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Mefford MT, Chen L, Lewis CE, Muntner P, Sidney S, Launer LJ, Monda KL, Ruzza A, Kassahun H, Rosenson RS, Carson AP. Long-Term Levels of LDL-C and Cognitive Function: The CARDIA Study. J Int Neuropsychol Soc 2021; 27:1048-1057. [PMID: 33563358 PMCID: PMC8353005 DOI: 10.1017/s1355617721000059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES It is uncertain if long-term levels of low-density lipoprotein-cholesterol (LDL-C) affect cognition in middle age. We examined the association of LDL-C levels over 25 years with cognitive function in a prospective cohort of black and white US adults. METHODS Lipids were measured at baseline (1985-1986; age: 18-30 years) and at serial examinations conducted over 25 years. Time-averaged cumulative LDL-C was calculated using the area under the curve for 3,328 participants with ≥3 LDL-C measurements and a cognitive function assessment. Cognitive function was assessed at the Year 25 examination with the Digit Symbol Substitution Test [DSST], Rey Auditory Visual Learning Test [RAVLT], and Stroop Test. A brain magnetic resonance imaging (MRI) sub-study (N = 707) was also completed at Year 25 to assess abnormal white matter tissue volume (AWMV) and gray matter cerebral blood flow volume (GM-CBFV) as secondary outcomes. RESULTS There were 15.6%, 32.9%, 28.9%, and 22.6% participants with time-averaged cumulative LDL-C <100 mg/dL, 101-129 mg/dL, 130-159 mg/dL, and ≥160 mg/dL, respectively. Standardized differences in all cognitive function test scores ranged from 0.16 SD lower to 0.09 SD higher across time-averaged LDL-C categories in comparison to those with LDL-C < 100 mg/dL. After covariate adjustment, participants with higher versus lower time-averaged LDL-C had a lower RAVLT score (p-trend = 0.02) but no differences were present for DSST, Stroop Test, AWMV, or GM-CBFV. CONCLUSION Cumulative LDL-C was associated with small differences in memory, as assessed by RAVLT scores, but not other cognitive or brain MRI measures over 25 years of follow-up.
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Affiliation(s)
| | - Ligong Chen
- University of Alabama at Birmingham, Birmingham, AL
| | | | - Paul Muntner
- University of Alabama at Birmingham, Birmingham, AL
| | | | - Lenore J. Launer
- Intramural Research Program, National Institute on Aging, Bethesda, MD
| | - Keri L. Monda
- Center for Observational Research, Amgen Inc., Thousand Oaks, CA
| | - Andrea Ruzza
- Global Clinical Development, Cardiovascular and Metabolic Therapeutic Area, Amgen Inc., Thousand Oaks, CA
| | - Helina Kassahun
- Global Clinical Development, Cardiovascular and Metabolic Therapeutic Area, Amgen Inc., Thousand Oaks, CA
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Simakova MN, Bisen S, Dopico AM, Bukiya AN. Statin therapy exacerbates alcohol-induced constriction of cerebral arteries via modulation of ethanol-induced BK channel inhibition in vascular smooth muscle. Biochem Pharmacol 2017; 145:81-93. [PMID: 28865873 DOI: 10.1016/j.bcp.2017.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/28/2017] [Indexed: 12/26/2022]
Abstract
Statins constitute the most commonly prescribed drugs to decrease cholesterol (CLR). CLR is an important modulator of alcohol-induced cerebral artery constriction (AICAC). Using rats on a high CLR diet (2% CLR) we set to determine whether atorvastatin administration (10mg/kg daily for 18-23weeks) modified AICAC. Middle cerebral arteries were pressurized in vitro at 60mmHg and AICAC was evoked by 50mM ethanol, that is within the range of blood alcohol detected in humans following moderate-to-heavy drinking. AICAC was evident in high CLR+atorvastatin group but not in high CLR diet+placebo. Statin exacerbation of AICAC persisted in de-endothelialized arteries, and was blunted by CLR enrichment in vitro. Fluorescence imaging of filipin-stained arteries showed that atorvastatin decreased vascular smooth muscle (VSM) CLR when compared to placebo, this difference being reduced by CLR enrichment in vitro. Voltage- and calcium-gated potassium channels of large conductance (BK) are known VSM targets of ethanol, with their beta1 subunit being necessary for ethanol-induced channel inhibition and resulting AICAC. Ethanol-induced BK inhibition in excised membrane patches from freshly isolated myocytes was exacerbated in the high CLR diet+atorvastatin group when compared to high CLR diet+placebo. Unexpectedly, atorvastatin decreased the amount and function of BK beta1 subunit as documented by immunofluorescence imaging and functional patch-clamp studies. Atorvastatin exacerbation of ethanol-induced BK inhibition disappeared upon artery CLR enrichment in vitro. Our study demonstrates for the first time statin's ability to exacerbate the vascular effect of a widely consumed drug of abuse, this exacerbation being driven by statin modulation of ethanol-induced BK channel inhibition in the VSM via CLR-mediated mechanism.
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Affiliation(s)
- Maria N Simakova
- Dept. Pharmacology, University of Tennessee HSC, Memphis, TN 38103, United States
| | - Shivantika Bisen
- Dept. Pharmacology, University of Tennessee HSC, Memphis, TN 38103, United States
| | - Alex M Dopico
- Dept. Pharmacology, University of Tennessee HSC, Memphis, TN 38103, United States
| | - Anna N Bukiya
- Dept. Pharmacology, University of Tennessee HSC, Memphis, TN 38103, United States.
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Khan AR, Bavishi C, Riaz H, Farid TA, Khan S, Atlas M, Hirsch G, Ikram S, Bolli R. Increased Risk of Adverse Neurocognitive Outcomes With Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors. Circ Cardiovasc Qual Outcomes 2017; 10:CIRCOUTCOMES.116.003153. [DOI: 10.1161/circoutcomes.116.003153] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 10/26/2016] [Indexed: 01/16/2023]
Abstract
Background—
There is encouraging evidence of the efficacy of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors; however, their long-term safety remains unclear. We performed a meta-analysis of studies to evaluate the long-term safety of PCSK9 inhibitors.
Methods and Results—
Our search strategy yielded 11 studies (9 smaller early-phase and 2 larger outcome trials). The outcomes assessed were cumulative serious adverse events, musculoskeletal adverse events, neurocognitive adverse events, and stroke. Odds ratio (OR) was calculated using the Mantel–Haenszel method. Subgroup analysis was done to assess the difference in safety between the smaller early-phase studies and the larger outcome studies. Our meta-analysis suggested no difference in the incidence of serious adverse events (OR, 1.00; 95% confidence interval [CI], 0.88−1.15), musculoskeletal adverse events (OR, 1.01; 95% CI, 0.87−1.13), neurocognitive adverse events (OR, 1.29; 95% CI, 0.64−2.59), or stroke (OR, 1.44; 95% CI, 0.57−3.65) with the use of PCSK9 inhibitors. Subgroup analysis of the 2 large outcome studies did suggest an increased incidence of neurocognitive adverse events (OR, 2.85; 95% CI, 1.34−6.06) with the use of PCSK9 inhibitors. However, the overall incidence of neurocognitive adverse events and stroke was <1%, whereas the cumulative incidence of serious adverse events and musculoskeletal events was >10% in both the groups.
Conclusions—
Our analysis suggests that PCSK9 inhibitors are not associated with an increased risk of cumulative severe adverse effects, musculoskeletal effects, or stroke. There is a signal toward adverse neurocognitive effects, seen in the outcome studies with a larger sample size and longer follow-up. There should be close monitoring, for the increased risk of neurocognitive events in the ongoing outcome studies and post-marketing surveillance.
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Affiliation(s)
- Abdur Rahman Khan
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Chirag Bavishi
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Haris Riaz
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Talha A. Farid
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Sobia Khan
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Michel Atlas
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Glenn Hirsch
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Sohail Ikram
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
| | - Roberto Bolli
- From the Division of Cardiovascular Medicine (A.R.K., T.A.F., S.K., G.H., S.I., R.B.), Institute of Molecular Cardiology (A.R.K., T.A.F., R.B.), and Kornhauser Health Sciences Library (M.A.), University of Louisville, KY; Division of Cardiovascular Medicine, St Lukes Roosevelt Hospital, New York, NY (C.B.); and Department of Internal Medicine, Cleveland Clinic, OH (H.R.)
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Lea SR, Metcalfe HJ, Plumb J, Beerli C, Poll C, Singh D, Abbott-Banner KH. Neutral sphingomyelinase-2, acid sphingomyelinase, and ceramide levels in COPD patients compared to controls. Int J Chron Obstruct Pulmon Dis 2016; 11:2139-2147. [PMID: 27660431 PMCID: PMC5019168 DOI: 10.2147/copd.s95578] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Increased pulmonary ceramide levels are suggested to play a causative role in lung diseases including COPD. Neutral sphingomyelinase-2 (nSMase-2) and acid SMase (aSMase), which hydrolyze sphingomyelin to produce ceramide, are activated by a range of cellular stresses, including inflammatory cytokines and pathogens, but notably cigarette smoke appears to only activate nSMase-2. Our primary objective was to investigate nSMase-2 and aSMase protein localization and quantification in lung tissue from nonsmokers (NS), smokers (S), and COPD patients. In addition, various ceramide species (C16, C18, and C20) were measured in alveolar macrophages from COPD patients versus controls. MATERIALS AND METHODS Patients undergoing surgical resection for suspected or confirmed lung cancer were recruited, and nSMase-2 and aSMase protein was investigated in different areas of lung tissue (small airways, alveolar walls, subepithelium, and alveolar macrophages) by immunohistochemistry. Ceramide species were measured in alveolar macrophages from COPD patients and controls by mass spectrometry. RESULTS nSMase-2 and aSMase were detected in the majority of small airways. There was a significant increase in nSMase-2 immunoreactivity in alveolar macrophages from COPD patients (54%) compared with NS (31.7%) (P<0.05), and in aSMase immunoreactivity in COPD (68.2%) and S (69.5%) alveolar macrophages compared with NS (52.4%) (P<0.05). aSMase labeling was also increased in the subepithelium and alveolar walls of S compared with NS. Ceramide (C20) was significantly increased in alveolar macrophages from COPD patients compared with controls. CONCLUSION nSMase-2 and aSMase are both increased in COPD alveolar macrophages at the protein level; this may contribute toward the elevated ceramide (C20) detected in alveolar macrophages from COPD patients.
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Affiliation(s)
- Simon R Lea
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
| | - Hannah J Metcalfe
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
| | - Jonathan Plumb
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
| | | | - Chris Poll
- Respiratory Diseases, Novartis Institute for Biomedical Research, Horsham, West Sussex, UK
| | - Dave Singh
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK
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5
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Swiger KJ, Martin SS. PCSK9 Inhibitors and Neurocognitive Adverse Events: Exploring the FDA Directive and a Proposal for N-of-1 Trials. Drug Saf 2015; 38:519-26. [DOI: 10.1007/s40264-015-0296-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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6
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Mandas A, Mereu RM, Catte O, Saba A, Serchisu L, Costaggiu D, Peiretti E, Caminiti G, Vinci M, Casu M, Piludu S, Fossarello M, Manconi PE, Dessí S. Cognitive Impairment and Age-Related Vision Disorders: Their Possible Relationship and the Evaluation of the Use of Aspirin and Statins in a 65 Years-and-Over Sardinian Population. Front Aging Neurosci 2014; 6:309. [PMID: 25426067 PMCID: PMC4224124 DOI: 10.3389/fnagi.2014.00309] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 10/22/2014] [Indexed: 11/13/2022] Open
Abstract
Neurological disorders (Alzheimer’s disease, vascular and mixed dementia) and visual loss (cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy) are among the most common conditions that afflict people of at least 65 years of age. An increasing body of evidence is emerging, which demonstrates that memory and vision impairment are closely, significantly, and positively linked and that statins and aspirin may lessen the risk of developing age-related visual and neurological problems. However, clinical studies have produced contradictory results. Thus, the intent of the present study was to reliably establish whether a relationship exist between various types of dementia and age-related vision disorders, and to establish whether statins and aspirin may or may not have beneficial effects on these two types of disorders. We found that participants with dementia and/or vision problems were more likely to be depressed and displayed worse functional ability in basic and instrumental activities of daily living than controls. Mini mental state examination scores were significantly lower in patients with vision disorders compared to subjects without vision disorders. A closer association with macular degeneration was found in subjects with Alzheimer’s disease than in subjects without dementia or with vascular dementia, mixed dementia, or other types of age-related vision disorders. When we considered the associations between different types of dementia and vision disorders and the use of statins and aspirin, we found a significant positive association between Alzheimer’s disease and statins on their own or in combination with aspirin, indicating that these two drugs do not appear to reduce the risk of Alzheimer’s disease or improve its clinical evolution and may, on the contrary, favor its development. No significant association in statin use alone, aspirin use alone, or the combination of these was found in subjects without vision disorders but with dementia, and, similarly, none in subjects with vision disorders but without dementia. Overall, these results confirm the general impression so far; namely, that macular degeneration may contribute to cognitive disorders (Alzheimer’s disease in particular). In addition, they also suggest that, while statin and aspirin use may undoubtedly have some protective effects, they do not appear to be magic pills against the development of cognitive impairment or vision disorders in the elderly.
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Affiliation(s)
- Antonella Mandas
- Dipartimento di Scienze Mediche, Università degli Studi di Cagliari , Cagliari , Italy
| | - Rosa Maria Mereu
- Divisione Geriatria, Centro Alzheimer e disturbi della Memoria, P.O. SS. Trinità , Cagliari , Italy
| | - Olga Catte
- Divisione Geriatria, Centro Alzheimer e disturbi della Memoria, P.O. SS. Trinità , Cagliari , Italy
| | - Antonio Saba
- Divisione Geriatria, Centro Alzheimer e disturbi della Memoria, P.O. SS. Trinità , Cagliari , Italy
| | - Luca Serchisu
- Dipartimento di Scienze Mediche, Università degli Studi di Cagliari , Cagliari , Italy
| | - Diego Costaggiu
- Dipartimento di Scienze Mediche, Università degli Studi di Cagliari , Cagliari , Italy
| | - Enrico Peiretti
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Giulia Caminiti
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Michela Vinci
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Maura Casu
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Stefania Piludu
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Maurizio Fossarello
- Dipartimento di Scienze Chirurgiche e Odontoiatriche, Clinica Oculistica, Università degli Studi di Cagliari , Cagliari , Italy
| | - Paolo Emilio Manconi
- Dipartimento di Scienze Mediche, Università degli Studi di Cagliari , Cagliari , Italy
| | - Sandra Dessí
- Dipartimento di Scienze Mediche, Università degli Studi di Cagliari , Cagliari , Italy
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Goldstein MR, Mascitelli L. Regarding long-term statin therapy: are we trading stronger hearts for weaker brains? Med Hypotheses 2014; 83:346-51. [PMID: 24986644 DOI: 10.1016/j.mehy.2014.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/01/2014] [Accepted: 06/09/2014] [Indexed: 12/17/2022]
Abstract
Ideally, the benefits of long-term statin therapy should outweigh the risks in all populations. However, some data suggest that long-term statin therapy might promote cerebral small vessel disease and impair myelination, perhaps resulting from cholesterol depletion and pleiotropic effects on amyloid-β metabolism and oligodendrocyte function. The clinical ramifications can be problematic and have a negative impact on the quality of life. Questions are proposed and the answers should be found by analysis of randomized prospective trials specifically investigating the effects of statin therapy on brain structure and function. Those trials should not be funded by drug companies and the investigators should not have financial ties to the pharmaceutical industry. The relevance of the aforementioned is amplified in light of the new cardiovascular guidelines that might culminate in more than a billion people receiving statin therapy worldwide.
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Affiliation(s)
- Mark R Goldstein
- NCH Physician Group, 1845 Veterans Park Drive, Suite 110, Naples, FL 34109, USA.
| | - Luca Mascitelli
- Comando Brigata Alpina "Julia"/Multinational Land Force, Medical Service, 8 Via S. Agostino, Udine 33100, Italy.
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Stuart SA, Robertson JD, Marrion NV, Robinson ESJ. Chronic pravastatin but not atorvastatin treatment impairs cognitive function in two rodent models of learning and memory. PLoS One 2013; 8:e75467. [PMID: 24040413 PMCID: PMC3769269 DOI: 10.1371/journal.pone.0075467] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 08/16/2013] [Indexed: 11/21/2022] Open
Abstract
Statins are some of the most commonly prescribed drugs and are used to reduce blood cholesterol. Recent evidence suggests that, in some patients, they may adversely influence cognitive function including causing memory impairments. These clinical observations have led to statin prescriptions now including a warning about possible cognitive impairments. In order to better understand the relationship between statin treatment and cognitive function, studies in animals are needed. The present study investigated the effects of chronic treatment with two statins, pravastatin and atorvastatin, in two rodent models of learning and memory. Adult rats were treated once daily with pravastatin (10mg/kg, orally) or atorvostatin (10mg/kg, orally) for 18 days. Before, during and after treatment, animals were tested in a simple discrimination and reversal learning task. On the last day of treatment and following one week withdrawal, animals were also tested in a task of novel object discrimination. Pravastatin tended to impair learning over the last few days of treatment and this effect was fully reversed once treatment ceased. In the novel object discrimination task, pravastatin significantly impaired object recognition memory. No effects were observed for atorvostatin in either task. These data suggest that chronic treatment with pravastatin impairs working and recognition memory in rodents. The reversibility of the effects on cessation of treatment is similar to what has been observed in patients, but the lack of effect of atorvostatin suggests that lipophilicity may not be a major factor influencing statin-induced cognitive impairments.
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Affiliation(s)
- Sarah A. Stuart
- School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
| | - James D. Robertson
- School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
| | - Neil V. Marrion
- School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
| | - Emma S. J. Robinson
- School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
- * E-mail:
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9
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Leszczynska A, Burzynska B, Plochocka D, Kaminska J, Zimnicka M, Kania M, Kiliszek M, Wysocka-Kapcinska M, Danikiewicz W, Szkopinska A. Investigating the effects of statins on cellular lipid metabolism using a yeast expression system. PLoS One 2009; 4:e8499. [PMID: 20041128 PMCID: PMC2796174 DOI: 10.1371/journal.pone.0008499] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2009] [Accepted: 12/07/2009] [Indexed: 12/04/2022] Open
Abstract
In humans, defects in lipid metabolism are associated with a number of severe diseases such as atherosclerosis, obesity and type II diabetes. Hypercholesterolemia is a primary risk factor for coronary artery disease, the major cause of premature deaths in developed countries. Statins are inhibitors of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR), the key enzyme of the sterol synthesis pathway. Since yeast Saccharomyces cerevisiae harbours many counterparts of mammalian enzymes involved in lipid-synthesizing pathways, conclusions drawn from research with this single cell eukaryotic organism can be readily applied to higher eukaryotes. Using a yeast strain with deletions of both HMG1 and HMG2 genes (i.e. completely devoid of HMGR activity) with introduced wild-type or mutant form of human HMGR (hHMGR) gene we investigated the effects of statins on the lipid metabolism of the cell. The relative quantification of mRNA demonstrated a different effect of simvastatin on the expression of the wild-type and mutated hHMGR gene. GC/MS analyses showed a significant decrease of sterols and enhanced conversion of squalene and sterol precursors into ergosterol. This was accompanied by the mobilization of ergosterol precursors localized in lipid particles in the form of steryl esters visualized by confocal microscopy. Changes in the level of ergosterol and its precursors in cells treated with simvastatin depend on the mutation in the hHMGR gene. HPLC/MS analyses indicated a reduced level of phospholipids not connected with the mevalonic acid pathway. We detected two significant phenomena. First, cells treated with simvastatin develop an adaptive response compensating the lower activity of HMGR. This includes enhanced conversion of sterol precursors into ergosterol, mobilization of steryl esters and increased expression of the hHMGR gene. Second, statins cause a substantial drop in the level of glycerophospholipids.
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Affiliation(s)
- Agata Leszczynska
- Institute of Biochemistry and Biophysics PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Beata Burzynska
- Institute of Biochemistry and Biophysics PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Danuta Plochocka
- Institute of Biochemistry and Biophysics PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Joanna Kaminska
- Institute of Biochemistry and Biophysics PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Magdalena Zimnicka
- Institute of Organic Chemistry PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Magdalena Kania
- Institute of Organic Chemistry PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Marek Kiliszek
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Witold Danikiewicz
- Institute of Organic Chemistry PAS, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Szkopinska
- Institute of Biochemistry and Biophysics PAS, Polish Academy of Sciences, Warsaw, Poland
- * E-mail:
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Abstract
Dementia is becoming one of the biggest threats to human health. However, there is no efficient therapeutic approach so far. Thus, traditional medicines, which have accumulated certain experience in the treatment of dementia, are attracting more and more attention. Indeed, many anti-dementia drugs or drug candidates have been derived from these medicines. In this article, the profile of anti-dementia agents contained in traditional Chinese medicine (TCM) is described. It is indicated that TCM is not only a rich source of acetylcholinesterase inhibitors, but also of great potential to derive other kinds of anti-dementia agents which are either directly associated with ameliorating dementia or have complementary effects. These agents have apparent implications for anti-dementia drug discovery, especially for finding multicomponent anti-dementia drugs.
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Affiliation(s)
- Xue-Juan Li
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, Center for Advanced Study, Shandong University of Technology, Zibo 255049, P. R. China
| | - Hong-Yu Zhang
- Institute of Bioinformatics and State Key Laboratory of Crop Genetic Improvement, College of Life Science and Technology, Huazhong Agricultural University, Wuhan 430070, P R China
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11
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Renshaw PF, Parsegian A, Yang CK, Novero A, Yoon SJ, Lyoo IK, Cohen BM, Carlezon WA. Lovastatin potentiates the antidepressant efficacy of fluoxetine in rats. Pharmacol Biochem Behav 2008; 92:88-92. [PMID: 19026674 DOI: 10.1016/j.pbb.2008.10.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 10/23/2008] [Accepted: 10/24/2008] [Indexed: 01/22/2023]
Abstract
BACKGROUND Cholesterol may have a role in the pathophysiology of depression. Lowering cholesterol levels with statins reduces risks for cardiovascular events, and there is clinical evidence that statins exert neuroprotective properties not fully explained by their effects on serum cholesterol levels. Altered cholesterol levels can affect serotonergic neurotransmission, which might be involved in the clinical efficacy of standard antidepressants. METHODS We examined interactions between a statin (lovastatin) and a selective serotonin reuptake inhibitor (fluoxetine) using the forced swim test (FST) in rats, a behavioral assay that identifies treatments with antidepressant effects in humans. Specifically, we determined if the addition of lovastatin to the diet would increase the efficacy of a subeffective dose of fluoxetine. RESULTS Rats maintained on a lovastatin-enriched diet for 30 days were more sensitive to the antidepressant-like effects of a low (subthreshold) dose of fluoxetine. The behavior of rats treated with this combination resembled that normally seen with higher doses of fluoxetine. No effects were observed in rats maintained on a lovastatin-enriched diet for 3 days. CONCLUSIONS Lovastatin can augment the antidepressant-like effects of a low dose of fluoxetine in rats, raising the possibility that statins could be used to facilitate the effects of antidepressants in humans.
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Affiliation(s)
- Perry F Renshaw
- Department of Psychiatry, Harvard Medical School, Belmont, MA 02478, USA.
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Baytan SH, Alkanat M, Okuyan M, Ekinci M, Gedikli E, Ozeren M, Akgun A. Simvastatin Impairs Spatial Memory in Rats at a Specific Dose Level. TOHOKU J EXP MED 2008; 214:341-9. [DOI: 10.1620/tjem.214.341] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Sukrucan H. Baytan
- Department of Physiology, Medical School, Karadeniz Technical University
| | - Mehmet Alkanat
- Department of Physiology, Medical School, Karadeniz Technical University
| | - Mukadder Okuyan
- Department of Physiology, Medical School, Karadeniz Technical University
| | - Murat Ekinci
- Department of Computer Engineering, Engineering School, Karadeniz Technical University
| | - Eyup Gedikli
- Department of Computer Engineering, Engineering School, Karadeniz Technical University
| | - Mehmet Ozeren
- Department of Obstetrics and Gynecology, Medical School, Karadeniz Technical University
| | - Ahmet Akgun
- Department of Physiology, Medical School, Karadeniz Technical University
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13
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Baytan SH, Alkanat M, Ozeren M, Ekinci M, Akgun A. Fluvastatin Alters Psychomotor Performance and Daily Activity but not the Spatial Memory in Rats. TOHOKU J EXP MED 2006; 209:311-20. [PMID: 16864953 DOI: 10.1620/tjem.209.311] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Statins, inhibitors of cholesterol synthesis for treating dyslipidemia and preventing cardiovascular complications, have been shown to alter central nervous system functions. Our aim was to investigate the effects of the fluvastatin, a member of statin family, on psychomotor performance, daily activity and spatial memory. Sprague-Dawley rats were treated with fluvastatin (n = 8) or placebo as a control (n = 11) regardless of sex. Fluvastatin (7.5 mg/kg) was administered orally once a day for four weeks, while the control group was administered only placebo. Psychomotor performance was measured by rotarod tests. No significant difference was observed in the fluvastatin group over the course of weeks, but the control group preferred to stay on the device shorter times (p < 0.05). For the first three weeks of the drug administration there was a statistical difference between the groups, however no difference was found after the 4th week. There was no difference in the Barnes maze spatial memory test between the groups and also within the groups over the course of time. Daily activity tests revealed that stereotypical and vertical movements of the fluvastatin group were significantly less than the control group in all four weeks. Ambulatory movements and the distances taken by the fluvastatin group were decreased significantly over the course of time (p < 0.005 and p < 0.001, respectively), but the control group did not reveal any significant change. Our results suggest that fluvastatin altered psychomotor performance and daily activity in rats, but it did not affect the spatial memory. These behavioral changes might be associated with alterations in the composition of the brain lipids caused by fluvastatin.
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Affiliation(s)
- Sukrucan H Baytan
- Department of Physiology, Karadeniz Technical University, Medical School, Trabzon, Turkey.
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Miesbach W, Chapman J, Scharrer I. Focal seizures after treatment with fluvastatin in a patient with a history of catastrophic antiphospholipid syndrome. J Neurol Sci 2005; 238:93-5. [PMID: 16111706 DOI: 10.1016/j.jns.2005.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2005] [Revised: 06/10/2005] [Accepted: 06/13/2005] [Indexed: 11/25/2022]
Abstract
We report a 36-year-old woman with the occurrence of painful focal seizures of her left hand and the left leg. She also had focal motor seizures at the left corner of her mouth. The duration and frequency of the episodes increased over four days from a few seconds once a day to frequent intervals lasting more than four hours at a time. The symptoms appeared one day after start of the treatment with fluvastatin (40 mg) administered in order to diminish the endothelial activation induced by antiphospholipid antibodies (aPL). The patient suffered from severe manifestations of the antiphospholipid syndrome (APS) including Catastrophic Antiphospholipid Syndrome (CAPS, Asherson's syndrome). In this case a single 40 mg dose of oral fluvastatin was linked to seizures. After discontinuation of this treatment, the seizures immediately disappeared and the patient fully recovered without evidence of permanent neurological damage. This data links statins to seizures in patients with compromised blood brain barrier such as APS.
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Affiliation(s)
- Wolfgang Miesbach
- Department of Internal Medicine III, University Hospital, Johann Wolfgang Goethe-University, Theodor-Stern Kai 7, 60590 Frankfurt/Main, Germany.
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