Does coenzyme-Q have a protective effect against atorvastatin induced myopathy? A histopathological
and immunohistochemical study in albino rats
Mahmoud Salah Khalil1,2, Nehal Khamis2,3, Abdulmajeed Al-drees4 and Hamza Mohammad Abdulghani5
1Department of Histology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt, 2College of Medicine, King Saud University, Riyadh, KSA, 3Department of Pathology, Faculty of Medicine, Suez Canal University, Egypt, 4Department of Physiology, College of Medicine and vice deanship, Prince Sultan Ben Abdulaziz, College of EMS, King Saud University, Riyadh, KSA and 5Department of Medical Education, College of Medicine, King Saud University, Riyadh, KSA
Offprint requests to: M.S. Khalil, Department of Histology, Faculty of Medicine, Suez Canal University, Egypt. e-mail: msalah28@
Summary. Introduction. 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. Materials and Methods. 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: 100mg/kg/ day coenzyme Q10 dissolved in 2ml 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.
Results. 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 amelio-rated by concomitantly giving coenzyme Q10. Conclusion: CoQ10 may ameliorate atorvastatin induced skeletal muscle injury. Histol Histopathol 30, 383-390 (2015)
Key words: Atorvastatin, CoQ10, Skeletal muscle, Histological, Immunohistochemical