Anna Gvozdjakova, PhD, DSc.
Comenius University, Medical Faculty
Pharmacobiochemical Laboratory of Third Medical Department
Bratislava, Slovakia
+ 421 2 59357 242 (PHONE/FAX)
anna.gvozdjakova@fmed.uniba.sk
“Importance of the Assessment of Coenzyme Q10, Alpha-Tocopherol and Oxidative Stress for the Diagnosis and Therapy of Infertility In Men,”
Bratisl Lek Listv, 2013;114(11):607-9. 49792 (2/2014)
Kirk Hamilton: Can you please share with us your educational background and current position?
Anna Gvozdjáková: I am a Professor of Medical Chemistry and Biochemistry, Charles University in Prague, Czech Republic.
Current position: Comenius University in Bratislava, Medical Faculty, Slovakia, leader of Mitochondrial Medicine and Coenzyme Q10.
Education: Doctor of Natural Sciences (Dr.); Doctor of Chemical Sciences (PhD); Doctor of Biological Sciences (DSc); Assoc. Prof. of Clinical Chemistry.
The results of our studies have been presented in multiple international congresses.
Since 1970 until today the key interest research activities of our department include mitochondria, oxidative stress, antioxidants, with a special focus on coenzyme Q10. Our department has been dedicated to coenzyme Q10 over the last 25 years, both in experimental research and in clinical medicine. This knowledge of basic mitochondrial research we have applied in patients in the clinical medicine setting. These clinical conditions include: ubiquinol therapy in children with autism; CoQ10 treatment in patients with asthma; and CoQ10 in the treatment of fertility disorders in men and women. We have contributed to the knowledge of the mechanism of the side-effects of statins. In a pilot study, in collaboration with Professor Halberg (USA – father of chronobiology in the world), Professor Singh (India) and Professor Mikulecky (Slovakia, Bratislava), we discovered the biological clock of coenzyme Q10 – “Q10-CLOCK” – and circadian cascade parameters of oxidative phosphorylation. Cooperation of our Institute has also been with Professor Fred L. Crane (USA – discoverer of Coenzyme Q10) and with Professor Gneiger (Mitochondrial Physiology – International Training Center in Mitochondria, Innsbruck, Austria). In endomyocardial biopsies we found a direct correlation between the levels of rejection of the transplanted heart; heart muscle mitochondrial function; and the concentration of coenzyme Q10 in the human transplanted heart. Current knowledge regarding the mitochondria were published in the monograph “Mitochondrial Medicine,” publisher Springer, Netherlands, 2008 (ed. A. Gvozdjáková), which serves to further train doctors, pharmacists, and postgraduate students. Experimental and clinical projects were funded by Slovak Grants VEGA, KEGA, APVV a APVT – and partially by Tishcon Corp., USA.
KH: What got you interested in studying the role of coenzyme Q10 (CoQ10), alpha-tocopherol (VE) and oxidative stress in infertile men?
AG: In plasma and spermatozoa of infertile men we estimated CoQ10 and alpha-tocopherol levels as well as TBARS (parameter of oxidative stress), also supplementary therapy with CARNI-Q-Gel® (Tishcon Corp.,USA) with part of the results published in the monograph “Mitochondrial Medicine”, ed. A. Gvozdjáková,Springer, Netherlands, 2008. Spermatozoa contain significant amounts of mitochondria. Previously, in spermatozoa of infertile men, we estimated mitochondrial respiration and energy production through oxidative phosphorylation. CoQ10 is important for mitochondrial function, together with α-tocopherol they have antioxidant properties.
KH: Is male infertility on the rise? If so what are the main causes? Environmental toxins (xenobiotics,estrogens, etc.) Poor diets that are micronutrient deficient and rich in inflammatory compounds?
AG: Yes, male infertility is on the rise. One of the main problems is stress.
KH: What is the biochemistry of CoQ10 that might alter the pathophysiology of male infertility?
AG: CoQ10 is important for sperm mitochondria energy production, as supplemental therapy increases sperm motility and quantity, and decreases sperm pathology.
KH: What is the biochemistry of VE that might alter the pathophysiology of male infertility?
AG: Vitamin E together with CoQ10 are important antioxidants that participate in membrane stability.
KH: What role dose oxidative stress play in male infertility?
AG: Increased free oxygen or nitrogen radicals participate in decreasing sperm function of infertile men.
KH: Have there been any studies utilizing antioxidants such as CoQ10, VE, alpha lipoic acid, carnitine or other such compounds showing benefit in infertile men?
AG: Several articles published have shown benefit of various antioxidants in infertility, sometimes in various concentrations and combinations of antioxidants.
KH: Can you tell us about your study and the basic results?
AG: Oxidative stress has been established as a major factor in the pathogenesis of male infertility. Low level of coenzyme Q10 contributes to the decreased sperm motility, which plays a vital role in sperm mitochondrial energy production and neutralization of reactive oxygen species (ROS). In this study were included infertile men, ages between 28 and 38 years. According to sperm motility, subject were divided into groups: a+b and b+c. Higher sperm density and decreased sperm pathology were found in group a+b vs b+c (class a and b – fast and weak forward motility, c- nonprogressive motility).
Concentrations of CoQ10-TOTAL and alpha-tocopherol were significantly increased in seminal fluid of groups a+b, opposite results were seen in plasma. Parameters of oxidative stress (TBARS – thiobarbituric acid reactive substances) were increased in all infertile men. Assessment of CoQ10-TOTAL, α-tocopherol and TBARS can play an important role for the diagnosis and targeted therapy of male infertility.
KH: Are there any potential side effects with the antioxidant therapy?
AG: In any organism there is a dynamic balance between the functional capacity of antioxidants and oxidative stress. Uncontrolled antioxidant supplementation in high daily doses could do damage to this dynamic balance.
KH: Who is a candidate for antioxidant therapy? All male infertility subjects? Only those with increased oxidative stress? If you were to use antioxidant agents which would you choose and at what daily dose?
AG: Supplementary therapy with antioxidants and products, which stimulate sperm energy production have a benefit in male infertility. Daily doses of supplementary products depends on antioxidant’s concentration in blood and seminal plasma as well as on oxidative stress levels in infertile men.
KH: How can the public or health professionals use this information?
AG: Lectures for the education of pharmacists, medical doctors and university students; discussions on live Slovak Television (2011); presentations at several international and home conferences; publications in various journals dedicated to the whole population.
KH: Do you have any further comments on this very interesting subject?
AG: Our many thanks mainly to Raj K. Chopra, president of Tishcon Corp., USA, for dietary supplements (various formulations of coenzyme Q10, carnitine , omega-3- and omega-6-PUFA) as well economic support of several experimental and clinical projects.