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Frydrychowicz C, Pasieka B, Pierer M, Mueller W, Petros S, Weidhase L. Colchicine triggered severe rhabdomyolysis after long-term low-dose simvastatin therapy: a case report. J Med Case Rep 2017; 11:8. [PMID: 28049514 PMCID: PMC5209950 DOI: 10.1186/s13256-016-1169-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 12/05/2016] [Indexed: 11/10/2022] Open
Abstract
Background Rhabdomyolysis is a widely recognized yet rare complication in statin use. Rhabdomyolysis might be triggered by the prescription of high doses of statins or by statin accumulation due to interactions with concomitant medication. Muscle cell destruction as evidenced by myoglobin elevation can induce potentially life-threatening acute renal failure. Case presentation We report a case of a 70-year-old obese white man with sudden onset of severe rhabdomyolysis with consecutive renal failure. His medication included low-dose simvastatin, which he had taken for 6 years up until the event. The statin was withdrawn immediately. After 3 days of veno-venous hemofiltration his renal function was completely restored. Conclusions Clinicians in both primary and special care might be unaware that side effects of statins do occur even after a long uneventful statin medication; they should be advised not to exclude that possibility upfront, even if a patient has tolerated the medication for years.
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Affiliation(s)
- Clara Frydrychowicz
- Department of Neuropathology, University Hospital Leipzig, Liebigstrasse 26, House G, 04103, Leipzig, Germany.
| | - Bastian Pasieka
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
| | - Matthias Pierer
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
| | - Wolf Mueller
- Department of Neuropathology, University Hospital Leipzig, Liebigstrasse 26, House G, 04103, Leipzig, Germany
| | - Sirak Petros
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
| | - Lorenz Weidhase
- Medical Intensive Care Unit, University Hospital Leipzig, Leipzig, Germany
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52
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STRÁNECKÝ V, NEŘOLDOVÁ M, HODAŇOVÁ K, HARTMANNOVÁ H, PIHEROVÁ L, ZEMÁNKOVÁ P, PŘISTOUPILOVÁ A, VRABLÍK M, ADÁMKOVÁ M, KMOCH S, JIRSA M. Large Copy-Number Variations in Patients With Statin-Associated Myopathy Affecting Statin Myopathy-Related Loci. Physiol Res 2016; 65:1005-1011. [DOI: 10.33549/physiolres.933284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Some patients are susceptible to statin-associated myopathy (SAM) either because of genetic variations affecting statin uptake and metabolism, or because they predispose their carriers to muscular diseases. Among the frequent variants examined using the genome-wide association study approach, SLCO1B1 c.521T>C represents the only validated predictor of SAM in patients treated with high-dose simvastatin. Our aim was to ascertain the overall contribution of large copy-number variations (CNVs) to SAM diagnosed in 86 patients. CNVs were detected by whole genome genotyping using Illumina HumanOmni2.5 Exome BeadChips. Exome sequence data were used for validation of CNVs in SAM-related loci. In addition, we performed a specific search for CNVs in the SLCO1B region detected recently in Rotor syndrome subjects. Rare deletions possibly contributing to genetic predisposition to SAM were found in two patients: one removed EYS associated previously with SAM, the other was present in LARGE associated with congenital muscular dystrophy. Another two patients carried deletions in CYP2C19, which may predispose to clopidogrel-statin interactions. We found no common large CNVs potentially associated with SAM and no CNVs in the SLCO1B locus. Our findings suggest that large CNVs do not play a substantial role in the etiology of SAM.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - M. JIRSA
- Laboratory of Experimental Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
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D'Antona G, Tedesco L, Ruocco C, Corsetti G, Ragni M, Fossati A, Saba E, Fenaroli F, Montinaro M, Carruba MO, Valerio A, Nisoli E. A Peculiar Formula of Essential Amino Acids Prevents Rosuvastatin Myopathy in Mice. Antioxid Redox Signal 2016; 25:595-608. [PMID: 27245589 PMCID: PMC5065032 DOI: 10.1089/ars.2015.6582] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
AIMS Myopathy, characterized by mitochondrial oxidative stress, occurs in ∼10% of statin-treated patients, and a major risk exists with potent statins such as rosuvastatin (Rvs). We sought to determine whether a peculiar branched-chain amino acid-enriched mixture (BCAAem), found to improve mitochondrial function and reduce oxidative stress in muscle of middle-aged mice, was able to prevent Rvs myopathy. RESULTS Dietary supplementation of BCAAem was able to prevent the structural and functional alterations of muscle induced by Rvs in young mice. Rvs-increased plasma 3-methylhistidine (a marker of muscular protein degradation) was prevented by BCAAem. This was obtained without changes of Rvs ability to reduce cholesterol and triglyceride levels in blood. Rather, BCAAem promotes de novo protein synthesis and reduces proteolysis in cultured myotubes. Morphological alterations of C2C12 cells induced by statin were counteracted by amino acids, as were the Rvs-increased atrogin-1 mRNA and protein levels. Moreover, BCAAem maintained mitochondrial mass and density and citrate synthase activity in skeletal muscle of Rvs-treated mice beside oxygen consumption and ATP levels in C2C12 cells exposed to statin. Notably, BCAAem assisted Rvs to reduce oxidative stress and to increase the anti-reactive oxygen species (ROS) defense system in skeletal muscle. Innovation and Conclusions: The complex interplay between proteostasis and antioxidant properties may underlie the mechanism by which a specific amino acid formula preserves mitochondrial efficiency and muscle health in Rvs-treated mice. Strategies aimed at promoting protein balance and controlling mitochondrial ROS level may be used as therapeutics for the treatment of muscular diseases involving mitochondrial dysfunction, such as statin myopathy. Antioxid. Redox Signal. 25, 595-608.
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Affiliation(s)
- Giuseppe D'Antona
- 1 Department of Public Health, Experimental and Forensic Medicine, Pavia University , Pavia, Italy
| | - Laura Tedesco
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
| | - Chiara Ruocco
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
| | - Giovanni Corsetti
- 3 Department of Clinical and Experimental Sciences, Brescia University , Brescia, Italy
| | - Maurizio Ragni
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
| | - Andrea Fossati
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
| | - Elisa Saba
- 4 Department of Molecular and Translational Medicine, Brescia University , Brescia, Italy
| | - Francesca Fenaroli
- 4 Department of Molecular and Translational Medicine, Brescia University , Brescia, Italy
| | - Mery Montinaro
- 4 Department of Molecular and Translational Medicine, Brescia University , Brescia, Italy
| | - Michele O Carruba
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
| | - Alessandra Valerio
- 4 Department of Molecular and Translational Medicine, Brescia University , Brescia, Italy
| | - Enzo Nisoli
- 2 Department of Medical Biotechnology and Translational Medicine, Center for Study and Research on Obesity, Milan University , Milan, Italy
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54
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Muntean DM, Thompson PD, Catapano AL, Stasiolek M, Fabis J, Muntner P, Serban MC, Banach M. Statin-associated myopathy and the quest for biomarkers: can we effectively predict statin-associated muscle symptoms? Drug Discov Today 2016; 22:85-96. [PMID: 27634340 DOI: 10.1016/j.drudis.2016.09.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/28/2016] [Accepted: 09/05/2016] [Indexed: 12/21/2022]
Abstract
Over the past three decades, statins have become the cornerstone of prevention and treatment of atherosclerotic cardiovascular and metabolic diseases. Albeit generally well tolerated, these drugs can elicit a variety of muscle-associated symptoms that represent the most important reason for treatment discontinuation. Statin-associated myopathy has been systematically underestimated by randomized controlled trials as compared with the incidence observed in clinical practice and obtained from patient registries. There are several reasons for this discrepancy, among which the lack of reliable diagnostic tests and a validated questionnaire to assess muscle symptoms are recognized as unmet needs. Here, we review the cellular and molecular mechanisms underlying statin-associated myopathy and discuss the experimental and clinical data on various biomarkers to diagnose and predict muscle-related complaints.
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Affiliation(s)
- Danina M Muntean
- Department of Pathophysiology Functional Sciences, Victor Babeş University of Medicine and Pharmacy of Timisoara, Timisoara, Romania; Center for Translational Research and Systems Medicine, Victor Babeş University of Medicine and Pharmacy of Timisoara, Timisoara, Romania
| | - Paul D Thompson
- Division of Cardiology, Hartford Hospital, Hartford, CT, USA
| | - Alberico L Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, IRCCS Multimedica, Milan, Italy
| | - Mariusz Stasiolek
- Department of Neurology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Lodz, Poland
| | - Jaroslaw Fabis
- Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Lodz, Poland
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria-Corina Serban
- Department of Pathophysiology Functional Sciences, Victor Babeş University of Medicine and Pharmacy of Timisoara, Timisoara, Romania; Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland; Healthy Aging Research Centre (HARC), Medical University of Lodz, Lodz, Poland.
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Camerino GM, De Bellis M, Conte E, Liantonio A, Musaraj K, Cannone M, Fonzino A, Giustino A, De Luca A, Romano R, Camerino C, Laghezza A, Loiodice F, Desaphy JF, Conte Camerino D, Pierno S. Statin-induced myotoxicity is exacerbated by aging: A biophysical and molecular biology study in rats treated with atorvastatin. Toxicol Appl Pharmacol 2016; 306:36-46. [PMID: 27377005 DOI: 10.1016/j.taap.2016.06.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 01/08/2023]
Abstract
Statin-induced skeletal muscle damage in rats is associated to the reduction of the resting sarcolemmal chloride conductance (gCl) and ClC-1 chloride channel expression. These drugs also affect the ClC-1 regulation by increasing protein kinase C (PKC) activity, which phosphorylate and close the channel. Also the intracellular resting calcium (restCa) level is increased. Similar alterations are observed in skeletal muscles of aged rats, suggesting a higher risk of statin myotoxicity. To verify this hypothesis, we performed a 4-5-weeks atorvastatin treatment of 24-months-old rats to evaluate the ClC-1 channel function by the two-intracellular microelectrodes technique as well as transcript and protein expression of different genes sensitive to statins by quantitative real-time-PCR and western blot analysis. The restCa was measured using FURA-2 imaging, and histological analysis of muscle sections was performed. The results show a marked reduction of resting gCl, in agreement with the reduced ClC-1 mRNA and protein expression in atorvastatin-treated aged rats, with respect to treated adult animals. The observed changes in myocyte-enhancer factor-2 (MEF2) expression may be involved in ClC-1 expression changes. The activity of PKC was also increased and further modulate the gCl in treated aged rats. In parallel, a marked reduction of the expression of glycolytic and mitochondrial enzymes demonstrates an impairment of muscle metabolism. No worsening of restCa or histological features was found in statin-treated aged animals. These findings suggest that a strong reduction of gCl and alteration of muscle metabolism coupled to muscle atrophy may contribute to the increased risk of statin-induced myopathy in the elderly.
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Affiliation(s)
- Giulia Maria Camerino
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Michela De Bellis
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Elena Conte
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Antonella Liantonio
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Kejla Musaraj
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Maria Cannone
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Adriano Fonzino
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Arcangela Giustino
- Department of Biomedical Sciences and Human Oncology, University of Bari - Aldo Moro, Medical School, Bari, Italy
| | - Annamaria De Luca
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Rossella Romano
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Claudia Camerino
- Department of Medical Sciences, Neurosciences and Sense Organs, University of Bari - Aldo Moro, Bari, Italy
| | - Antonio Laghezza
- Section of Medicinal Chemistry, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Fulvio Loiodice
- Section of Medicinal Chemistry, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Jean-Francois Desaphy
- Department of Biomedical Sciences and Human Oncology, University of Bari - Aldo Moro, Medical School, Bari, Italy
| | - Diana Conte Camerino
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy
| | - Sabata Pierno
- Section of Pharmacology, Department of Pharmacy & Drug Sciences, University of Bari - Aldo Moro, Bari, Italy.
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56
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Neřoldová M, Stránecký V, Hodaňová K, Hartmannová H, Piherová L, Přistoupilová A, Mrázová L, Vrablík M, Adámková V, Hubáček JA, Jirsa M, Kmoch S. Rare variants in known and novel candidate genes predisposing to statin-associated myopathy. Pharmacogenomics 2016; 17:1405-14. [PMID: 27296017 DOI: 10.2217/pgs-2016-0071] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Genetic variants affecting statin uptake, metabolism or predisposing to muscular diseases may confer susceptibility to statin-induced myopathy. Besides the SLCO1B1 rs4149056 genotype, common genetic variants do not seem to determine statin-associated myopathy. Here we aimed to address the potential role of rare variants. METHODS We performed whole exome sequencing in 88 individuals suffering from statin-associated myopathy and assessed the burden of rare variants using candidate-gene and exome-wide association analysis. RESULTS In the novel candidate gene CLCN1, we identified a heterozygote truncating mutation p.R894* in four patients. In addition, we detected predictably pathogenic case-specific variants in MYOT, CYP3A5, SH3TC2, FBXO32 and RBM20. CONCLUSION These findings support the role of rare variants and nominate loci for follow-up studies.
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Affiliation(s)
- Magdaléna Neřoldová
- Laboratory of Experimental Hepatology, Center for Experimental Medicine, Institute for Clinical & Experimental Medicine, Prague, Czech Republic
| | - Viktor Stránecký
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Kateřina Hodaňová
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Hana Hartmannová
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Lenka Piherová
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Anna Přistoupilová
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
| | - Lenka Mrázová
- Laboratory for Atherosclerosis Research, Center for Experimental Medicine, Institute for Clinical & Experimental Medicine, Prague, Czech Republic
| | - Michal Vrablík
- Third Medical Department, First Faculty of Medicine, Charles University & General Faculty Hospital, Prague, Czech Republic
| | - Věra Adámková
- Preventive Cardiology Department, Institute for Clinical & Experimental Medicine, Prague, Czech Republic
| | - Jaroslav A Hubáček
- Laboratory for Atherosclerosis Research, Center for Experimental Medicine, Institute for Clinical & Experimental Medicine, Prague, Czech Republic
| | - Milan Jirsa
- Laboratory of Experimental Hepatology, Center for Experimental Medicine, Institute for Clinical & Experimental Medicine, Prague, Czech Republic
| | - Stanislav Kmoch
- Institute of Inherited Metabolic Diseases, First Medical Faculty, Charles University, Prague, Czech Republic
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58
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Fernandes V, Santos MJ, Pérez A. Statin-related myotoxicity. ACTA ACUST UNITED AC 2016; 63:239-49. [DOI: 10.1016/j.endonu.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Revised: 12/01/2015] [Accepted: 01/11/2016] [Indexed: 10/22/2022]
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59
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Involvement of Monocarboxylate Transporter 4 Expression in Statin-Induced Cytotoxicity. J Pharm Sci 2016; 105:1544-9. [PMID: 26935883 DOI: 10.1016/j.xphs.2016.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/11/2015] [Accepted: 01/05/2016] [Indexed: 11/24/2022]
Abstract
Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are the most widely used cholesterol-lowering agents for prevention of obstructive cardiovascular events. However, statins can cause a variety of skeletal muscle problems, and exercise leads to an increase in statin-induced muscle injury. Exercise induces the protein content of monocarboxylate transporter 4 (MCT4), which is expressed strongly in skeletal muscle and is thought to play a major role in the transport of metabolically important monocarboxylates such as l-lactate. We previously reported that α-cyano-4-hydroxycinnamate, an MCT4 inhibitor, increased the inhibition of growth of RD cells, a prototypic embryonal rhabdomyosarcoma cell line (an RD cell line), as a model of in vitro skeletal muscle, induced by a statin. However, it is unclear whether statin-induced RD cell cytotoxicity is associated with MCT4 expression. We, therefore, examined the relationship between statin-induced cytotoxicity and MCT4 expression in RD cells. Atorvastatin reduced the number of viable cells and upregulated MCT4, but not MCT1, mRNA level in a concentration-dependent manner. MCT4 knockdown suppressed atorvastatin-, simvastatin-, and fluvastatin-induced reduction of cell viability and apoptosis compared with negative control-treated cells. In this study, we demonstrated that MCT4 expression is associated with statin-induced cytotoxicity.
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60
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Eng H, Scialis RJ, Rotter CJ, Lin J, Lazzaro S, Varma MV, Di L, Feng B, West M, Kalgutkar AS. The Antimicrobial Agent Fusidic Acid Inhibits Organic Anion Transporting Polypeptide-Mediated Hepatic Clearance and May Potentiate Statin-Induced Myopathy. Drug Metab Dispos 2016; 44:692-9. [DOI: 10.1124/dmd.115.067447] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/12/2016] [Indexed: 12/19/2022] Open
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Boulanger-Piette A, Bergeron J, Desgreniers J, Côté-Levesque M, Brassard D, Joanisse DR, Frenette J. [Statin intolerance and associated muscular dysfunctions]. Med Sci (Paris) 2015; 31:1109-14. [PMID: 26672664 DOI: 10.1051/medsci/20153112014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hypercholesterolemia is a major risk factor for cardiovascular diseases. The 2012-2013 survey of Canada's public health measures revealed that dyslipidemia was present in 38% of the respondents aged between 18 and 79 years. According to the American College of Cardiology, the American Heart Association, the Canadian Cardiovascular Society and the Canadian Working Group Consensus, statins remain the treatment of choice for dyslipidemia and the reduction of cardiovascular risk. However, concerns and questions persist regarding statins use and safety, potential and harmful muscular side-effects, interactions with exercise, and molecular mechanisms of myotoxicity. The goal of the present review is to provide a clear picture of the clinical situation and to investigate possible mechanisms of statin-induced myopathy. A better understanding of muscle pathology in statin users is absolutely essential to minimize their muscle symptoms and to provide a sound clinical basis for the management of cardiovascular risk.
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Affiliation(s)
- Antoine Boulanger-Piette
- Centre de recherche du CHU de Québec-CHUL, université Laval, 2705, boulevard Laurier, Québec, QC, G1V 4G2 Canada
| | - Jean Bergeron
- Centre de recherche du CHU de Québec-CHUL, université Laval, 2705, boulevard Laurier, Québec, QC, G1V 4G2 Canada
| | - Joël Desgreniers
- Faculté de médecine, département de réadaptation, université Laval, 1050, avenue de la Médecine, Québec, QC, G1V 0A6 Canada
| | - Michèle Côté-Levesque
- Faculté de médecine, département de réadaptation, université Laval, 1050, avenue de la Médecine, Québec, QC, G1V 0A6 Canada
| | - Dominic Brassard
- Faculté de médecine, département de réadaptation, université Laval, 1050, avenue de la Médecine, Québec, QC, G1V 0A6 Canada
| | - Denis R Joanisse
- Pavillon éducation physique et sports, université Laval, 2300, rue de la Terrasse, Québec, QC, G1V 0A6, Canada
| | - Jérôme Frenette
- Centre de recherche du CHU de Québec-CHUL, université Laval, 2705, boulevard Laurier, Québec, QC, G1V 4G2 Canada
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Kuzma-Kuzniarska M, Cornell HR, Moneke MC, Carr AJ, Hulley PA. Lovastatin-Mediated Changes in Human Tendon Cells. J Cell Physiol 2015; 230:2543-51. [PMID: 25846724 PMCID: PMC4832302 DOI: 10.1002/jcp.25010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 03/31/2015] [Indexed: 01/18/2023]
Abstract
Statins are among the most widely prescribed drugs worldwide. Numerous studies have shown their beneficial effects in prevention of cardiovascular disease through cholesterol-lowering and anti-atherosclerotic properties. Although some statin patients may experience muscle-related symptoms, severe side effects of statin therapy are rare, primarily due to extensive first-pass metabolism in the liver. Skeletal muscles appear to be the main site of side effects; however, recently some statin-related adverse effects have been described in tendon. The mechanism behind these side effects remains unknown. This is the first study that explores tendon-specific effects of statins in human primary tenocytes. The cells were cultured with different concentrations of lovastatin for up to 1 week. No changes in cell viability or morphology were observed in tenocytes incubated with therapeutic doses. Short-term exposure to lovastatin concentrations outside the therapeutic range had no effect on tenocyte viability; however, cell migration was reduced. Simvastatin and atorvastatin, two other drug family members, also reduced the migratory properties of the cells. Prolonged exposure to high concentrations of lovastatin induced changes in cytoskeleton leading to cell rounding and decreased levels of mRNA for matrix proteins, but increased BMP-2 expression. Gap junctional communication was impaired but due to cell shape change and separation rather than direct gap junction inhibition. These effects were accompanied by inhibition of prenylation of Rap1a small GTPase. Collectively, we showed that statins in a dose-dependent manner decrease migration of human tendon cells, alter their expression profile and impair the functional network, but do not inhibit gap junction function.
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Affiliation(s)
- Maria Kuzma-Kuzniarska
- Botnar Research Centre, Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Hannah R Cornell
- Botnar Research Centre, Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Michael C Moneke
- Botnar Research Centre, Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Andrew J Carr
- Botnar Research Centre, Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Philippa A Hulley
- Botnar Research Centre, Institute of Musculoskeletal Sciences, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
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63
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Liu MH. Antihyperlipidemic therapies targeting PCSK9: Novel therapeutic agents for lowering low-density lipoprotein cholesterol. Int J Cardiol 2015; 195:212-4. [DOI: 10.1016/j.ijcard.2015.05.150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/23/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
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64
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Variability in hepatic expression of organic anion transporter 7/SLC22A9, a novel pravastatin uptake transporter: impact of genetic and regulatory factors. THE PHARMACOGENOMICS JOURNAL 2015; 16:341-51. [PMID: 26239079 DOI: 10.1038/tpj.2015.55] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 05/26/2015] [Accepted: 06/23/2015] [Indexed: 02/07/2023]
Abstract
Human organic anion transporter 7 (OAT7, SLC22A9) is a hepatic transport protein poorly characterized so far. We therefore sought to identify novel OAT7 substrates and factors contributing to variable hepatic OAT7 expression. Using OAT7-expressing cells, pravastatin was identified as a substrate. Hepatic SLC22A9/OAT7 mRNA and protein expression varied 28-fold and 15-fold, respectively, in 126 Caucasian liver samples. Twenty-four variants in SLC22A9 were genotyped, including three rare missense variants (rs377211288, rs61742518, rs146027075), which occurred only heterozygously. No variant significantly affected hepatic SLC22A9/OAT7 expression. The three missense variants, however, showed functional consequences when expressed in vitro. Hepatic nuclear factor 4-alpha (HNF4α) emerged as a major transcriptional regulator of SLC22A9 by a series of in silico and in vitro analyses. In conclusion, pravastatin is the first identified OAT7 drug substrate. Substantial inter-individual variability in hepatic OAT7 expression, majorly driven by HNF4α, may contribute to pravastatin drug disposition and might affect response.The Pharmacogenomics Journal advance online publication, 4 August 2015; doi:10.1038/tpj.2015.55.
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Simons JE, Holbrook AM, Don-Wauchope AC. Successful reintroduction of statin therapy after statin-associated rhabdomyolysis. J Clin Lipidol 2015; 9:594-6. [DOI: 10.1016/j.jacl.2015.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 02/24/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW This article highlights the recent findings regarding statin-associated muscle side effects, including mechanisms and treatment as well as the need for more comprehensive clinical trials in statin myalgia. RECENT FINDINGS Statin myalgia is difficult to diagnose and treat, as major clinical trials have not routinely assessed muscle side-effects, there are few clinically relevant biomarkers and assessment tools for the symptoms, many apparent statin-related muscle symptoms may be nonspecific and related to other drugs or health conditions, and prevalence estimates vary widely. Data thus suggest that only 30-50% of patients with self-reported statin myalgia actually experience muscle pain on statins during blinded, placebo-controlled trials. In addition, evidence to date involving mechanisms underlying statin myalgia and its range of symptoms and presentations supports the hypothesis that there are multiple, interactive and potentially additive mechanisms underlying statin-associated muscle side-effects. SUMMARY There are likely multiple and interactive mechanisms underlying statin myalgia, and recent studies have produced equivocal data regarding prevalence of statin-associated muscle side-effects, contributing factors and effectiveness of common interventions. Therefore, more clinical trials on statin myalgia are critical to the field, as are systematic resources for quantifying, predicting and reporting statin-associated muscle side-effects.
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Affiliation(s)
- Beth A Taylor
- aDivision of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford bDepartment of Health Sciences, University of Hartford, West Hartford cUniversity of Connecticut School of Medicine, Farmington, Connecticut, USA
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