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Mohammadkhani N, Gharbi S, Rajani HF, Farzaneh A, Mahjoob G, Hoseinsalari A, Korsching E. Statins: Complex outcomes but increasingly helpful treatment options for patients. Eur J Pharmacol 2019; 863:172704. [DOI: 10.1016/j.ejphar.2019.172704] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/15/2022]
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Cote DJ, Rosner BA, Smith-Warner SA, Egan KM, Stampfer MJ. Statin use, hyperlipidemia, and risk of glioma. Eur J Epidemiol 2019; 34:997-1011. [PMID: 31559554 PMCID: PMC7206659 DOI: 10.1007/s10654-019-00565-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/18/2019] [Indexed: 02/01/2023]
Abstract
Background Statins have previously been shown to have protective effects for other cancers, but no prospective studies of statin use and glioma have been conducted. Methods We evaluated the association between statin use and risk of glioma in the female Nurses' Health Study (NHS, n = 114,419) and Nurses' Health Study II (NHSII, n = 115,813) and the male Health Professionals Follow-up Study (HPFS, n = 50,223). Glioma cases were confirmed by medical record review. Age and multivariable-adjusted hazard ratios of glioma by statin use were estimated using Cox proportional hazards models. Results In 4,430,700 person-years of follow-up, we confirmed 483 incident cases of glioma. Compared with never-users, ever statin use was associated with borderline increased risk of glioma in the combined cohorts (age-adjusted HR = 1.23, 95% CI 0.99-1.54), as was longer duration of statin use (HR = 1.48, 95% CI 1.08-2.03 comparing > 8 years of use to never use, p-trend = 0.01). We also observed a significant inverse association between hyperlipidemia and glioma in multivariable models (HR = 0.74, 95% CI 0.59-0.93 in combined cohorts), which was attenuated in lagged analyses. Compared to never use, in multivariable-adjusted models, ever statin use (HR = 1.43, 95% CI 1.10-1.86) and statin use duration (HR = 1.72, 95% CI 1.21-2.45, for > 8 years of use, p-trend = 0.003) were each significantly associated with increased glioma risk. Conclusion In contrast to case-control studies reporting inverse associations, we found borderline increased risk of glioma with statin use. Results were strengthened after adjustment for cardiovascular risk factors due to an unexpected inverse association between hyperlipidemia and glioma risk. Further studies of statin use, hyperlipidemia, and glioma risk are warranted.
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Affiliation(s)
- David J Cote
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
- Department of Neurosurgery, Computational Neurosciences Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie A Smith-Warner
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Kathleen M Egan
- Division of Population Sciences, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Meir J Stampfer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Macías Saint-Gerons D, Bosco Cortez F, Jiménez López G, Castro JL, Tabarés-Seisdedos R. Cataracts and statins. A disproportionality analysis using data from VigiBase. Regul Toxicol Pharmacol 2019; 109:104509. [PMID: 31669197 DOI: 10.1016/j.yrtph.2019.104509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/03/2019] [Accepted: 10/24/2019] [Indexed: 01/21/2023]
Abstract
The basis of the association between statin use and cataract has been explored using the World Health Organization (WHO) global database of individual case safety reports (ICSRs) for drug monitoring (VigiBase) through January 2019. The reporting odds ratios (RORs) as a measure of disproportionality for reported cataracts and individual statins have been calculated. Subgroup analyses according statin lipophilicity, sex, and age groups have been performed. Moreover, RORs have been calculated for non-statin lipid lowering drugs. An increased disproportionality have been found for most individual statins lovastatin: [ROR: 14.80, 95% confidence interval (CI): 13.30, 16.46)], atorvastatin (ROR: 3.48, 95% CI 3.19-3.80), pravastatin (ROR: 3.15, 95% CI: 2.54-3.90), rosuvastatin (ROR: 2.90, 95% CI: 2.53-3.31), simvastatin (ROR: 2.27, 95%CI: 1.99-2.60), fluvastatin (ROR: 2.03, 95% CI: 1.33-3.08) and statins (overall) ROR: 3.66, 95% CI:3.46-3.86). Increased disproportionality for cataract and statins (drug-class) have been found regardless of statin lipophilicity, sex and group age (more or less than 65 years old). No disproportionality was found for other lipid-lowering drugs (ezetimibe, fibrates or PCSK9 inhibitors). These findings suggest an increased risk of cataract associated with statins as a drug-class. Further studies to characterize the risk are advised. Benefits and potential harms should be considered before starting treatment with statins.
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Affiliation(s)
- Diego Macías Saint-Gerons
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain; Unit of Medicines and Health Technologies (MT), Dep. of Health Systems and Services (HSS), Pan American Health Organization (PAHO/WHO), United States.
| | | | | | - José Luis Castro
- Unit of Medicines and Health Technologies (MT), Dep. of Health Systems and Services (HSS), Pan American Health Organization (PAHO/WHO), United States
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
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Palleria C, Roberti R, Iannone LF, Tallarico M, Barbieri MA, Vero A, Manti A, De Sarro G, Spina E, Russo E. Clinically relevant drug interactions between statins and antidepressants. J Clin Pharm Ther 2019; 45:227-239. [PMID: 31587356 DOI: 10.1111/jcpt.13058] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/24/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Statins, also known as 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors, and antidepressant drugs are frequently used in combination due to the high and growing incidence of cardiovascular diseases and psychiatric disorders worldwide. Several aspects on management, the risk of adverse events (AEs) occurrence and the potential clinically relevant pharmacokinetic (PK) and pharmacodynamic (PD) drug-drug interactions (DDIs) between these two classes have not been well investigated. The aim of the present review was to describe the PK and PD interactions, of clinical relevance, between statins and antidepressant drugs and provide a comprehensive overview of their pharmacological features for appropriate multiple drug regimens. METHODS Relevant studies were identified through a literature search of PubMed and the Cochrane databases focusing on clinically relevant DDIs between statins and antidepressants. Only papers in English were included in the search. RESULTS AND DISCUSSION Pharmacodynamic (PD) drug-drug interactions (DDIs) are unlikely to occur as statins are highly selective inhibitors of HMG-CoA reductase with no relevant effect on other enzymes or receptor systems. Despite the numerous PK studies on individual drugs belonging to statins and antidepressant agents, only a few case reports regarding specific DDIs are present in the literature and no clinical studies have been performed. PK data allow to speculate on potential DDIs, comparing the metabolic pathways, intestinal and liver transporters and elimination routes. Overall, second-generation antidepressants, in particular citalopram, escitalopram, mirtazapine, reboxetine and venlafaxine, have weak inhibitory effects on various cytochrome (CYP) isozymes and seem to have a more advantageous DDIs profile in vivo. Conversely, nefazodone, fluoxetine, paroxetine and fluvoxamine influence considerably CYPs activity with potential effects on statins plasma levels, although pravastatin, pitavastatin and rosuvastatin are not susceptible to inhibition by any CYP. Albeit no studies have been performed on P-glycoprotein (P-gp), interactions of clinical relevance are unlikely. WHAT IS NEW AND CONCLUSION Although DDIs with antidepressants are potentially, but rarely clinically significant, the use of antidepressants with a more favourable drug interaction profile is advisable. An evaluation on DDIs between these drugs can be useful for future PK/PD studies on drug-drug interaction to provide clinicians with more data for appropriate multiple drug regimens.
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Affiliation(s)
- Caterina Palleria
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Roberta Roberti
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | | | - Martina Tallarico
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | | | - Ada Vero
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | - Antonia Manti
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
| | | | - Edoardo Spina
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Emilio Russo
- Science of Health Department, School of Medicine, University of Catanzaro, Catanzaro, Italy
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Xiong Z, Cao X, Wen Q, Chen Z, Cheng Z, Huang X, Zhang Y, Long C, Zhang Y, Huang Z. An overview of the bioactivity of monacolin K / lovastatin. Food Chem Toxicol 2019; 131:110585. [DOI: 10.1016/j.fct.2019.110585] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/01/2019] [Accepted: 06/13/2019] [Indexed: 12/20/2022]
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Venkatesan N, Liyanage AT, Castro-Núñez J, Asafo-Adjei T, Cunningham LL, Dziubla TD, Puleo DA. Biodegradable polymerized simvastatin stimulates bone formation. Acta Biomater 2019; 93:192-199. [PMID: 31055123 DOI: 10.1016/j.actbio.2019.04.059] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/25/2019] [Accepted: 04/29/2019] [Indexed: 12/24/2022]
Abstract
Previous research from our labs demonstrated the synthesis of polymerized simvastatin by ring-opening polymerization and slow degradation with controlled release of simvastatin in vitro. The objective of the present study was to evaluate the degradation and intramembranous bone-forming potential of simvastatin-containing polyprodrugs in vivo using a rat calvarial onlay model. Poly(ethylene glycol)-block-poly(simvastatin) and poly(ethylene glycol)-block-poly(simvastatin)-ran-poly(glycolide) were compared with simvastatin conventionally encapsulated in poly(lactic-co-glycolic acid) (PLGA) and pure PLGA. The rate of degradation was higher for PLGA with and without simvastatin relative to the simvastatin polyprodrugs. Significant new bone growth at the circumference of poly(ethylene glycol)-block-poly(simvastatin) disks was observed beginning at 4 weeks, whereas severe bone resorption (4 weeks) and bone loss (8 weeks) were observed for PLGA loaded with simvastatin. No significant systemic effects were observed for serum total cholesterol and body weight. Increased expression of osteogenic (BMP-2, Runx2, and ALP), angiogenic (VEGF), and inflammatory cytokines (IL-6 and NF-ĸB) genes was seen with all polymers at the end of 8 weeks. Poly(ethylene glycol)-block-poly(simvastatin), with slow degradation and drug release, controlled inflammation, and significant osteogenic effect, is a candidate for use in bone regeneration applications. STATEMENT OF SIGNIFICANCE: Traditional drug delivery systems, e.g., drug encapsulated in poly(lactic-co-glycolic acid) (PLGA), are typically passive and have limited drug payload. As an alternative, we polymerized the drug simvastatin, which has multiple physiological effects, into macromolecules ("polysimvastatin") via ring-opening polymerization. We previously demonstrated that the rate of degradation and drug (simvastatin) release can be adjusted by copolymerizing it with other monomers. The present results demonstrate significant new bone growth around polysimvastatin, whereas severe bone loss occurred for PLGA loaded with simvastatin. This degradable biomaterial with biofunctionality integrated into the polymeric backbone is a useful candidate for bone regeneration applications.
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Lin MS, Lin YS, Chang ST, Wang PC, Chien-Chia Wu V, Lin WY, Chung CM. Effect of initiating statin therapy on long-term outcomes of patients with dyslipidemia after intracerebral hemorrhage. Atherosclerosis 2019; 288:137-145. [PMID: 31374467 DOI: 10.1016/j.atherosclerosis.2019.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Intracerebral hemorrhage (ICH) has a higher mortality than ischemic stroke. Statin is beneficial for stroke, but high potency statin treatment has been associated with the risk of hemorrhagic stroke. The aim of this study was to assess the impact of initiating statin therapy after ICH on cardiovascular outcomes. METHODS Dyslipidemic patients were retrieved from the ICH population from the National Health Insurance Research Database in Taiwan. We retrospectively compared patients prescribed with and without statin treatment after ICH. Outcomes of interest were mortality, myocardial infarction, ischemic stroke, and hemorrhagic stroke during 5 years of follow-up. RESULTS Of 17,980 adult patients with ICH and dyslipidemia, 8927 were eligible for analysis over the study period, including 1613 patients receiving statin therapy and 7314 patients not taking statins. After propensity score matching, the mean age was 61.2 ± 12.2 years in the statin group and 61.6 ± 13.0 years in the non-statin group. Hypertension was dominant, followed by diabetes mellitus, and the mean estimated NIHSS score was 12.9. The patients who received statin therapy were associated with lower risks of all-cause mortality (12.7% vs. 21.3%; hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.45-0.65), cardiovascular death (4.0% vs. 7.1%; HR, 0.54; 95% CI, 0.39-0.75) and ICH (5.4% vs. 8.5%; HR, 0.62; 95% CI, 0.46-0.83) compared to those who did not receive statins. CONCLUSIONS Initiating statin therapy after ICH was associated with a decreased risk of recurrent ICH and mortality for dyslipidemia patients.
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Affiliation(s)
- Ming-Shyan Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yu-Sheng Lin
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan
| | - Shih-Tai Chang
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Po-Chang Wang
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | | | - Wey-Yil Lin
- Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan
| | - Chang-Min Chung
- Division of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Taoyuan County, Taiwan.
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Contribution of Statins towards Periodontal Treatment: A Review. Mediators Inflamm 2019; 2019:6367402. [PMID: 30936777 PMCID: PMC6415285 DOI: 10.1155/2019/6367402] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 12/23/2018] [Indexed: 01/09/2023] Open
Abstract
The pleiotropic effects of statins have been evaluated to assess their potential benefit in the treatment of various inflammatory and immune-mediated diseases including periodontitis. Herein, the adjunctive use of statins in periodontal therapy in vitro, in vivo, and in clinical trials was reviewed. Statins act through several pathways to modulate inflammation, immune response, bone metabolism, and bacterial clearance. They control periodontal inflammation through inhibition of proinflammatory cytokines and promotion of anti-inflammatory and/or proresolution molecule release, mainly, through the ERK, MAPK, PI3-Akt, and NF-κB pathways. Moreover, they are able to modulate the host response activated by bacterial challenge, to prevent inflammation-mediated bone resorption and to promote bone formation. Furthermore, they reduce bacterial growth, disrupt bacterial membrane stability, and increase bacterial clearance, thus averting the exacerbation of infection. Local statin delivery as adjunct to both nonsurgical and surgical periodontal therapies results in better periodontal treatment outcomes compared to systemic delivery. Moreover, combination of statin therapy with other regenerative agents improves periodontal healing response. Therefore, statins could be proposed as a potential adjuvant to periodontal therapy. However, optimization of the combination of their dose, type, and carrier could be instrumental in achieving the best treatment response.
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Lipophilic statins inhibit growth and reduce invasiveness of human endometrial stromal cells. J Assist Reprod Genet 2018; 36:535-541. [PMID: 30554393 DOI: 10.1007/s10815-018-1352-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 10/19/2018] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To compare effects of lipid-soluble statins (simvastatin, lovastatin, atorvastatin) and water-soluble statin (pravastatin) on growth and invasiveness of human endometrial stromal (HES) cells. METHODS Endometrial biopsies were collected during the proliferative phase from five volunteers. HES cells were isolated and cultured in the absence or in the presence of simvastatin, lovastatin, atorvastatin, and pravastatin. Effects of statins on DNA synthesis, cell viability, activity of caspases 3/7 and invasiveness were evaluated. RESULTS The proliferation of HES cells was significantly decreased by simvastatin (by 47-89%), lovastatin (by 46-78%), and atorvastatin (by 21-48%) in a concentration-dependent manner. Activity of executioner caspases 3/7 was significantly increased by simvastatin (by 10-25%), lovastatin (by 19%) and atorvastatin (by 7-10%) in a concentration-dependent manner. The greatest effects were observed in response to simvastatin. Accounting for the effects of statins on cell number, the invasiveness of HES cells was significantly decreased in cells treated with simvastatin (by 49%), lovastatin (by 54%), and atorvastatin (by 53%). Pravastatin had little or no effects on any of the tested endpoints. CONCLUSIONS Present findings demonstrate that only lipid-soluble among tested statins were effective in inhibition of growth and invasiveness of HES cells. These findings may have clinical relevance in treatment of endometriosis.
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Akinwunmi B, Vitonis AF, Titus L, Terry KL, Cramer DW. Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study. Int J Cancer 2018; 144:991-1000. [PMID: 30006925 DOI: 10.1002/ijc.31758] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/25/2018] [Accepted: 07/04/2018] [Indexed: 12/17/2022]
Abstract
Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.
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Affiliation(s)
- Babatunde Akinwunmi
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Global Education, Harvard Medical School, Boston, MA
| | - Allison F Vitonis
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA
| | - Linda Titus
- Departments of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Kathryn L Terry
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
| | - Daniel W Cramer
- Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA
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61
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Comparative risk of lipophilic and hydrophilic statins on incident depression: A retrospective cohort study. J Affect Disord 2018; 238:542-546. [PMID: 29936394 DOI: 10.1016/j.jad.2018.06.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 05/21/2018] [Accepted: 06/04/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the risk of new-onset depression in a cohort of US adult patients initiating lipophilic statin therapy compared to hydrophilic statin therapy. DESIGN Retrospective cohort study. SETTING Large US commercial claims database PARTICIPANTS: 1:1 propensity score matched cohort of lipophilic (atorvastatin, lovastatin and simvastatin) and hydrophilic (pravastatin and rosuvastatin) statin initiators between January 2009 to June 2015. OUTCOME New onset of depression. RESULTS In a propensity-score matched cohort of 299,298 statin initiators, the crude incidence of depression in the hydrophilic and lipophilic group was 136.6 and 142.8 per 10,000 person-years respectively. Compared to hydrophilic statin use, lipophilic statin use was not associated with a statistically significant increase in the risk of depression, adjusted HR 1.05 (95% CI, 1.00-1.10, p = 0.078) and excess incidence of 6.3 (95% CI, -0.7-13.7) per 10,000 person-years. Findings were consistent across the subgroups of patients with history of psychiatric conditions HR 1.05 (95% CI, 0.94-1.16, p = 0.41), and those initiating statins for primary or secondary prevention, HR 1.03 (95% CI, 0.97-1.10, p = 0.33) and 1.07 (95% CI, 0.99-1.16, p = 0.10) respectively. Within individual lipophilic statins, only simvastatin was associated with a moderate increase in the risk of depression HR 1.09 (95% CI, 1.02-1.16, p = 0.003), followed by lovastatin HR 1.07 (95% CI, 0.93-1.24, p = 0.34) and atorvastatin HR 1.05 (95% CI, 0.97-1.13, p = 0.27). LIMITATIONS Findings are generalizable to patients with commercial insurance. CONCLUSIONS Lipophilic statin use was not associated with a significant increase in the risk of incident depression.
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Arefieva TI, Filatova AY, Potekhina AV, Shchinova AM. Immunotropic Effects and Proposed Mechanism of Action for 3-Hydroxy-3-methylglutaryl-coenzyme A Reductase Inhibitors (Statins). BIOCHEMISTRY (MOSCOW) 2018; 83:874-889. [PMID: 30208827 DOI: 10.1134/s0006297918080023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Inhibitors of HMG-CoA reductase (statins) are the major group of lipid-lowering drugs. Along with hypocholesterolemic activity, statins exhibit anti-inflammatory and immunomodulatory properties that expand their clinical use, particularly, in the treatment of chronic inflammatory and autoimmune disorders. In this review, we critically analyze the data of statin effects on immune cells (e.g., monocytes and T cells) involved in the development of atherosclerosis and other chronic inflammatory diseases. We (i) discuss the properties of statins and routes of cell entry, as well as their major intracellular targets; (ii) evaluate the data on the effects of statins on the subset composition of circulatory monocytes, ability of monocytes to migrate to the site of inflammation (cell motility and expression of adhesion molecules and chemokine receptors), production of cytokines, matrix metalloproteinases, and reactive oxygen species by monocytes/macrophages, and antigen-presenting activity in peripheral blood monocyte-derived dendritic cells; and (iii) summarize the data on the regulation of proliferation and differentiation of various CD4+ T cell subsets (type 1/2/17 helper T cells and regulatory T cells) by statins.
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Affiliation(s)
- T I Arefieva
- National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow, 121552, Russia.,Kurchatov Institute National Research Center Complex, Moscow, 123182, Russia
| | - A Yu Filatova
- National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow, 121552, Russia.
| | - A V Potekhina
- National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow, 121552, Russia
| | - A M Shchinova
- National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, Moscow, 121552, Russia
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ADME properties evaluation in drug discovery: in silico prediction of blood-brain partitioning. Mol Divers 2018; 22:979-990. [PMID: 30083853 DOI: 10.1007/s11030-018-9866-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 08/02/2018] [Indexed: 10/28/2022]
Abstract
The absorption, distribution, metabolism and excretion properties are important for drugs, and prediction of these properties in advance will save the cost of drug discovery substantially. The ability to penetrate the blood-brain barrier is critical for drugs targeting central nervous system, which is represented by the ratio of its concentration in brain and in blood. Herein, a quantitative structure-property relationship study was carried out to predict blood-brain partitioning coefficient (logBB) of a data set consisting of 287 compounds. Four different methods including support vector machine, multivariate linear regression, multivariate adaptive regression splines and random forest were employed to build prediction models with 116 molecular descriptors selected by Boruta algorithm. The RF model had best performance in training set ([Formula: see text] = 0.938), test set ([Formula: see text] = 0.840) and tenfold cross-validation ([Formula: see text] = 0.788). Finally, we found that the polar surface area and octanol-water partition coefficient have the greatest influence on blood-brain partitioning. Results suggest that the proposed model is a useful and practical tool to predict the logBB values of drug candidates.
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64
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Rocha KCE, Pereira BMV, Rodrigues AC. An update on efflux and uptake transporters as determinants of statin response. Expert Opin Drug Metab Toxicol 2018; 14:613-624. [PMID: 29842801 DOI: 10.1080/17425255.2018.1482276] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Statins are used in the treatment of dyslipidemia promoting primary and secondary prevention against detrimental cardiovascular events. ATP-binding cassette (ABC) and solute carrier (SLC) membrane transporters transport statins across the cell membrane. Differences in drug transporter tissue expression and activity contribute to variability in statin pharmacokinetics (PK) and response. Areas covered: The purpose of this review is to discuss factors impacting transporter expression and the effect this has on statin efficacy and safety. Previous studies have demonstrated that genetic polymorphisms, drug-drug interactions (DDI), nuclear receptors, and microRNAs affect statin PK and pharmacodynamics. Expert opinion: Genetic variants of ABCG2 and SLCO1B1 transporters affect statin PK and, as a result, the intended lipid-lowering response. However, the effect size is small, limiting its applicability in clinical practice. Furthermore, genetic variants do not totally explain the observed intervariability in statin response. Thus, it is likely that transcriptional and post-transcriptional regulation of drug transporters are also highly involved. Further studies are required to understand the contribution of each of these new factors in statin disposition and toxicity.
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Affiliation(s)
- Karina Cunha E Rocha
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
| | - Beatriz Maria Veloso Pereira
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
| | - Alice Cristina Rodrigues
- a Department of Pharmacology , Institute of Biomedical Sciences, University of Sao Paulo , Sao Paulo , SP , Brazil
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Desai P, Wallace R, Anderson ML, Howard BV, Ray R, Wu C, Safford M, Martin LW, Schlecht N, Liu S, Cirillo D, Jay A, Manson JE, Simon MS. An analysis of the effect of statins on the risk of Non-Hodgkin's Lymphoma in the Women's Health Initiative cohort. Cancer Med 2018; 7:2121-2130. [PMID: 29608241 PMCID: PMC5943473 DOI: 10.1002/cam4.1368] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 01/06/2018] [Accepted: 01/08/2018] [Indexed: 12/19/2022] Open
Abstract
Statins have been shown to induce a phosphoprotein signature that modifies MYC (myelocytomatosis viral oncogene) activation and to have anti‐inflammatory activity that may impact the risk of Non‐Hodgkin's lymphoma (NHL). We analyzed the relationship between statins and risk of NHL using data from the Women's Health Initiative (WHI). The study population included 161,563 postmenopausal women ages 50–79 years from which 712 cases of NHL were diagnosed after 10.8 years of follow‐up. Information on statin use and other risk factors was collected by self‐ and interviewer‐administered questionnaires. Multivariable‐adjusted HR and 95% CI evaluating the relationship between statin use at baseline, as well as in a time‐dependent manner and risk of NHL, were computed from Cox proportional hazards analyses. A separate analysis was performed for individual NHL subtypes: diffuse large B‐Cell lymphoma (DLBCL) (n = 228), follicular lymphoma (n = 169), and small lymphocytic lymphoma (n = 74). All statistical tests were two‐sided. There was no significant association between use of statins at baseline and risk of NHL (HR 0.85, 95% C.I. 0.67–1.08). However, in the multivariable‐adjusted time‐dependent models, statin use was associated with a borderline lower risk of NHL (HR 0.81, 95% C.I. 0.66–1.00). Considering subtypes of NHL, statin use was associated with a lower risk of DLBCL (HR 0.62, 95% C.I. 0.42–0.91). This effect was driven by lipophilic statins (HR 0.62, 95% C.I. 0.40–0.96). In the WHI, statins were associated with a lower overall risk of DLBCL, particularly attributable to lipophilic statins. These results may have impact on primary or secondary prevention of NHL, particularly DLBCL.
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Affiliation(s)
- Pinkal Desai
- Weill Cornell Medical College, New York, New York
| | - Robert Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | | | - Barbara V Howard
- MedStar Health Research Institute and Georgetown/Howard Universities Center for Clinical and Translational Science, Washington, District of Columbia
| | - Roberta Ray
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Chunyuan Wu
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Lisa W Martin
- George Washington University, Washington, District of Columbia
| | | | - Simin Liu
- Brown University School of Public Health, Providence, Rhode Island
| | - Dominic Cirillo
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Allison Jay
- St John Providence Hospital, Warren, Michigan
| | - JoAnn E Manson
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Michael S Simon
- Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
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Liu R, Dangwal S, Shaik I, Aichele C, Kim SJ. Hydrophilicity-controlled MFI-type zeolite-coated mesh for oil/water separation. Sep Purif Technol 2018. [DOI: 10.1016/j.seppur.2017.11.064] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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67
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Wu YC, Cao L, Mei WJ, Wu HQ, Luo SH, Zhan HY, Wang ZY. Bis-2(5H)-furanone derivatives as new anticancer agents: Design, synthesis, biological evaluation, and mechanism studies. Chem Biol Drug Des 2018; 92:1232-1240. [DOI: 10.1111/cbdd.13183] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/03/2018] [Accepted: 02/10/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Yan-Cheng Wu
- School of Chemistry and Environment; South China Normal University; Key Laboratory of Theoretical Chemistry of Environment; Ministry of Education; Guangzhou China
- School of Chemistry and Chemical Engineering; Guangdong Pharmaceutical University; Zhongshan China
| | - Liang Cao
- School of Chemistry and Environment; South China Normal University; Key Laboratory of Theoretical Chemistry of Environment; Ministry of Education; Guangzhou China
| | - Wen-Jie Mei
- School of Pharmacy; Guangdong Pharmaceutical University; Guangzhou China
| | - Han-Qing Wu
- School of Chemistry and Environment; South China Normal University; Key Laboratory of Theoretical Chemistry of Environment; Ministry of Education; Guangzhou China
| | - Shi-He Luo
- School of Chemistry and Environment; South China Normal University; Key Laboratory of Theoretical Chemistry of Environment; Ministry of Education; Guangzhou China
| | - Hai-Ying Zhan
- School of Chemistry and Chemical Engineering; Guangdong Pharmaceutical University; Zhongshan China
| | - Zhao-Yang Wang
- School of Chemistry and Environment; South China Normal University; Key Laboratory of Theoretical Chemistry of Environment; Ministry of Education; Guangzhou China
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Li HH, Lin CL, Huang CN. Neuroprotective effects of statins against amyloid β-induced neurotoxicity. Neural Regen Res 2018; 13:198-206. [PMID: 29557360 PMCID: PMC5879882 DOI: 10.4103/1673-5374.226379] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
A growing body of evidence suggests that disruption of the homeostasis of lipid metabolism affects the pathogenesis of Alzheimer's disease (AD). In particular, dysregulation of cholesterol homeostasis in the brain has been reported to considerably increase the risk of developing AD. Thus, dysregulation of lipid homeostasis may increase the amyloid β (Aβ) levels by affecting amyloid precursor protein (APP) cleavage, which is the most important risk factor involved in the pathogenesis of AD. Previous research demonstrated that Aβ can trigger neuronal insulin resistance, which plays an important role in response to Aβ-induced neurotoxicity in AD. Epidemiological studies also suggested that statin use is associated with a decreased incidence of AD. Therefore, statins are believed to be a good candidate for conferring neuroprotective effects against AD. Statins may play a beneficial role in reducing Aβ-induced neurotoxicity. Their effect involves a putative mechanism beyond its cholesterol-lowering effects in preventing Aβ-induced neurotoxicity. However, the underlying molecular mechanisms of the protective effect of statins have not been clearly determined in Aβ-induced neurotoxicity. Given that statins may provide benefits beyond the inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, these drugs may also improve the brain. Thus, statins may have beneficial effects on impaired insulin signaling by activating AMP-activated protein kinase (AMPK) in neuronal cells. They play a potential therapeutic role in targeting Aβ-mediated neurotoxicity.
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Affiliation(s)
- Hsin-Hua Li
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, China
| | - Chih-Li Lin
- Institute of Medicine, Chung Shan Medical University; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, China
| | - Chien-Ning Huang
- Institute of Medicine, Chung Shan Medical University; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan, China
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Vlad A, Vlad M, Petrica L, Ursoniu S, Gadalean F, Popescu R, Vlad D, Dumitrascu V, Gluhovschi G, Gluhovschi C, Velciov S, Bob F, Matusz P, Secara A, Simulescu A, Jianu DC. Therapy with atorvastatin versus rosuvastatin reduces urinary podocytes, podocyte-associated molecules, and proximal tubule dysfunction biomarkers in patients with type 2 diabetes mellitus: a pilot study. Ren Fail 2017; 39:112-119. [PMID: 27841047 PMCID: PMC6014491 DOI: 10.1080/0886022x.2016.1254657] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 09/28/2016] [Accepted: 10/25/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diabetic nephropathy is a severe complication of Type 2 diabetes. Tubular lesions may play an important role in its early stages. The aim of our study was to determine if atorvastatin protects the podocytes and the proximal tubule in patients with Type 2 diabetes. METHODS A total of 63 patients with Type 2 diabetes completed this 6-months prospective pilot study. They were randomized to continue rosuvastatin therapy (control group) or to be administered an equipotent dose of atorvastatin (intervention group), and were assessed regarding urinary podocytes, podocyte-associated molecules, and biomarkers of proximal tubule dysfunction. RESULTS The patients from the intervention group presented a significant reduction in podocyturia (from 7.0 to 4.0 cells/ml, p < .05), urinary nephrin (from 1.7 to 1.3 mg/g, p < .001), urinary vascular endothelial growth factor (from 262.8 to 256.9, p < .01), urinary alpha1-microglobulin (from 10.0 to 8.3 mg/g, p < .01), urinary kidney injury molecule-1 (from 139.5 to 136.3 ng/g, p < .001), and urinary advanced glycation end-products (from 112.6 to 101.3 pg/ml, p < .001). Podocyturia correlated directly with the podocyte damage biomarkers, proximal tubule dysfunction biomarkers, albumin to creatinine ratio, and advanced glycation end-products, and inversely with the glomerular filtration rate. CONCLUSIONS In patients with Type 2 diabetes, atorvastatin exerts favorable effects on the kidney. There is a correlation between the evolution of the podocytes and of the proximal tubule biomarkers, supporting the hypothesis that the glomerular changes parallel proximal tubule dysfunction in the early stages of diabetic nephropathy.
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Affiliation(s)
- Adrian Vlad
- Department of Diabetes and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Mihaela Vlad
- Department of Endocrinology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ligia Petrica
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Sorin Ursoniu
- Department of Public Health Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Florica Gadalean
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Roxana Popescu
- Department of Cellular and Molecular Biology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Daliborca Vlad
- Department of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Victor Dumitrascu
- Department of Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Gheorghe Gluhovschi
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristina Gluhovschi
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Silvia Velciov
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Flaviu Bob
- Department of Nephrology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Petru Matusz
- Department of Anatomy, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Alina Secara
- Department of Nephrology, “Pius Brinzeu”, County Emergency Hospital, Timisoara, Romania
| | - Anca Simulescu
- Department of Nephrology, “Pius Brinzeu”, County Emergency Hospital, Timisoara, Romania
| | - Dragos Catalin Jianu
- Department of Neurology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Tian B, Al-Moujahed A, Bouzika P, Hu Y, Notomi S, Tsoka P, Miller JW, Lin H, Vavvas DG. Atorvastatin Promotes Phagocytosis and Attenuates Pro-Inflammatory Response in Human Retinal Pigment Epithelial Cells. Sci Rep 2017; 7:2329. [PMID: 28539592 PMCID: PMC5443823 DOI: 10.1038/s41598-017-02407-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/25/2017] [Indexed: 11/09/2022] Open
Abstract
Phagocytosis of daily shed photoreceptor outer segments is an important function of the retinal pigment epithelium (RPE) and it is essential for retinal homeostasis. RPE dysfunction, especially impairment of its phagocytic ability, plays an essential role in the pathogenesis of age-related macular degeneration (AMD). Statins, or HMG CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase inhibitors, are drugs with multiple properties that have been extensively used to treat hyperlipidemia. However, their effect on RPE cells has not been fully elucidated. Here we report that high dose atorvastatin increased the phagocytic function of ARPE-19 cells, as well as rescue the cells from the phagocytic dysfunction induced by cholesterol crystals and oxidized low-density lipoproteins (ox-LDL), potentially by increasing the cellular membrane fluidity. Similar effects were observed when evaluating two other hydrophobic statins, lovastatin and simvastatin. Furthermore, atorvastatin was able to block the induction of interleukins IL-6 and IL-8 triggered by pathologic stimuli relevant to AMD, such as cholesterol crystals and ox-LDL. Our study shows that statins, a well-tolerated class of drugs with rare serious adverse effects, help preserve the phagocytic function of the RPE while also exhibiting anti-inflammatory properties. Both characteristics make statins a potential effective medication for the prevention and treatment of AMD.
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Affiliation(s)
- Bo Tian
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
| | - Ahmad Al-Moujahed
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
- Department of Pathology, Boston University School of Medicine, Boston, MA, 02118, United States
| | - Peggy Bouzika
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
| | - Yijun Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Shoji Notomi
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
| | - Pavlina Tsoka
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
| | - Joan W Miller
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States
| | - Haijiang Lin
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States.
- Department of Ophthalmology & Visual Sciences, University of Massachusetts Medical School, Worcester, MA, 01605, United States.
| | - Demetrios G Vavvas
- Retina Service, Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, 02114, United States.
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71
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Rosuvastatin: Beyond the cholesterol-lowering effect. Pharmacol Res 2016; 107:1-18. [PMID: 26930419 DOI: 10.1016/j.phrs.2016.02.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/13/2016] [Accepted: 02/14/2016] [Indexed: 12/18/2022]
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Vavvas DG, Daniels AB, Kapsala ZG, Goldfarb JW, Ganotakis E, Loewenstein JI, Young LH, Gragoudas ES, Eliott D, Kim IK, Tsilimbaris MK, Miller JW. Regression of Some High-risk Features of Age-related Macular Degeneration (AMD) in Patients Receiving Intensive Statin Treatment. EBioMedicine 2016; 5:198-203. [PMID: 27077128 PMCID: PMC4816836 DOI: 10.1016/j.ebiom.2016.01.033] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/26/2016] [Accepted: 01/27/2016] [Indexed: 12/26/2022] Open
Abstract
Importance Age-related macular degeneration (AMD) remains the leading cause of blindness in developed countries, and affects more than 150 million worldwide. Despite effective anti-angiogenic therapies for the less prevalent neovascular form of AMD, treatments are lacking for the more prevalent dry form. Similarities in risk factors and pathogenesis between AMD and atherosclerosis have led investigators to study the effects of statins on AMD incidence and progression with mixed results. A limitation of these studies has been the heterogeneity of AMD disease and the lack of standardization in statin dosage. Objective We were interested in studying the effects of high-dose statins, similar to those showing regression of atherosclerotic plaques, in AMD. Design Pilot multicenter open-label prospective clinical study of 26 patients with diagnosis of AMD and the presence of many large, soft drusenoid deposits. Patients received 80 mg of atorvastatin daily and were monitored at baseline and every 3 months with complete ophthalmologic exam, best corrected visual acuity (VA), fundus photographs, optical coherence tomography (OCT), and blood work (AST, ALT, CPK, total cholesterol, TSH, creatinine, as well as a pregnancy test for premenopausal women). Results Twenty-three subjects completed a minimum follow-up of 12 months. High-dose atorvastatin resulted in regression of drusen deposits associated with vision gain (+ 3.3 letters, p = 0.06) in 10 patients. No subjects progressed to advanced neovascular AMD. Conclusions High-dose statins may result in resolution of drusenoid pigment epithelial detachments (PEDs) and improvement in VA, without atrophy or neovascularization in a high-risk subgroup of AMD patients. Confirmation from larger studies is warranted. High dose lipophilic statin administration was associated with regression of large soft drusen and vision gain in 10/23 AMD patients. Duration of treatment before a positive response was observed was usually 1–1.5 years. Patients on high-dose statin appeared to be protected from progression to “wet” neovascular-AMD.
There is a lack of effective therapies for dry age-related macular degeneration (AMD), one of the leading causes of blindness affecting millions. Although AMD shares similarities with atherosclerosis, prior studies on statins and AMD have failed to show improvement. A limitation of these studies has been the heterogeneity of AMD disease and the lack of standardization in statin dosage. Here, we present for the first time evidence that treatment with high-dose atorvastatin (80 mg) is associated with regression of lipid deposits and improvement in visual acuity, without atrophy or neovascularization, in high-risk AMD patients.
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Affiliation(s)
- Demetrios G. Vavvas
- Corresponding authors at: 243 Charles St., Boston, MA 02114, USA.243 Charles St.BostonMA02114USA
| | - Anthony B. Daniels
- Corresponding authors at: 243 Charles St., Boston, MA 02114, USA.243 Charles St.BostonMA02114USA
| | | | | | | | | | | | | | | | | | - Miltiadis K. Tsilimbaris
- Corresponding authors at: 243 Charles St., Boston, MA 02114, USA.243 Charles St.BostonMA02114USA
| | - Joan W. Miller
- Corresponding authors at: 243 Charles St., Boston, MA 02114, USA.243 Charles St.BostonMA02114USA
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Gottlieb K, Wacher V, Sliman J, Pimentel M. Review article: inhibition of methanogenic archaea by statins as a targeted management strategy for constipation and related disorders. Aliment Pharmacol Ther 2016; 43:197-212. [PMID: 26559904 PMCID: PMC4737270 DOI: 10.1111/apt.13469] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 09/29/2015] [Accepted: 10/20/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Observational studies show a strong association between delayed intestinal transit and the production of methane. Experimental data suggest a direct inhibitory activity of methane on the colonic and ileal smooth muscle and a possible role for methane as a gasotransmitter. Archaea are the only confirmed biological sources of methane in nature and Methanobrevibacter smithii is the predominant methanogen in the human intestine. AIM To review the biosynthesis and composition of archaeal cell membranes, archaeal methanogenesis and the mechanism of action of statins in this context. METHODS Narrative review of the literature. RESULTS Statins can inhibit archaeal cell membrane biosynthesis without affecting bacterial numbers as demonstrated in livestock and humans. This opens the possibility of a therapeutic intervention that targets a specific aetiological factor of constipation while protecting the intestinal microbiome. While it is generally believed that statins inhibit methane production via their effect on cell membrane biosynthesis, mediated by inhibition of the HMG-CoA reductase, there is accumulating evidence for an alternative or additional mechanism of action where statins inhibit methanogenesis directly. It appears that this other mechanism may predominate when the lactone form of statins, particularly lovastatin lactone, is administered. CONCLUSIONS Clinical development appears promising. A phase 2 clinical trial is currently in progress that evaluates the effect of lovastatin lactone on methanogenesis and symptoms in patients with irritable bowel syndrome with constipation. The review concludes with an outlook for the future and subsequent work that needs to be done.
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Affiliation(s)
| | - V. Wacher
- Synthetic BiologicsInc.RockvilleMDUSA
| | - J. Sliman
- Synthetic BiologicsInc.RockvilleMDUSA
| | - M. Pimentel
- GastroenterologyCedars‐Sinai Medical CenterLos AngelesCAUSA
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Fong CW. Binding energies of tyrosine kinase inhibitors: Error assessment of computational methods for imatinib and nilotinib binding. Comput Biol Chem 2015; 58:40-54. [PMID: 26025598 DOI: 10.1016/j.compbiolchem.2015.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 05/09/2015] [Accepted: 05/13/2015] [Indexed: 11/30/2022]
Abstract
The binding energies of imatinib and nilotinib to tyrosine kinase have been determined by quantum mechanical (QM) computations, and compared with literature binding energy studies using molecular mechanics (MM). The potential errors in the computational methods include these critical factors. Errors in X-ray structures such as structural distortions and steric clashes give unrealistically high van der Waals energies, and erroneous binding energies.MM optimization gives a very different configuration to the QM optimization for nilotinib, whereas the imatinib ion gives similar configurations. Solvation energies are a major component of the overall binding energy. The QM based solvent model (PCM/SMD) gives different values from those used in the implicit PBSA solvent MM models. A major error in inhibitor—kinase binding lies in the non-polar solvation terms. Solvent transfer free energies and the required empirical solvent accessible surface area factors for nilotinib and imatinib ion to give the transfer free energies have been reverse calculated. These values differ from those used in the MM PBSA studies.An intertwined desolvation—conformational binding selectivity process is a balance of thermodynamic desolvation and intramolecular conformational kinetic control.The configurational entropies (TΔS) are minor error sources.
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Desai P, Lehman A, Chlebowski RT, Kwan ML, Arun M, Manson JE, Lavasani S, Wasswertheil-Smoller S, Sarto GE, LeBoff M, Cauley J, Cote M, Beebe-Dimmer J, Jay A, Simon MS. Statins and breast cancer stage and mortality in the Women's Health Initiative. Cancer Causes Control 2015; 26:529-39. [PMID: 25736184 DOI: 10.1007/s10552-015-0530-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/03/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE To evaluate the association between statins and breast cancer stage and mortality in the Women's Health Initiative. METHODS The study population included 128,675 postmenopausal women aged 50-79 years, out of which there were 7,883 newly diagnosed cases of in situ (19%), local (61%)-, regional (19%)- and distant (1%)-stage breast cancer and 401 deaths due to breast cancer after an average of 11.5 (SD = 3.7) years of follow-up. Stage was coded using SEER criteria and was stratified into early (in situ and local)- versus late (regional and distant)-stage disease. Information on statins and other risk factors were collected by self- and interviewer-administered questionnaires. Cause of death was based on medical record review. Multivariable-adjusted hazards ratios (HR) and 95% confidence intervals (CIs) evaluating the relationship between statin use (at baseline only and in a time-dependent manner) and diagnosis of late-stage breast cancer and breast cancer-specific mortality were computed from Cox proportional hazards analyses after adjusting for appropriate confounders. RESULTS Statins were used by 10,474 women (8%) at baseline. In the multivariable-adjusted time-dependent model, use of lipophilic statins was associated with a reduction in diagnosis of late-stage breast cancer (HR 0.80, 95% CI 0.64-0.98, p = 0.035) which was also significant among women with estrogen receptor-positive disease (HR 0.72, 95% CI 0.56-0.93, p = 0.012). Breast cancer mortality was marginally lower in statin users compared with nonusers (HR 0.59, 95 % CI 0.32-1.06, p = 0.075). CONCLUSIONS Prior statin use is associated with lower breast cancer stage at diagnosis.
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Affiliation(s)
- Pinkal Desai
- Weill Cornell Medical College, New York, NY, USA
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Permeability of the Blood–Brain Barrier: Molecular Mechanism of Transport of Drugs and Physiologically Important Compounds. J Membr Biol 2015; 248:651-69. [DOI: 10.1007/s00232-015-9778-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/23/2015] [Indexed: 01/08/2023]
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Morimoto T, Katanasaka Y, Sunagawa Y, Hirano S, Miyazaki Y, Funamoto M, Hojo Y, Suzuki H, Morimoto E, Ueno M, Shimatsu A, Satoh-Asahara N, Yamakage H, Wada H, Hasegawa K. Effects of Statins on Left Ventricular Diastolic Function in Patients with Dyslipidemia and Diastolic Dysfunction (Stat-LVDF Study). Biol Pharm Bull 2015; 38:1404-9. [DOI: 10.1248/bpb.b15-00126] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Tatsuya Morimoto
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
- Shizuoka General Hospital
- Division of Translational Research, Kyoto Medical Center, National Hospital Organization
| | - Yasufumi Katanasaka
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
- Shizuoka General Hospital
- Division of Translational Research, Kyoto Medical Center, National Hospital Organization
| | - Yoichi Sunagawa
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
- Shizuoka General Hospital
- Division of Translational Research, Kyoto Medical Center, National Hospital Organization
| | - Sae Hirano
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
- Shizuoka Saiseikai General Hospital
| | - Yusuke Miyazaki
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
| | - Masafumi Funamoto
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
| | - Yuya Hojo
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
| | - Hidetoshi Suzuki
- Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka
| | | | - Morio Ueno
- Department of Ophthalmology, Kyoto Prefectural University of Medicine
| | - Akira Shimatsu
- Clinical Research Institute, Kyoto Medical Center, National Hospital Organization
| | - Noriko Satoh-Asahara
- Clinical Research Institute, Kyoto Medical Center, National Hospital Organization
| | - Hajime Yamakage
- Clinical Research Institute, Kyoto Medical Center, National Hospital Organization
| | - Hiromichi Wada
- Division of Translational Research, Kyoto Medical Center, National Hospital Organization
| | - Koji Hasegawa
- Division of Translational Research, Kyoto Medical Center, National Hospital Organization
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