Coenzyme Q10 in Preclinical Research: Comprehensive Review of Mitochondrial Mechanisms, Therapeutic Potential and Translational Challenges

Coenzyme Q₁₀ (CoQ10), or ubiquinone/ubiquinol, is an essential lipid-soluble quinone with central roles in mitochondrial electron transport and antioxidant defence. Over several decades, extensive preclinical research has established CoQ10 as a bioenergetic and cytoprotective molecule with relevance across diverse disease models, including cardiac ischemia–reperfusion injury, heart failure, neurodegenerative disorders such as Parkinson’s disease, diabetes-associated organ damage, and primary mitochondrial disorders involving CoQ biosynthesis defects. Mechanistic investigations demonstrate that CoQ10 improves mitochondrial respiration, restores ATP synthesis, reduces reactive oxygen species, stabilizes membranes, influences mitophagy, and modulates redox-sensitive signalling pathways. Novel formulations developed to overcome poor oral bioavailability—such as ubiquinol, nano-CoQ10, liposomal preparations, and mitochondrial-targeted derivatives like MitoQ—show dramatically enhanced efficacy in experimental systems. Despite strong preclinical evidence, translation to clinical outcomes has been inconsistent, largely due to limitations in delivery, dosing, and model relevance.