A Mitochondrial Targeted Ubiquinol (MitoQ) Improves Immune Cell Bioenergetics in Patients with Heart Failure with Preserved Ejection Fraction

BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a proinflammatory syndrome. Mitochondrial dysfunction that is characteristic of HFpEF could alter immunometabolism, attenuating the functional reserve of immune cells. In addition, immune cell mitochondrial respiration is a biomarker of systemic mitochondrial health. The aim of this study was to assess the impact of a chronic oral mitochondrial targeted ubiquinol (MitoQ) on the immune cell bioenergetic profile in patients with HFpEF. We hypothesized that MitoQ administration in patients with HFpEF, would improve mitochondrial respiration in peripheral blood mononuclear cells (PBMC’s). METHODS: In this double-blind, crossover trial 8 patients with a clinical diagnosis of HFpEF (6 female, 2 male; 6 African American/Black, 2 white; mean ± SEM, Age, 58±5 years; BMI, 37±1 kg/m 2 ) received a 4 week oral dose of MitoQ (MTQ, 20 mg/day) and placebo (PLB) in random order separated by a 2 week wash out period. Following completion of each trial arm, a venous blood sample was obtained and PBMCs were isolated using density gradient centrifugation. High resolution respirometry coupled with modulators of cellular respiration was performed to obtain basal respiration, ATP-linked respiration, maximal respiration, and spare respiratory capacity of the immune cells. Paired samples t-tests were used to compare variables between conditions. RESULTS: MitoQ was safe, well tolerated, and compliance was high (MTQ, 99 ± 1%; PLB, 89±4%). Basal respiration (MTQ, 106.4 ± 11.5 pmol/min; PLB, 66.5±5.9 pmol/min; p=0.002), ATP-linked respiration (MTQ, 41.4± 16.9 pmol/min; PLB, 16.3±6.7 pmol/min; p=0.04), maximal respiration (MTQ, 323.9 ± 50.0 pmol/min; PLB, 65.4±23.1 pmol/min; p=0.01), spare respiratory capacity (MTQ, 217.5 ± 39.6 pmol/min; PLB, 149.6 ±18.2 pmol/min; p=0.02), were higher following MTQ compared to PLB. CONCLUSIONS: In patients with HFpEF, administration of a mitochondrial targeted ubiquinol improved the immune cell mitochondrial respiration capacity and effciency. An increase in spare respiratory capacity following MTQ reflects an improvement in functional reserve that would augment the ability to respond to an acute stressor. These findings have positive implications for the ability to target and improve mitochondrial function in patients with HFpEF. Future work should investigate if the observed improvements in immune cell mitochondrial function are mirrored in other tissues. Supported by AHA 19CDA3474002. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.