
relation between dietary supplementation and cancer treatment may also
have therapeutic implications in the future.

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