A Rapidly Progressive Case of Statin-induced Necrotizing Autoimmune Myopathy

Unveiling the Enigma of Statin-Induced Necrotizing Autoimmune Myopathy: A Comprehensive Case Analysis and Pathogenic Insights

Statins are widely prescribed to patients for their efficiency in cholesterol management. However, they carry the risk of inducing a relatively rare, serious, and potentially life-threatening condition known as statin-induced necrotizing autoimmune myopathy (SINAM). This case report provides an in-depth analysis of SINAM, focusing on its epidemiology, clinical presentation, and the challenges involved in accurate diagnosis. In addition, we review evolving theories addressing its pathogenesis and current therapeutic approaches. This report identifies the need for early diagnosis and intervention and recommends a multidisciplinary approach to optimize patient outcomes. This article also highlights the need for further research studies to enhance our understanding of SINAM and its management.

Construction of Escherichia coli Whole-Cell Biosensors for Statin Efficacy and Production Test

Statins are widely used cholesterol-lowering drugs. Their potential application in anti-cancer treatment is also under investigation. The individual variance in statin response has been observed, which may be caused by the variation in human HMG-CoA reductase (hHMGR)—the inhibition target of statin drugs. Herein, we reported the design and construction of two Escherichia coli whole-cell biosensors. The first one is statin-efficacy testing sensor, which is composed of two separate modules: a hybrid mevalonate (MVA) pathway and a HMG-CoA sensing system. A truncated hHMGR was used as the key enzyme of the MVA pathway and a promiscuous transcription factor (TF) BsFapR was used as the HMG-CoA sensor. When hHMGR was inhibited by statins, HMG-CoA accumulated intracellularly and was sensed by BsFapR, which subsequently turned on its cognate promoter. This biosensor has the potential to be used as a “precision medicine” tool—selecting potent statin drugs for individual patients. The second one is a statin-production testing sensor, which is based on another promiscuous TF AraCM that can sense statins. This biosensor can be used in optimization of statin-producing strains. The prototypes of these two biosensors were successfully constructed and their further optimization is highly expected.