Increased beneficial outcome of metformin by co-enzyme Q10 against experimentally-induced hind limb ischemia reperfusion injury in normal and diabetic rats

ABSTRACT

Background: Skeletal muscles are susceptible for ischemic reperfusion injury especially in settings in order to achieve homeostasis in traumatic injury and vascular surgery. This study aimed at investigating the implication of induction of diabetes on generation of ischemic reperfusion injury in rat gastrocnemius muscle. In addition, the possible beneficial effect of metformin and co-enzyme q10 was investigated.Methods: About 80 male adult Sprague Dawley rats divided into 10 groups. Metformin was administrated as continuous oral dose for 28 days. Coenzyme q10 was administrated parenterally 2 and 24 hours before induction of ischemia in diabetic and non-diabetic animals.Results: In diabetic ischemic groups, tested drugs either singly or in combination significantly reduce HB1cA and plasma levels of muscle specific enzyme CPK and muscle myokin IL6, raised natural antioxidant GSH and reduced oxidative stress parameters (SOD and MDA), apoptotic (caspase-3) and inflammatory parameters TNF-? and TGF? were reduced. Continuous oral metformin for 28 days was more powerful than parenteral short-term coenzyme q10 as regards all tested parameters except for GSH and caspase-3 both drugs were equi-effective. Combined drugs have more powerful ameliorating effect than either drug singly except for HB1cA which was equi-effective with that of metformin. Regarding non diabetic ischemic groups, metformin was more powerful in reduction of caspase-3, IL6 and TNF- ? while coenzyme q10 was more powerful in elevating GSH.Conclusions: Co-enzyme q10 can be used as add on therapy with metformin in order to decrease the deleterious effects resulted from hind limb ischemia reperfusion in normal and diabetic rats.