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Ren Z, Zhou L. Association of statin use with osteoporosis risk: a drug-targeted Mendelian randomization study. Inflammopharmacology 2024; 32:1253-1261. [PMID: 38363475 DOI: 10.1007/s10787-024-01441-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 01/20/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Hypercholesterolemia and the related inflammatory response promote the development of osteoporosis, but whether targeted interventions are protective against this bone metabolic disease remains unknown. The aim of this study was to investigate the association between the use of statins (one well-recognized cholesterol-lowering drug with anti-inflammatory properties) and the risk of osteoporosis using a drug-targeted Mendelian randomization (MR) approach. METHODS Instrumental variables predicting three cholesterol-lowering target genes (including HGMCR) and the cholesterol effectors mediated by these genes (i.e., total cholesterol, LDL cholesterol, and non-HDL cholesterol) were extracted from expression quantitative trait loci and genome-wide association studies. Inverse variance-weighted (IVW), summary data-based MR (SMR), multivariate MR, and colocalization analysis were used to determine the association of the interventions represented by these instrumental variables with heel bone mineral density (one diagnostic indicator of osteoporosis). RESULTS The IVW reported that increased levels of HGMCR-mediated total cholesterol, LDL cholesterol, and non-HDL cholesterol were associated with the decreased level of heel bone mineral density (P = 4.086e-10, P = 1.487e-09, P = 1.967e-09). The colocalization analysis supported the relationship between HGMCR-mediated non-HDL cholesterol and heel bone mineral density. The SMR reported that higher expression of HGMCR was associated with the decreased level of this osteoporosis indicator (P = 0.036). The multivariate MR further confirmed the role of HGMCR in the correlation between cholesterol traits and heel bone mineral density, and also reported that estrogen played a mediating role in the above correlations. CONCLUSION These evidence supported a protective effect of HMGCR-mediated non-HDL cholesterol reduction or statin use against osteoporosis.
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Affiliation(s)
- Zhaozhou Ren
- Department of Orthopedics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning Province, China
| | - Long Zhou
- Department of Orthopedics, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, Liaoning Province, China.
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2
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Belk MG, Ku PM, George DL, Hobbs ALV. Rhabdomyolysis Suspected to be Caused by Eravacycline Therapy: A Case Report. J Pharm Pract 2024; 37:239-242. [PMID: 36656727 DOI: 10.1177/08971900221117872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Eravacycline is approved by the U.S. Food and Drug Administration (FDA) for the treatment of complicated intra-abdominal infections. It is a novel, fully synthetic fluorocycline antibiotic belonging to the tetracycline class with a broad-spectrum of activity and an appealing side effect profile. This report describes a 74-year-old female who presented to the hospital with non-ST-elevation myocardial infarction (NSTEMI) requiring coronary artery bypass graft surgery. After surgery, she developed a sternal wound infection that grew multidrug resistant organisms, leading to a much longer than anticipated hospital stay. Eravacycline was eventually added to the antimicrobial regimen for the persistent infection. Shortly after therapy with eravacycline began, the patient started experiencing muscle pain and the creatine phosphokinase (CPK) level was noted to be elevated. Other causes, such as concomitant administration of an HMG-CoA reductase inhibitor, were explored in this case but not thought to be the cause of rhabdomyolysis. The patient's CPK dropped considerably upon discontinuation of the novel antibiotic, and symptoms resolved. The adverse drug event was reported to the drug manufacturer; however, there are no reports up until this time that address a possible relationship between eravacycline administration and the development of rhabdomyolysis.
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Affiliation(s)
- Madeline G Belk
- Department of Pharmacy, Huntsville Hospital, Huntsville, AL, USA
| | - Pam M Ku
- Department of Pharmacy, Augusta University Medical Center, Augusta, GA, USA
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3
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Dépreux F, Czech L, Young H, Richter CP, Zhou Y, Whitlon DS. Statins protect mice from high-decibel noise-induced hearing loss. Biomed Pharmacother 2023; 163:114674. [PMID: 37435721 DOI: 10.1016/j.biopha.2023.114674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/01/2023] [Accepted: 04/06/2023] [Indexed: 07/13/2023] Open
Abstract
No medical interventions for noise induced hearing loss (NIHL) are approved by the Food and Drug Administration (USA). Here, we evaluate statins in CBA/CaJ mice as potential drugs for hearing loss. Direct delivery of fluvastatin to the cochlea and oral delivery of lovastatin were evaluated. Baseline hearing was assessed using Auditory Brain Stem Responses (ABRs). For fluvastatin, a cochleostomy was surgically created in the basal turn of the cochlea by a novel, laser-based procedure, through which a catheter attached to a mini-osmotic pump was inserted. The pump was filled with a solution of 50 µM fluvastatin+carrier or with the carrier alone for continuous delivery to the cochlea. Mice were exposed to one octave band noise (8-16 kHz x 2 h x 110 dB SPL). In our past work with guinea pigs, fluvastatin protected in the contralateral cochlea. In this study in CBA/CaJ mice, hearing was also assessed in the contralateral cochlea 1-4 weeks after noise exposure. At two weeks post exposure, ABR thresholds at 4, 8, 12, 16, and 32 kHz were elevated, as expected, in the noise+carrier alone treated mice by approximately 9-, 17-, 41-, 29-, and 34-dB, respectively. Threshold elevations were smaller in mice treated with noise+fluvastatin to about 2-, 6-, 20-,12- and 12-dB respectively. Survival of inner hair cell synapses were not protected by fluvastatin over these frequencies. Lovastatin delivered by gavage showed lower threshold shifts than with carrier alone. These data show that direct and oral statin delivery protects mice against NIHL.
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Affiliation(s)
- Frédéric Dépreux
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Lyubov Czech
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Hunter Young
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Claus-Peter Richter
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; Knowles Hearing Center, Northwestern University, Chicago, IL 60208, USA; Department of Biomedical Engineering, Northwestern University, Chicago, IL 60208, USA
| | - Yingjie Zhou
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Donna S Whitlon
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; Knowles Hearing Center, Northwestern University, Chicago, IL 60208, USA; Northwestern University Interdepartmental Neurosciences Program, Chicago, IL 60611, USA.
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4
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Dolivo DM, Reed CR, Gargiulo KA, Rodrigues AE, Galiano RD, Mustoe TA, Hong SJ. Anti-fibrotic effects of statin drugs: a review of evidence and mechanisms. Biochem Pharmacol 2023:115644. [PMID: 37321414 DOI: 10.1016/j.bcp.2023.115644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/17/2023]
Abstract
Fibrosis is a pathological repair process common among organs, that responds to damage by replacement of tissue with non-functional connective tissue. Despite the widespread prevalence of tissue fibrosis, manifesting in numerous disease states across myriad organs, therapeutic modalities to prevent or alleviate fibrosis are severely lacking in quantity and efficacy. Alongside development of new drugs, repurposing of existing drugs may be a complementary strategy to elect anti-fibrotic compounds for pharmacologic treatment of tissue fibrosis. Drug repurposing can provide key advantages to de novo drug discovery, harnessing the benefits of previously elucidated mechanisms of action and already existing pharmacokinetic profiles. One class of drugs a wealth of clinical data and extensively studied safety profiles is the statins, a class of antilipidemic drugs widely prescribed for hypercholesterolemia. In addition to these widely utilized lipid-lowering effects, increasing data from cellular, pre-clinical mammalian, and clinical human studies have also demonstrated that statins are able to alleviate tissue fibrosis originating from a variety of pathological insults via lesser-studied, pleiotropic effects of these drugs. Here we review literature demonstrating evidence for direct effects of statins antagonistic to fibrosis, as well as much of the available mechanistic data underlying these effects. A more complete understanding of the anti-fibrotic effects of statins may enable a clearer picture of their anti-fibrotic potential for various clinical indications. Additionally, more lucid comprehension of the mechanisms by which statins exert anti-fibrotic effects may aid in development of novel therapeutic agents that target similar pathways but with greater specificity or efficacy.
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Affiliation(s)
- David M Dolivo
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States.
| | - Charlotte R Reed
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Kristine A Gargiulo
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Adrian E Rodrigues
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Robert D Galiano
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Thomas A Mustoe
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States
| | - Seok Jong Hong
- Department of Surgery-Northwestern University Feinberg School of Medicine, United States.
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5
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Park SK, Lee JH, Hwang HS, Kim HS, Han KD, Na KS. Association of Meibomian Gland Dysfunction with Oral Statin Use. J Clin Med 2022; 11:jcm11154632. [PMID: 35956248 PMCID: PMC9369571 DOI: 10.3390/jcm11154632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 11/22/2022] Open
Abstract
This retrospective cross-sectional study aimed to determine the association of oral statin use, dry eye disease (DED), and meibomian gland dysfunction (MGD). A total of 93 subjects were included and divided into two groups: statin users (n = 45) and nonstatin users (n = 47). Significant differences were observed in the total cholesterol (p = 0.013), low-density lipoprotein (LDL) (p = 0.005), and meiboscore (p = 0.000) levels between the two groups. For stratified analysis, the statin group was divided into subgroups according to the type or dose of statin and total duration of statin use. However, there were no differences in clinical features between the subgroups. In multiple regression analysis, meiboscore was significantly associated with age (slope = 0.05, p = 0.00) and statin use (slope = −1.19, p = 0.00), with an R2 of 0.44. Thus, older adults and participants who do not use statin appeared to have higher scores. In conclusion, although the mechanism is unclear, statins may exert a protective effect on the meibomian gland. Further lipidomic studies are required to determine the pharmacological effects of statins on the meibomian gland and other meibum components.
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Affiliation(s)
- Sun-Kyoung Park
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Ji-Hye Lee
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Ho-Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 03080, Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
- Correspondence: ; Tel.: +82-2-2258-1188; Fax: +82-2-590-1693
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Navia KL, Anthony BK, Berlau DJ. A case for continuing statin medications in the intensive care unit: Reducing the risk for delirium. Am J Health Syst Pharm 2022; 79:1431-1437. [PMID: 35526279 DOI: 10.1093/ajhp/zxac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE The objective of this review is to detail the utility of statin medications in the prevention and treatment of intensive care unit (ICU) delirium. SUMMARY Delirium is a syndrome characterized by altered mental status, inattention, and disorganized thinking. It is particularly concerning in the ICU where specific risk factors are much more prevalent. Nonpharmacological therapy is the mainstay of treatment, aimed at increasing patient awareness; pharmacological therapies have also been explored with varying success. The utility of statin medications in this scenario has been investigated because of the numerous pleiotropic effects of these drugs. Although the benefits in terms of treating delirium are uncertain, statins may be good candidates for prevention. The peak anti-inflammatory effect of statins is delayed, so initiating a statin on admission will likely have little protective benefit, whereas continuation of a home regimen seems more likely to exert an effect. CONCLUSION Statin medications are very commonly used, and, while their role in treating delirium is unclear, continuation of these medications from a home regimen is reasonable to decrease the odds of delirium in the intensive care population.
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Affiliation(s)
- Kyra L Navia
- Regis University School of Pharmacy, Denver, CO, USA
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Dehghankelishadi P, Maritz MF, Dmochowska N, Badiee P, Cheah E, Kempson I, Berbeco RI, Thierry B. Formulation of simvastatin within high density lipoprotein enables potent tumour radiosensitisation. J Control Release 2022; 346:98-109. [PMID: 35447296 DOI: 10.1016/j.jconrel.2022.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 10/18/2022]
Abstract
Preclinical, clinical and epidemiologic studies have established the potent anticancer and radiosensitisation effects of HMG-CoA reductase inhibitors (statins). However, the low bioavailability of oral statin formulations is a key barrier to achieving effective doses within tumour. To address this issue and ascertain the radiosensitisation potential of simvastatin, we developed a parenteral high density lipoprotein nanoparticle (HDL NP) formulation of this commonly used statin. A scalable method for the preparation of the simvastatin-HDL NPs was developed using a 3D printed microfluidic mixer. This enables the production of litre scale amounts of particles with minimal batch to batch variation. Simvastatin-HDL NPs enhanced the radiobiological response in 2D/3D head and neck squamous cell carcinoma (HNSCC) in vitro models. The simvastatin-HDL NPs radiosensitisation was comparable to that of 10 and 5 times higher doses of free drug in 2D and 3D cultures, respectively, which could be partially explained by more efficient cellular uptake of the statin in the nanoformulation as well as by the inherent biological activity of the HDL NPs on the cholesterol pathway. The radiosensitising potency of the simvastatin-HDL nanoformulation was validated in an immunocompetent MOC-1 HNSCC tumour bearing mouse model. This data supports the rationale of repurposing statins through reformulation within HDL NPs. Statins are safe and readily available molecules including as generic, and their use as radiosensitisers could lead to much needed effective and affordable approaches to improve treatment of solid tumours.
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Affiliation(s)
- Pouya Dehghankelishadi
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia; UniSA Clinical and Health Sciences, University of South Australia, City West Campus, Adelaide, SA 5000, Australia
| | - Michelle F Maritz
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia
| | - Nicole Dmochowska
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia
| | - Parisa Badiee
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia; UniSA Clinical and Health Sciences, University of South Australia, City West Campus, Adelaide, SA 5000, Australia
| | - Edward Cheah
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia; UniSA Clinical and Health Sciences, University of South Australia, City West Campus, Adelaide, SA 5000, Australia
| | - Ivan Kempson
- Future Industries Institute, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia
| | - Ross I Berbeco
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Benjamin Thierry
- Future Industries Institute and ARC Centre of Excellence Convergent Bio-Nano Science and Technology, University of South Australia, Mawson Lakes Campus, Adelaide, SA 5095, Australia.
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Sim Y, Lim C, Phyu N, Tan KTB, Chew LST, Wong CY, Madhukumar P, Yong WS, Lim SZ, Hamzah JLB, Tan SY, Chay WY, Wong FY, Tan PH, Tan VKM. The Impact of Statin Use and Breast Cancer Recurrence - A Retrospective Study in Singapore. Front Oncol 2022; 12:835320. [PMID: 35433431 PMCID: PMC9008885 DOI: 10.3389/fonc.2022.835320] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Statins, HMG-CoA reductase inhibitors, are commonly used cholesterol-lowering medications which are also increasingly recognized to have anti-cancer properties for various cancers, including breast cancer. Most clinical evidence supports a protective effect of statin on reducing breast cancer recurrence, particularly in hormone-receptor positive breast cancers.This study seeks to study the impact of statin use on breast cancer recurrence in an Asian population. Methods This is a retrospective study of patients diagnosed with breast cancer at the National Cancer Centre and Singapore General Hospital from 2005-2015. Statin use was defined as use after surgery. Associations between statin use, breast cancer recurrence and overall survival were estimated using Cox proportional hazards regression with adjustment for age, TNM stage, grade, ER/HER2 status, and co-morbidities. Associations between statin-use and disease-specific survival were estimated using competing risks regression. Results A total of 7858 females with breast cancer were studied, 1353(17.2%) were statin users, 6505(82.8%) were non-statin users, with a median follow-up of 8.67 years. Distribution of cancer stage, histology, molecular subtypes and grades were similar in both groups. Estrogen receptor(ER) positive (HR 0.57,95%CI 0.43-0.76,p<0.001) and HER2 negative (HR 0.74,95%CI 0.57-0.96,p=0.026) invasive cancers had a lower risk of recurrence in statin users. Statin users trended towards a long term recurrence-risk reduction (all subtypes,HR 0.48,p=0.002; ER-, HR 0.34,p=0.036; HER2+,HR 0.10,p=0.002). The risk-reduction benefit is not appreciated in statin users with DCIS, possibly due to small recurrence event numbers. Disease-specific survival benefit was seen in statin users with ER+ cancers (adjusted SHR 0.71,95%CI 0.53-0.96,p=0.027), especially ER+ invasive cancers (adjusted SHR 0.72, 95%CI 0.53-0.97,p=0.028), but with no statistically significant benefit in overall survival for statin users (all subtypes). Conclusion This is the first known retrospective study on the effect of statin use and breast cancer recurrence in an Asian population. Similar to previous international studies, statin use is associated with a risk reduction in breast cancer recurrence. This is especially beneficial in patients who have ER+ and HER2- invasive breast cancer. Statin use is also associated with a reduced risk of breast cancer recurrence in all subtypes of breast cancer in the long term (>6 years post diagnosis).
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Affiliation(s)
- Yirong Sim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Cindy Lim
- Clinical Trials and Epidemiological Sciences (CTE), National Cancer Centre Singapore, Singapore, Singapore
| | - Nitar Phyu
- Department of Cancer Informatics, National Cancer Centre Singapore, Singapore, Singapore
| | - Kiat Tee Benita Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore.,Department of General Surgery, Sengkang General Hospital, Singapore, Singapore
| | - Lita Sui Tjien Chew
- Department of Pharmacy, National Cancer Center Singapore, Singapore, Singapore
| | - Chow Yin Wong
- Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Preetha Madhukumar
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Wei Sean Yong
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Sue Zann Lim
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Julie Liana Bte Hamzah
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Si Ying Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
| | - Wen Yee Chay
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Fuh Yong Wong
- Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Veronique Kiak-Mien Tan
- Department of Breast Surgery, Division of Surgery and Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore.,Department of Breast Surgery, Singapore General Hospital, Singapore, Singapore.,SingHealth Duke-National University of Singapore (NUS) Breast Centre, Singapore, Singapore
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Xu P, Zhao Y, Yu T, Yu Y, Ni X, Wang H, Sun L, Han P, Wang L, Sun T, Liu X, Zhou H, Peng J, Hou M, Hou Y, Xu M. Atorvastatin restores imbalance of cluster of differentiation 4 (CD4) + T cells in immune thrombocytopenia in vivo and in vitro. Br J Haematol 2021; 201:530-541. [PMID: 34825359 DOI: 10.1111/bjh.17938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/25/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
Immune thrombocytopenia (ITP) is an autoimmune haemorrhagic disease, in which the overactivation of T cells is crucial in the pathogenesis. Atorvastatin (AT), a lipid-lowering medicine, has shown promising immunomodulatory effects in certain inflammatory conditions. However, the immunoregulatory role of AT in ITP remains elusive. To investigate the effect of AT in the treatment of ITP, cluster of differentiation 4 (CD4)+ T cells were isolated from patients with ITP and cultured with different dosages of AT. We found that AT significantly inhibited cell proliferation, led to cell cycle arrest, induced apoptosis, and repressed the activation of CD4+ T cells in vitro. ITP murine models were then established, and results showed that AT treatment led to faster recovery of the platelet count to normal and exhibited comparable immunomodulatory function. Furthermore, we found the phosphorylation of mammalian target of rapamycin (mTOR), protein kinase B (AKT) and extracellular signal-regulated kinase (ERK), as well as activation of rat sarcoma virus (RAS) were all reduced dramatically after AT treatment in vitro. In conclusion, our present study demonstrated that AT could reinstate the functions of CD4+ T cells by inhibiting the excessive activation, proliferation, and survival of CD4+ T cells in ITP via the RAS/mitogen-activated protein kinase kinase (MEK)/ERK and the mTOR/phosphatidylinositol-3 kinase (PI3K)/AKT pathway. Therefore, we propose that AT could be used as a potential therapeutic option for ITP by restoring the over-activated cellular immunity.
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Affiliation(s)
- Pengcheng Xu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yajing Zhao
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tianshu Yu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yafei Yu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaofei Ni
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Haoyi Wang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lu Sun
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Panpan Han
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lingjun Wang
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tao Sun
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xinguang Liu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hai Zhou
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jun Peng
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Provincial Key Laboratory of Immunohematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ming Hou
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Provincial Key Laboratory of Immunohematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- Leading Research Group of Scientific Innovation, Department of Science and Technology of Shandong Province, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yu Hou
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Miao Xu
- Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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10
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Kim KJ, Choi J, Kim JY, Bae JH, Kim KJ, Kim HY, Yoo HJ, Seo JA, Kim NH, Choi KM, Baik SH, Kim SG, Kim NH. Statin Therapy and the Risk of Osteoporotic Fractures in Patients with Metabolic Syndrome: a Nested Case-Control Study. J Lipid Atheroscler 2021; 10:322-333. [PMID: 34621703 PMCID: PMC8473960 DOI: 10.12997/jla.2021.10.3.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/07/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE We aimed to investigate the association between statin use and the risk of major osteoporotic fractures in patients with metabolic syndrome (MetS). METHODS A nested case-control study was performed in patients with MetS (≥50 years) who had no history of osteoporotic fracture using the Korean National Health Insurance Service-Health Screening Cohort. This study included 17,041 patients diagnosed with new-onset osteoporotic fractures and controls matched in a 1:1 ratio by age, sex, body mass index, cohort entry date, and follow-up duration. Conditional logistic regression analysis was used to evaluate covariate-adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS During a 4-year follow-up period, the risk of major osteoporotic fractures was significantly reduced by 9% (OR, 0.91; 95% CI, 0.85-0.97) in statin users compared with that in non-users. Among subtypes of major osteoporotic fracture, a risk reduction with statin therapy was significant for vertebral fracture (OR, 0.86; 95% CI, 0.79-0.94) but not for non-vertebral fracture (OR, 0.97; 95% CI, 0.88-1.06). Longer duration (OR, 0.97; 95% CI, 0.96-0.99, per 1-year increase) and higher cumulative dose (OR, 0.97; 95% CI, 0.95-0.99, per 365 defined daily doses) of statins were negatively associated with the risk of major osteoporotic fracture. CONCLUSION This study supports the hypothesis that statin therapy has a beneficial effect on major osteoporotic fractures, especially vertebral fractures, in patients with MetS.
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Affiliation(s)
- Kyoung Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jimi Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Ji Yoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Bae
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hee Young Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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11
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Kaplan DE, Mehta R, Garcia-Tsao G, Albrecht J, Aytaman A, Baffy G, Bajaj J, Hernaez R, Hunt K, Ioannou G, Johnson K, Kanwal F, Lee TH, Monto A, Pandya P, Schaubel D, Taddei TH. SACRED: Effect of simvastatin on hepatic decompensation and death in subjects with high-risk compensated cirrhosis: Statins and Cirrhosis: Reducing Events of Decompensation. Contemp Clin Trials 2021; 104:106367. [PMID: 33771685 DOI: 10.1016/j.cct.2021.106367] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/21/2021] [Accepted: 03/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND/AIMS The development of decompensation in cirrhosis demarcates a marked change in the natural history of chronic liver disease. HMG-CoA reductase inhibitors (statins) exert pleiotropic effects that reduce inflammation and fibrosis as well as improve vascular reactivity. Retrospective studies uniformly have associated statin utilization with improved outcomes for patients with cirrhosis. Prospective human studies have shown that statins reduce portal hypertension and reduce death in patients with decompensated cirrhosis after variceal hemorrhage when added to standard therapy with an acceptable safety profile. This proposal aims to extend these findings to demonstrate that simvastatin reduces incident hepatic decompensation events among cirrhotic patients at high risk for hepatic decompensation. METHODS We will perform the SACRED Trial (NCT03654053), a phase III, prospective, multi-center, double-blind, randomized clinical trial at 11 VA Medical Centers. Patients with compensated cirrhosis with clinically significant portal hypertension will be stratified based upon the concomitant use of nonselective beta-blockers and randomized to simvastatin 40 mg/day versus placebo for up to 24 months. Patients will be observed for the development of hepatic decompensation (variceal hemorrhage, ascites, encephalopathy), hepatocellular carcinoma, liver-related death, death from any cause, and/or complications of statin therapy. Ancillary studies will evaluate patient-reported outcomes and pharmacogenetic corollaries of safety and/or efficacy. CONCLUSION Statins have a long track-record of safety and tolerability. This class of medications is generic and inexpensive, and thus, if the hypothesis is proven, there will be few barriers to widespread acceptance of the role of statins to prevent decompensation in patients with compensated cirrhosis. ClinicalTrials.gov Identifier: NCT03654053.
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12
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Greco S, D'Amuri A, Giorgini E, Luciani F, Lopreiato M, Fortunato V, Scopa A, Vestita G, Capatti E, Passaro A. Role of Statins in Coronavirus-Related Disease (COVID-19): A Retrospective Cohort Study in Northern Italy. High Blood Press Cardiovasc Prev 2021; 28:355-364. [PMID: 33905094 PMCID: PMC8077187 DOI: 10.1007/s40292-021-00452-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/12/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction The outbreak by SARS-CoV-2 has rapidly spread worldwide. The need for specific treatments to adequately stop the inflammatory response and its sequelae is day by day more urgent and many therapeutic strategies were performed since COVID-19 burst in the last months. Statins were thought to be effective against this novel coronavirus for their anti-inflammatory properties, even if the real effects on COVID patients are still partially unexplored. Methods We retrospectively evaluated 501 adult patients, consecutively admitted to the two COVID-hospitals of Ferrara’s territory, and divided them into two groups: ST = patients on statin therapy on admission and NST=patients not on statin therapy on admission. We searched for differences between groups in terms of anamnestic, clinical and laboratory data and then in terms of COVID-19 outcomes. Results We found significant differences between groups in terms of age, comorbidities, procalcitonin and CPK serum levels: ST patients were older, more comorbid, with lower procalcitonin and higher CPK serum levels. Male sex was, together with the Charlson Comorbidity Index, an independent predictor of needing intensification of care, while age only was a good predictor of in-hospital and 100-day mortality. Differences were also found in the survival functions between the two groups. Conclusions After a period of observation of 100 days, ST patients, despite their older age and their greater load of comorbidities, have similar survival functions to NST patients. If adjusted for age and CCI the survival functions of ST group are considerably more favourable than those of the second group. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-021-00452-y.
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Affiliation(s)
- Salvatore Greco
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Andrea D'Amuri
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Enrico Giorgini
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Francesco Luciani
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Mariarosaria Lopreiato
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Valeria Fortunato
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Alessandro Scopa
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Grazia Vestita
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy
| | - Eleonora Capatti
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Via Aldo Moro, 8 Cona, 44124, Ferrara, Italy
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara, Via Luigi Borsari, 46, 44121, Ferrara, Italy.
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Via Aldo Moro, 8 Cona, 44124, Ferrara, Italy.
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13
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Su VYF, Pan SW, Yen YF, Feng JY, Su WJ, Chen YM. Statin use and impact on tuberculosis risk. Expert Rev Anti Infect Ther 2021; 19:1093-1098. [PMID: 33641582 DOI: 10.1080/14787210.2021.1892488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Tuberculosis, a chronic infection caused by Mycobacterium tuberculosis (MTB), is one of the 10 leading causes of death in the world. The current treatment is a combination antimicrobial therapy administered for 6-9 months. It is important to find therapeutic strategy to shorten the treatment during and strengthen the host immune response against MTB.Areas covered: There is evidence that MTB uses cholesterol in the host macrophage to infect and survive inside the host macrophage. Statins inhibit the synthesis of cholesterol and aid in reducing the levels of cholesterol in human, which have been associated with better outcome in infectious diseases. In this narrative review, we discuss recent studies that investigated the effects of statins on the prevention or treatment of TB infection.Expert opinion: The evaluation of the published evidence suggests that statins may be beneficial in the treatment of patients with TB infections. Future studies may focus not only on the beneficial effects of statins, but also on distinguishing the effects of different statins.
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Affiliation(s)
- Vincent Yi-Fong Su
- Department of Internal Medicine, Taipei City Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Sheng-Wei Pan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yung-Feng Yen
- Department of Internal Medicine, Taipei City Hospital, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Jia-Yih Feng
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Juin Su
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuh-Min Chen
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan.,Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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14
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Mäkinen S, Datta N, Nguyen YH, Kyrylenko P, Laakso M, Koistinen HA. Simvastatin profoundly impairs energy metabolism in primary human muscle cells. Endocr Connect 2020; 9:1103-1113. [PMID: 33295884 PMCID: PMC7780958 DOI: 10.1530/ec-20-0444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Simvastatin use is associated with muscular side effects, and increased risk for type 2 diabetes (T2D). In clinical use, simvastatin is administered in inactive lipophilic lactone-form, which is then converted to active acid-form in the body. Here, we have investigated if lactone- and acid-form simvastatin differentially affect glucose metabolism and mitochondrial respiration in primary human skeletal muscle cells. METHODS Muscle cells were exposed separately to lactone- and acid-form simvastatin for 48 h. After pre-exposure, glucose uptake and glycogen synthesis were measured using radioactive tracers; insulin signalling was detected with Western blotting; and glycolysis, mitochondrial oxygen consumption and ATP production were measured with Seahorse XFe96 analyzer. RESULTS Lactone-form simvastatin increased glucose uptake and glycogen synthesis, whereas acid-form simvastatin did not affect glucose uptake and decreased glycogen synthesis. Phosphorylation of insulin signalling targets Akt substrate 160 kDa (AS160) and glycogen synthase kinase 3β (GSK3β) was upregulated with lactone-, but not with acid-form simvastatin. Exposure to both forms of simvastatin led to a decrease in glycolysis and glycolytic capacity, as well as to a decrease in mitochondrial respiration and ATP production. CONCLUSIONS These data suggest that lactone- and acid-forms of simvastatin exhibit differential effects on non-oxidative glucose metabolism as lactone-form increases and acid-form impairs glucose storage into glycogen, suggesting impaired insulin sensitivity in response to acid-form simvastatin. Both forms profoundly impair oxidative glucose metabolism and energy production in human skeletal muscle cells. These effects may contribute to muscular side effects and risk for T2D observed with simvastatin use.
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Affiliation(s)
- Selina Mäkinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Neeta Datta
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Yen H Nguyen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Petro Kyrylenko
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Heikki A Koistinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, University of Helsinki, Helsinki University Central Hospital, Helsinki, Finland
- Correspondence should be addressed to H A Koistinen:
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15
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Santos DM, Pantano L, Pronzati G, Grasberger P, Probst CK, Black KE, Spinney JJ, Hariri LP, Nichols R, Lin Y, Bieler M, Seither P, Nicklin P, Wyatt D, Tager AM, Medoff BD. Screening for YAP Inhibitors Identifies Statins as Modulators of Fibrosis. Am J Respir Cell Mol Biol 2020; 62:479-492. [PMID: 31944822 DOI: 10.1165/rcmb.2019-0296oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Idiopathic pulmonary fibrosis is a lung disease with limited therapeutic options that is characterized by pathological fibroblast activation and aberrant lung remodeling with scar formation. YAP (Yes-associated protein) is a transcriptional coactivator that mediates mechanical and biochemical signals controlling fibroblast activation. In this study, we developed a high-throughput small-molecule screen for YAP inhibitors in primary human lung fibroblasts. Multiple HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase inhibitors (statins) were found to inhibit YAP nuclear localization via induction of YAP phosphorylation, cytoplasmic retention, and degradation. We further show that the mevalonate pathway regulates YAP activation, and that simvastatin treatment reduces fibrosis markers in activated human lung fibroblasts and in the bleomycin mouse model of pulmonary fibrosis. Finally, we show that simvastatin modulates YAP in vivo in mouse lung fibroblasts. Our results highlight the potential of small-molecule screens for YAP inhibitors and provide a mechanism for the antifibrotic activity of statins in idiopathic pulmonary fibrosis.
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Affiliation(s)
| | - Lorena Pantano
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Gina Pronzati
- Division of Pulmonary and Critical Care Medicine, and
| | | | | | | | | | - Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, and.,Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Yufei Lin
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | - David Wyatt
- Biotherapeutics Discovery, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riß, Germany
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16
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Affiliation(s)
- Simin Dashti‐Khavidaki
- Department of Clinical PharmacyFaculty of PharmacyTehran University of Medical SciencesTehranIran
| | - Hossein Khalili
- Department of Clinical PharmacyFaculty of PharmacyTehran University of Medical SciencesTehranIran
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17
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Ponvilawan B, Charoenngam N, Rittiphairoj T, Ungprasert P. Receipt of Statins Is Associated With Lower Risk of Multiple Myeloma: Systematic Review and Meta-analysis. Clin Lymphoma Myeloma Leuk 2020; 20:e399-e413. [PMID: 32199765 DOI: 10.1016/j.clml.2020.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 01/26/2020] [Accepted: 02/13/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Studies on receipt of statins and risk of multiple myeloma (MM) yielded conflicting results. This systematic review and meta-analysis was conducted in order to comprehensively investigate the relationship between receipt of statins and risk of MM. PATIENTS AND METHODS Potentially eligible studies that compared the risk of MM between statin recipients and those who did not receive statins were identified from Medline and Embase databases from inception to August 2019 using a search strategy that comprised terms for "statin" and "multiple myeloma." To be eligible, cohort studies must have recruited 2 groups of participants, statin recipients and nonrecipients, and followed their participants for incident MM. Eligible case-control studies must have recruited cases of MM and controls without MM, and must have explored the history of receipt of statins. Relative risk, hazard risk ratio, standardized incidence ratio, or odds ratio (OR) of this association must be reported. Relative risk and standard error from each study were extracted and combined using random-effect generic inverse variance. Relative risk of cohort study was used as an estimate for OR to calculate the pooled effect estimate along with the OR of the case-control studies. RESULTS A total of 1744 articles were identified using the search strategy, and 10 studies were included in the meta-analysis. The odds of MM were significantly lower among statin recipients than nonrecipients, with a pooled OR of 0.80 (95% confidence interval, 0.68-0.93; I2 72%). The funnel plot was relatively symmetrical and did not suggest publication bias. CONCLUSION Receipt of statins is associated with a significant 20% reduction in the odds of MM.
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Affiliation(s)
- Ben Ponvilawan
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Nipith Charoenngam
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Patompong Ungprasert
- Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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18
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Itoh H, Miura A, Takeda I, Matsui M, Tamano K, Machida M, Shibata T. Search for transcription factors affecting productivity of the polyketide FR901512 in filamentous fungal sp. No. 14919 and identification of Drf1, a novel negative regulator of the biosynthetic gene cluster. Biosci Biotechnol Biochem 2019; 83:1163-1170. [PMID: 30821612 DOI: 10.1080/09168451.2019.1584519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In order to increase secondary metabolite production in filamentous fungi, a transcription factor gene in the biosynthetic gene cluster and global regulator genes such as laeA are considered plausible as targets for overexpression by genetic modification. In this study, we examined these overexpression effect in fungal sp. No. 14919 that produces FR901512, an HMG-CoA reductase inhibitor. Resultantly, the productivity was improved at 1.7-1.8 fold by overexpressing frlE, a transcription factor gene in the biosynthetic gene cluster, whereas productivity did not change by overexpression of laeA and veA. Furthermore, we searched for extra transcription factors affecting the productivity by transcriptome analysis between wild-type strain and highly productive UV mutants. After verifying productivity decrease by overexpression, Drf1, a novel transcription factor encoded by drf1 was identified as the negative regulator. Because each frlE product (FrlE) and Drf1 worked on the same cluster in positive and negative regulatory manners, their network was analyzed.
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Affiliation(s)
- Hiroya Itoh
- a Biotechnology Labs., Astellas Pharma Inc ., Tsukuba , Japan.,b Technology Research Association of Highly Efficient Gene Design (TRAHED) , Tokyo , Japan
| | - Ai Miura
- c Bioproduction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST) , Sapporo , Japan
| | - Itaru Takeda
- c Bioproduction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST) , Sapporo , Japan
| | - Makoto Matsui
- b Technology Research Association of Highly Efficient Gene Design (TRAHED) , Tokyo , Japan.,d Pharmaceutical Science & Technology Labs ., Astellas Pharma Inc ., Tsukuba , Japan
| | - Koichi Tamano
- c Bioproduction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST) , Sapporo , Japan
| | - Masayuki Machida
- b Technology Research Association of Highly Efficient Gene Design (TRAHED) , Tokyo , Japan.,c Bioproduction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST) , Sapporo , Japan
| | - Takashi Shibata
- b Technology Research Association of Highly Efficient Gene Design (TRAHED) , Tokyo , Japan.,d Pharmaceutical Science & Technology Labs ., Astellas Pharma Inc ., Tsukuba , Japan
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19
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Chen Y, Li X, Zhang R, Xia Y, Shao Z, Mei Z. Effects of statin exposure and lung cancer survival: A meta-analysis of observational studies. Pharmacol Res 2019; 141:357-365. [PMID: 30641276 DOI: 10.1016/j.phrs.2019.01.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 12/15/2022]
Abstract
Statin exposure has been reported to improve survival in several cancers. However, studies evaluating the association between statins and prognostic outcomes in patients with lung cancer are conflicting and heterogeneous. Pubmed, EMBASE and reference lists of included studies were searched to identify studies investigating the association between statin exposure and lung cancer prognosis. The primary outcome measure was overall survival (OS) and secondary ones included cancer-specific survival (CSS) and recurrence-free survival (RFS). Hazard ratios (HRs) with 95% confidence intervals (95% CIs) of these outcomes were pooled using random-effects models. Thirteen studies with data from 99,297 individuals satisfying the inclusion criteria were identified. Studies were ranked to be at low to moderate risk of bias. Meta-analysis showed that statin exposure was significantly associated with improved OS (pooled HR 0.79, 95% CI 0.72-0.86), CSS (pooled HR 0.83, 95% CI 0.77-0.89) and RFS (pooled HR 0.85, 95% CI 0.81-0.89). Subgroup analyses showed that statin users after diagnosis of lung cancer had more survival benefit for OS (HR 0.68, 95% CI 0.51-0.92) than those before diagnosis (HR 0.86, 95% CI 0.81-0.90) and current users (HR 0.79, 95% CI 0.62-1.02) (P for interaction <0.001). Besides, statin users were likely to have more survival benefits in stage IV lung cancer patients (HR 0.77, 95% CI 0.74-0.79) than in mixed stage (I-IV or I-III) patients (P for interaction = 0.004). Statin exposure is associated with significantly improved survival in patients with lung cancer. Future studies are warranted to further demonstrate the therapeutic role of statins in specific lung cancer patients.
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Affiliation(s)
- Yafei Chen
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Xiaoli Li
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Rui Zhang
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Yuhong Xia
- Second Department of Respiratory and Critical Care Medicine, Xinxiang Central Hospital, Xinxiang, Henan, China
| | - Zhuo Shao
- Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
| | - Zubing Mei
- Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Anorectal Disease Institute of Shuguang Hospital, Shanghai, China.
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20
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Baik SY, Kim H, Yang SJ, Kim TM, Lee SH, Cho JH, Lee H, Yim HW, Yoon KH, Kim HS. Long-term effects of various types of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on changes in glomerular filtration rate in Korea. Front Med 2018; 13:713-722. [PMID: 30483915 DOI: 10.1007/s11684-018-0661-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 06/15/2018] [Indexed: 11/24/2022]
Abstract
Few long-term follow-up studies have compared the changes in renal function according to the type of statin used in Korea. We compared the long-term effects of statin intensity and type on the changes in the glomerular filtration rate (GFR). We extracted data of patients who took statin for the first time. We analyzed whether or not different statins affect the changes in GFR at 3 months after baseline and 4 years after. We included 3678 patients and analyzed the changes in GFR. The GFR decreased by 3.2% ± 0.4% on average 4 years after the first statin prescription, indicating statistically significant deterioration (from 83.5 ± 0.4 mL/min/1.73 m2 to 79.9 0.4 mL/min/1.73 m2, P < 0.001). When comparing the GFR among different statins, significant differences were observed between atorvastatin and fluvastatin (-5.3% ± 0.7% vs. 1.2% ± 2.2%, P < 0.05) and between atorvastatin and simvastatin (-5.3% ± 0.7% vs. -0.7% ± 0.8%, P < 0.05). In pitavastatin (odds ratio [OR]= 0.64, 95% confidence interval [CI]= 0.46-0.87, P < 0.005) and simvastatin (OR = 0.69, 95% CI = 0.53-0.91, P < 0.008), the GFR rate that decreased by < 60 mL/min/1.73 m2 was significantly lower than that of atorvastatin. Regarding long-term statin intake, GFR changed with the type of statin. This work is the first in Korea to compare each statin in terms of changes in the GFR after the statin prescription.
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Affiliation(s)
- Seo Yeon Baik
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Hyunah Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, 04310, Republic of Korea
| | - So Jung Yang
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Tong Min Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jae Hyoung Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Hyunyong Lee
- Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Kun-Ho Yoon
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Hun-Sung Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea. .,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
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21
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Zhang J, Ma K, Han J, Wang K, Chen H, Bao L, Liu L, Xiong W, Zhang Y, Huang Y, Liu H. Eight new triterpenoids with inhibitory activity against HMG-CoA reductase from the medical mushroom Ganoderma leucocontextum collected in Tibetan plateau. Fitoterapia 2018; 130:79-88. [PMID: 30145334 DOI: 10.1016/j.fitote.2018.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 11/22/2022]
Abstract
Eight new triterpenoids, ganoleucoins T-Z(1-3, 5-8), and AA (9), together with eleven known triterpenes were isolated and identified from the wild fruiting bodies of the medicinal mushroom Ganoderma leucocontextum. The structures of new compounds were determined on the basis of NMR and MS spectral analysis. The inhibitory effects of 1-9 on HMG-CoA reductase were tested in vitro. Compounds 1, 7 and 8 showed significant HMG-CoA reductase inhibition with IC50 values of 10.2, 9.72 and 8.68 μM, respectively. The other isolated compounds presented relatively weak inhibitory activity with IC50 values >100 μM. Preliminary structure-activity relationship analysis showed that the HMG moiety in 7 and 8 contributed greatly to their inhibitory activity against HMG-CoA reductase. This work further demonstrates the mushroom G. leucocontextum to be valuable herbal medicine that deserves deep investigation.
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22
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Silva MBDCE, Souza CADC, Philadelpho BO, Cunha MMND, Batista FPR, Silva JRD, Druzian JI, Castilho MS, Cilli EM, Ferreira ES. In vitro and in silico studies of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitory activity of the cowpea Gln-Asp-Phe peptide. Food Chem 2018; 259:270-277. [PMID: 29680054 DOI: 10.1016/j.foodchem.2018.03.132] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/06/2018] [Accepted: 03/28/2018] [Indexed: 11/25/2022]
Abstract
Previous studies have shown that cowpea protein positively interferes with cholesterol metabolism. In this study, we evaluated the ability of the fraction containing peptides of <3 kDa, as well as that of the Gln-Asp-Phe (QDF) peptide, derived from cowpea β-vignin protein, to inhibit HMG-CoA reductase activity. We established isolation and chromatography procedures to effectively obtain the protein with a purity above 95%. In silico predictions were performed to identify peptide sequences capable of interacting with HMG-CoA reductase. In vitro experiments showed that the fraction containing peptides of <3 kDa displayed inhibition of HMG-CoA reductase activity. The tripeptide QDF inhibits HMG-CoA reductase (IC50 = 12.8 μM) in a dose-dependent manner. Furthermore, in silico studies revealed the binding profile of the QDF peptide and hinted at the molecular interactions that are responsible for its activity. Therefore, this study shows, for the first time, a peptide from cowpea β-vignin protein that inhibits HMG-CoA reductase and the chemical modifications that should be investigated to evaluate its binding profile.
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Affiliation(s)
| | | | - Biane Oliveira Philadelpho
- School of Pharmacy, Federal University of Bahia, Barão de Jeremoabo Street, 40170-115 Salvador, BA, Brazil
| | | | | | - Jaff Ribeiro da Silva
- School of Pharmacy, Federal University of Bahia, Barão de Jeremoabo Street, 40170-115 Salvador, BA, Brazil
| | - Janice Izabel Druzian
- School of Pharmacy, Federal University of Bahia, Barão de Jeremoabo Street, 40170-115 Salvador, BA, Brazil
| | - Marcelo Santos Castilho
- School of Pharmacy, Federal University of Bahia, Barão de Jeremoabo Street, 40170-115 Salvador, BA, Brazil
| | - Eduardo Maffud Cilli
- Institute of Chemistry, Sao Paulo State University (UNESP), Rua Prof. Francisco Swgni, 14800-0600 Araraquara, SP, Brazil
| | - Ederlan S Ferreira
- School of Pharmacy, Federal University of Bahia, Barão de Jeremoabo Street, 40170-115 Salvador, BA, Brazil.
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23
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Zanetti HR, Roever L, Gonçalves A, Resende ES. Human Immunodeficiency Virus Infection, Antiretroviral Therapy, and Statin: a Clinical Update. Curr Atheroscler Rep 2018; 20:9. [PMID: 29423787 DOI: 10.1007/s11883-018-0708-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW This clinical update is intended to focus in relationship between HIV infection and use of antiretroviral therapy (ART) and statin. RECENT FINDINGS Though ART significantly changed the course of HIV infection, it is related to numerous side effects principally to the lipid profile. In this way, statins became one of the most used lipid-lowering therapies in this population. In our clinical update, we evaluated studies that demonstrate the relationship and molecular mechanisms that HIV infection and ART use trigger dyslipidemia and also the use of statin to reduce this condition. We have demonstrated that use of statin can be used in dyslipidemic HIV-infected people as long as there is no drug interaction with ART. Recently, studies using rosuvastatin have shown greater effects when compared to the other statins.
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Affiliation(s)
- Hugo Ribeiro Zanetti
- Master Institute of Education President Antônio Carlos, Avenida Minas Gerais, 1889 - Centro, Araguari, MG, 38.440-046, Brazil. .,Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil.
| | - Leonardo Roever
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Alexandre Gonçalves
- Master Institute of Education President Antônio Carlos, Avenida Minas Gerais, 1889 - Centro, Araguari, MG, 38.440-046, Brazil.,Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil.,Paulista University, Brasília, DF, Brazil.,Atenas College, Paracatu, MG, Brazil
| | - Elmiro Santos Resende
- Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil
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24
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Demir C, Anil C, Bozkus Y, Mousa U, Kut A, Nar A, Tutuncu NB. Do Statins Affect Thyroid Volume and Nodule Size in Patients with Hyperlipidemia in a Region with Mild-to-Moderate Iodine Deficiency? A Prospective Study. Med Princ Pract 2018; 27:1-7. [PMID: 29402848 PMCID: PMC5968300 DOI: 10.1159/000486748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 01/07/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the antiproliferative pleiotropic effects of statins on thyroid function, volume, and nodularity. SUBJECTS AND METHODS One hundred and six hyperlipidemic patients were included in this prospective study. The 69 patients in the statin groups received atorvastatin (16 received 10 mg and 18 received 20 mg) or rosuvastatin (20 received 10 mg and 15 received 20 mg). The 37 patients in the control group, assessed as not requiring drugs, made only lifestyle changes. Upon admission and after 6 months, all patients were evaluated by ultrasonography as well as for lipid variables (total cholesterol, high- and low-density lipoprotein cholesterol, and triglycerides) and thyroid function and structure. RESULTS After 6 months, no differences in thyroid function, thyroid volume, the number of thyroid nodules, or nodule size were observed in the statin and control groups. In a subgroup analysis, total thyroid volume had decreased more in patients receiving 20 mg of rosuvastatin than that in the control group (p < 0.05). Maximum nodule size had decreased more in those receiving 10 mg of rosuvastatin (p < 0.05). CONCLUSIONS Our results suggest an association between rosuvastatin treatment and smaller thyroid volume and maximum nodule diameter; this could be attributable to the antiproliferative effects of statin therapy on the thyroid.
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Affiliation(s)
- Canan Demir
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
| | - Cuneyd Anil
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
- *Cuneyd Anil, Department of Endocrinology and Metabolism, Baskent University School of Medicine, Fevzi Cakmak Cad., 10. Sok., No. 45, Bahcelievler, TR-06490 Ankara (Turkey), E-Mail
| | - Yusuf Bozkus
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
| | - Umut Mousa
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
| | - Altug Kut
- Department Family Medicine, Baskent University School of Medicine, Ankara, Turkey
| | - Asli Nar
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
| | - Neslihan B. Tutuncu
- Department of Endocrinology and Metabolism, Baskent University School of Medicine, Ankara, Turkey
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25
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Xu Y, Wang Y, Zhi J, Qi L, Zhang T, Li X. Impact of matrix metalloproteinase 9 rs3918242 genetic variant on lipid-lowering efficacy of simvastatin therapy in Chinese patients with coronary heart disease. BMC Pharmacol Toxicol 2017; 18:28. [PMID: 28390432 PMCID: PMC5385050 DOI: 10.1186/s40360-017-0132-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 03/28/2017] [Indexed: 01/05/2023] Open
Abstract
Background Genetic variation of matrix metalloproteinase 9 (MMP-9) gene polymorphism has been suggested to modulate coronary heart diseases (CHD), yet the underlying mechanisms are not well understood. Methods We investigated the association of MMP9 rs3918242 single nucleotide polymorphism with inflammation and lipid-lowering efficacy after simvastatin treatment in Chinese patients with CHD. Fasting serum lipid profile and plasma inflammatory mediators were determined at baseline in 264 patients with CHD and 186 healthy control subjects, and after HMG-CoA reductase inhibitor simvastatin treatment (20 mg/day) for 12 weeks in CHD subjects. Results We found that plasma MMP-9, TNF-α and IL-10 levels were significantly elevated in patients with CHD compared to control subjects before treatment. The plasma MMP9 in CHD patients carrying rs3918242 CC, CT and TT genotypes were comparable. Interestingly, CHD patients carrying TT genotype had significantly higher level of triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) than those carrying CC genotype (P <0.05). Simvastatin treatment significantly reduced LDL-C, TG and plasma inflammatory mediator levels in CHD patients. The reduction of LDL-C upon simvastatin therapy was significantly greater in patients carrying TT genotype than those carrying CC genotype (P <0.05). Conclusions MMP9 rs3918242 TT genotype is associated with elevated serum TG and LDL-C, and enhanced LDL-C-lowering response upon simvastatin treatment in Chinese patients with CHD. Clinical trial registration This study was retrospectively registered at Chinese Clinical Trial Registry (Registration number: ChiCTR-ROC-17010971) on March 23rd 2017.
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Affiliation(s)
- Yuanyuan Xu
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China
| | - Yan Wang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China
| | - Jixin Zhi
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China
| | - Lichun Qi
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China
| | - Tong Zhang
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China
| | - Xueqi Li
- Department of Cardiology, The Fourth Affiliated Hospital of Harbin Medical University, 37 Yiyuan Rd, Nangang Region, Heilongjiang, Harbin, 150001, China.
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26
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Jeong YJ, Kim H, Baik SJ, Kim TM, Yang SJ, Lee SH, Cho JH, Lee H, Yim HW, Choi IY, Yoon KH, Kim HS. Analysis and comparison of the cost-effectiveness of statins according to the baseline low-density lipoprotein cholesterol level in Korea. J Clin Pharm Ther 2017; 42:292-300. [PMID: 28251662 DOI: 10.1111/jcpt.12512] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/02/2017] [Indexed: 01/01/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE There are a few Korean studies on the economics of statins based on reduction in low-density lipoprotein cholesterol (LDL-C) data from other countries. This study aimed to analyse and compare the cost-effectiveness of statins according to the baseline LDL-C level in Korea. METHODS Between January 2009 and December 2015, the data of patients who were prescribed statins for the first time were extracted from electronic medical records. We performed a cost-effectiveness analysis (CEA) based on the LDL-C reduction rate (CEA-RR) and target achievement rate. RESULTS AND DISCUSSION Among high-intensity statins, the CEA-RR value of rosuvastatin (20 mg) was significantly lower than that of atorvastatin (40 mg) at all baseline LDL-C levels, except levels of 160-189 mg/dL. Additionally, at baseline LDL-C levels of 130-159 mg/dL, the CEA-RR value of rosuvastatin (20 mg) was three times lower than that of atorvastatin (40 mg) (9·1 ± 2·5 $/% vs. 31·7 ± 15·0 $/%, P < 0·001). Among moderate-to-low-intensity statins, rosuvastatin (5 mg) showed the lowest CEA-RR value (4·0 ± 0·6 $/%), and the value significantly increased for pitavastatin (2 mg) (8·0 ± 0·6 $/%), atorvastatin (10 mg) (9·5 ± 0·5 $/%), simvastatin (10·8 ± 1·1 $/%) and pravastatin (40 mg) (11·5 ± 0·9 $/%) in order (P < 0·0001). On changing from atorvastatin (10 mg) to atorvastatin (20 mg), the additional yearly cost was 16·0 and additional CEA-RR value was 2·74 $/%. On the other hand, on changing from atorvastatin (10 mg) to rosuvastatin (10 mg), the additional yearly cost was -16·3 and additional CEA-RR value was -1·8 $/%. WHAT IS NEW AND CONCLUSION We successfully compared the cost-effectiveness of statins according to the baseline LDL-C level in Korea. It is expected that our findings will help clinical decision-making with regard to statin prescription, and this will help reduce national medical expenditure.
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Affiliation(s)
- Y J Jeong
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - S J Baik
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - T M Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S J Yang
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S-H Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J-H Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H Lee
- Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - H W Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - I Y Choi
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - K-H Yoon
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H-S Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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27
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Nayan M, Punjani N, Juurlink DN, Finelli A, Austin PC, Kulkarni GS, Uleryk E, Hamilton RJ. Statin use and kidney cancer survival outcomes: A systematic review and meta-analysis. Cancer Treat Rev 2016; 52:105-116. [PMID: 27992843 DOI: 10.1016/j.ctrv.2016.11.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 11/19/2016] [Accepted: 11/21/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Statin use has been associated with improved survival outcomes in various malignancies. Randomized controlled trials are currently underway evaluating their utility as adjunctive cancer therapies. However, studies evaluating the association between statin use and outcomes in kidney cancer yield conflicting results. METHODS We searched MEDLINE and EMBASE to identify studies evaluating the association between statin use and kidney cancer survival outcomes. We evaluated risk of bias with the Newcastle-Ottawa Scale. We pooled hazard ratios for recurrence-free survival, progression-free survival, cancer-specific survival, and overall survival using random-effects models. We evaluated publication bias through Begg's and Egger's tests, and the trim and fill procedure. RESULTS We identified 12 studies meeting inclusion criteria and summarized data from 18,105 patients. No study was considered to be at high risk of bias. Statin use was not significantly associated with recurrence-free survival (pooled HR 0.97, 95% CI 0.89-1.06) or progression-free survival (pooled HR 0.92, 95% CI 0.51-1.65); however, statin use was associated with marked improvements in cancer-specific survival (pooled HR 0.67, 95% CI 0.47-0.94) and overall survival (pooled HR 0.74, 95% CI 0.63-0.88). There was no strong evidence of publication bias for any outcome. CONCLUSIONS Our results demonstrate that statin use among patients with kidney cancer is associated with significantly improved cancer-specific and overall survival. Further studies are needed to confirm the therapeutic role of statins in kidney cancer.
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Affiliation(s)
- Madhur Nayan
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada
| | - Nahid Punjani
- Division of Urology, London Health Sciences Centre, Western University, London, Canada
| | - David N Juurlink
- Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - Antonio Finelli
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada
| | - Peter C Austin
- Institute for Clinical Evaluative Sciences, Toronto, Canada; Institute of Health Management, Policy and Evaluation, University of Toronto, Toronto, Canada; Schulich Heart Research Program, Sunnybrook Research Institute, Toronto, Canada
| | - Girish S Kulkarni
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada
| | | | - Robert J Hamilton
- Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, Canada.
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28
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Yang SH, Lin HY, Changou CA, Chen CH, Liu YR, Wang J, Jiang X, Luh F, Yen Y. Integrin β3 and LKB1 are independently involved in the inhibition of proliferation by lovastatin in human intrahepatic cholangiocarcinoma. Oncotarget 2016; 7:362-73. [PMID: 26517522 PMCID: PMC4808004 DOI: 10.18632/oncotarget.6238] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/14/2015] [Indexed: 02/06/2023] Open
Abstract
Human intrahepatic cholangiocarcinomas are one of the most difficult cancers to treat. In our study, Lovastatin, a 3-hydroxy-3-methylglutaryl-coenzyme-CoA (HMG-CoA) reductase inhibitor, demonstrated anticancer properties by inhibiting cancer cell proliferation, cell migration and cell adhesion. Lovastatin inhibited the expressions of transforming growth factor (TGF)-β1, cyclooxygenase (COX)-2, and intercellular adhesion molecule (ICAM)-1. Furthermore, lovastatin inhibited the expressions of integrin β1 and integrin β3 but not integrin αv or integrin β5. While Lovastatin's inhibitory effects on TGFβ1, COX2, and ICAM-1 expression were independently controlled by the tumor suppressor LKB1, integrin β3 expression was not affected. Lovastatin's inhibitory effect on cell adhesion was associated with the decreased expression of integrin β3 and cell surface heterodimer integrin αvβ3. Quantitative real time PCR, fluorescent microscopy, and cell migration assays all confirmed that Lovastatin inhibits integrin αvβ3 downstream signaling including FAK activation, and β-catenin, vimentin, ZO-1, and β-actin. Overall, Lovastatin reduced tumor cell proliferation and migration by modifying the expression of genes involved in cell adhesion and other critical cellular processes. Our study highlights novel anti-cancer properties of Lovastatin and supports further exploration of statins in the context of cholangiocarcinoma therapy.
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Affiliation(s)
- Sheng-Huei Yang
- PhD Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yun Lin
- PhD Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan
| | - Chun A Changou
- PhD Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,Integrated Laboratory, Center of Translational Medicine, Taipei Medical University, Taipei, Taiwan.,Core Facility, Taipei Medical University, Taipei, Taiwan
| | - Chun-Han Chen
- PhD Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Yun-Ru Liu
- Office of Human Research, Taipei Medical University, Taipei, Taiwan
| | - Jinghan Wang
- The First Department of Biliary Surgery, Eastern Hepatobiliary Surgical Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoqing Jiang
- The First Department of Biliary Surgery, Eastern Hepatobiliary Surgical Hospital, Second Military Medical University, Shanghai, China
| | - Frank Luh
- School of medicine, Taipei Medical University, Taipei, Taiwan.,Sino-American Cancer Foundation, Arcadia, California, United States
| | - Yun Yen
- PhD Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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29
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Su XW, Nandar W, Neely EB, Simmons Z, Connor JR. Statins accelerate disease progression and shorten survival in SOD1(G93A) mice. Muscle Nerve 2016; 54:284-91. [PMID: 26799243 DOI: 10.1002/mus.25048] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 01/11/2016] [Accepted: 01/14/2016] [Indexed: 12/12/2022]
Abstract
INTRODUCTION HMG-CoA reductase inhibitors (statins) and H63D HFE polymorphism may modify amyotrophic lateral sclerosis (ALS). We hypothesized that statins worsen phenotype in ALS mice, dependent on HFE genotype. METHODS Mice harboring SOD1(G93A) heterozygous for H67D Hfe (homologous to human H63D HFE) were administered simvastatin and/or coenzyme Q10, and were allowed to reach end stage. Disease progression was measured by grip strength. A separate group of animals was administered simvastatin and euthanized at the symptomatic 120-day time-point. Mitochondria from gastrocnemius muscle and lumbar spine were analyzed. RESULTS Simvastatin and H67D Hfe accelerated disease progression. Simvastatin decreased survival. Coenzyme Q10 did not rescue statin-induced effects. Statins did not alter mitochondrial protein levels. CONCLUSIONS Statins and Hfe genotype alter disease course in the ALS mouse model. Because the H63D HFE polymorphism is present in 30% of patients with ALS, studying disease progression in patients who receive statins, stratified for HFE genotype, may guide therapy. Muscle Nerve, 2016 Muscle Nerve 54: 284-291, 2016.
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Affiliation(s)
- Xiaowei W Su
- Department of Neurosurgery, Penn State College of Medicine, Mailcode H110, 500 University Drive, Hershey, Pennsylvania, 17033, USA
| | - Wint Nandar
- Department of Neurosurgery, Penn State College of Medicine, Mailcode H110, 500 University Drive, Hershey, Pennsylvania, 17033, USA
| | - Elizabeth B Neely
- Department of Neurosurgery, Penn State College of Medicine, Mailcode H110, 500 University Drive, Hershey, Pennsylvania, 17033, USA
| | - Zachary Simmons
- Department of Neurology, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - James R Connor
- Department of Neurosurgery, Penn State College of Medicine, Mailcode H110, 500 University Drive, Hershey, Pennsylvania, 17033, USA
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30
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Kim HS, Lee SH, Kim H, Lee SH, Cho JH, Lee H, Yim HW, Kim SH, Choi IY, Yoon KH, Kim JH. Statin-related aminotransferase elevation according to baseline aminotransferases level in real practice in Korea. J Clin Pharm Ther 2016; 41:266-72. [PMID: 27015878 DOI: 10.1111/jcpt.12377] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/12/2016] [Indexed: 12/31/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Higher rate of statin-related hepatotoxicity has been reported for Koreans than for Westerners. Moreover, statin-related aminotransferase elevation for those who show borderline levels of aspartate transaminase (AST) and alanine transaminase (ALT) (≤×3 of UNL) at baseline has not been fully investigated. METHODS Post-statin changes AST/ALT levels during the first year for 21 233 Korean outpatients at two large academic teaching hospitals from January 2009 to December 2013 were analysed using electronic health record data. The date of the first statin prescription was set as baseline. We also performed a comparative analysis of statin-related AST/ALT elevations according to the type of statin, followed by an analysis of clinical risk factors. RESULTS AND DISCUSSION The progression rate to abnormal AST/ALT values [>×3 the upper normal limit (UNL)] was significantly higher (2·4-16% vs. 0·3-1·7%, P < 0·001) in subjects with borderline (>×1, but ≤×3 of UNL) compared with normal AST/ALT values at baseline. Those with normal baseline AST/ALT did not show significantly different progression rate between different statin medications (P = 0·801). However, patients taking pitavastatin (HR = 0·76, P = 0·657) were least likely to develop abnormal AST/ALT, whereas those taking fluvastatin (HR = 2·96, P = 0·029) were the most likely to develop abnormal AST/ALT compared with atorvastatin for patients who were with baseline borderline AST/ALT. However, given the small sample sizes and the observational nature of our study, these need further study. WHAT IS NEW AND CONCLUSION It is advisable to regularly monitor AST/ALT levels even in patients with AST/ALT increases >×1. Future studies should aim to determine the possible risk factors for each specific statin type by analysing various confounding variables.
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Affiliation(s)
- H-S Kim
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S H Lee
- Division of Biomedical Informatics, Systems Biomedical Informatics Research Centre, Seoul National University College of Medicine, Seoul, Korea
| | - H Kim
- College of Pharmacy, Sookmyung Women's University, Seoul, Korea
| | - S-H Lee
- Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Cho
- Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H Lee
- Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - H W Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - S-H Kim
- Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine, Seoul, Korea
| | - I-Y Choi
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - K-H Yoon
- Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Department of Endocrinology and Metabolism, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - J H Kim
- Division of Biomedical Informatics, Systems Biomedical Informatics Research Centre, Seoul National University College of Medicine, Seoul, Korea
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Rachmawati H, Soraya IS, Kurniati NF, Rahma A. In Vitro Study on Antihypertensive and Antihypercholesterolemic Effects of a Curcumin Nanoemulsion. Sci Pharm 2016; 84:131-40. [PMID: 27110504 PMCID: PMC4839556 DOI: 10.3797/scipharm.isp.2015.05] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 12/15/2015] [Indexed: 11/22/2022] Open
Abstract
Atherosclerosis and hypertension can potentially progess into dangerous cardiovascular diseases such as myocardial infarction and stroke. Statins are widely used to lower cholesterol levels while antihypertensive agents such as captopril are widely prescribed to treat high blood pressure. Curcumin, a phenolic compound isolated from Curcuma domestica, has been proven effective for a broad spectrum of diseases, including hypertension and hypercholesterolemia. Therefore, curcumin is quite promising as an alternative therapeutic compound. Our previous studies have proven a significant increase in physical properties, bioavailability, and stability of curcumin when encapsulated in a nanoemulsion. The purpose of this study was to assess the ability of the nanoemulsion in enhancing curcumin activity as a antihypertensive and antihypercholesterolemic agent. The formulation and preparation method of the curcumin nanoemulsion have been developed in our previous study. Physical characterization was performed, including measurement of droplet size, polidispersity index, zeta potential, entrapment efficiency, and loading capacity. Antihypertensive activity of curcumin was evaluated by determining Angiotensin Converting Enzyme (ACE) inhibition in vitro. A substrate for ACE, hippuryl-L-histidyl-L-leucine was allowed to react with ACE, resulting in hippuric acid formation as the product. The degree of ACE inhibition by curcumin was represented by the amount of hippuric acid formed. Antihypercholesterolemic activity of curcumin was studied using the HMG-CoA reductase assay equipped with a 96-well UV plate. This assay was based on the spectrophotometric measurement of the decrease in absorbance which represents the oxidation of NADPH by the catalytic subunit of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) in the presence of the substrate HMG-CoA. Curcumin is known to have no significant difference in inhibiting ACE compared to Captopril, but when it was incorporated in the self-nanoemulsifying carrier, it slightly increased the inhibitory effect on ACE. In contrast, the effect of curcumin in reducing cholesterol based on the HMGR assay was more pronounced. Curcumin encapsulated in a nanoemulsion showed significant cholesterol-lowering activity compared to a standard drug, pravastatin. Therefore, we conclude that curcumin does not show ACE inhibitory effects, but has potential use as an alternative therapeutic compound to treat hyperlipidaemia. Curcumin encapsulated in a nanoemulsion increased not only the HMGR inhibition, but also ACE inhibition of curcumin. These effects are suggested to be the result of improved solubility in the nanoemulsion system.
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Affiliation(s)
- Heni Rachmawati
- School of Pharmacy, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia; National Research Center for Nanoscience and Nanotechnology, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia
| | - Irene Surya Soraya
- School of Pharmacy, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia
| | - Neng Fisheri Kurniati
- School of Pharmacy, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia
| | - Annisa Rahma
- School of Pharmacy, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia; National Research Center for Nanoscience and Nanotechnology, Bandung Institute of Technology, Ganesah 10, Bandung 40132, Indonesia
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Wang HJ, Park JY, Kwon O, Choe EY, Kim CH, Hur KY, Lee MS, Yun M, Cha BS, Kim YB, Lee H, Kang ES. Chronic HMGCR/ HMG-CoA reductase inhibitor treatment contributes to dysglycemia by upregulating hepatic gluconeogenesis through autophagy induction. Autophagy 2015; 11:2089-2101. [PMID: 26389569 DOI: 10.1080/15548627.2015.1091139] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Statins (HMGCR/HMG-CoA reductase [3-hydroxy-3-methylglutaryl-CoA reductase] inhibitors) are widely used to lower blood cholesterol levels but have been shown to increase the risk of type 2 diabetes mellitus. However, the molecular mechanism underlying diabetogenic effects remains to be elucidated. Here we show that statins significantly increase the expression of key gluconeogenic enzymes (such as G6PC [glucose-6-phosphatase] and PCK1 (phosphoenolpyruvate carboxykinase 1 [soluble]) in vitro and in vivo and promote hepatic glucose output. Statin treatment activates autophagic flux in HepG2 cells. Acute suppression of autophagy with lysosome inhibitors in statin treated HepG2 cells reduced gluconeogenic enzymes expression and glucose output. Importantly, the ability of statins to increase gluconeogenesis was impaired when ATG7 was deficient and BECN1 was absent, suggesting that autophagy plays a critical role in the diabetogenic effects of statins. Moreover autophagic vacuoles and gluconeogenic genes expression in the liver of diet-induced obese mice were increased by statins, ultimately leading to elevated hepatic glucose production, hyperglycemia, and insulin resistance. Together, these data demonstrate that chronic statin therapy results in insulin resistance through the activation of hepatic gluconeogenesis, which is tightly coupled to hepatic autophagy. These data further contribute to a better understanding of the diabetogenic effects of stains in the context of insulin resistance.
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Affiliation(s)
- Hye Jin Wang
- a Division of Endocrinology and Metabolism ; Department of Internal Medicine ; Yonsei University College of Medicine ; Seoul , Korea.,b Institute of Endocrine Research; Yonsei University College of Medicine ; Seoul , Korea.,c Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine ; Seoul , Korea
| | - Jae Yeo Park
- d Department of Clinical Nursing Science ; Yonsei University College of Nursing ; Seoul , Korea.,e Nursing Policy and Research Institute; Biobehavioral Research Center; Yonsei University ; Seoul , Korea
| | - Obin Kwon
- c Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine ; Seoul , Korea.,f Department of Pharmacology ; Yonsei University College of Medicine ; Seoul , Korea
| | - Eun Yeong Choe
- a Division of Endocrinology and Metabolism ; Department of Internal Medicine ; Yonsei University College of Medicine ; Seoul , Korea.,b Institute of Endocrine Research; Yonsei University College of Medicine ; Seoul , Korea
| | - Chul Hoon Kim
- c Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine ; Seoul , Korea.,f Department of Pharmacology ; Yonsei University College of Medicine ; Seoul , Korea
| | - Kyu Yeon Hur
- g Department of Medicine ; Samsung Medical Center; Sungkyunkwan University School of Medicine ; Seoul , Korea
| | - Myung-Shik Lee
- g Department of Medicine ; Samsung Medical Center; Sungkyunkwan University School of Medicine ; Seoul , Korea.,h Samsung Advanced Institute for Health Sciences and Technology; Sungkyunkwan University School of Medicine ; Seoul , Korea
| | - Mijin Yun
- i Department of Nuclear Medicine ; Yonsei University College of Medicine ; Seoul , Korea
| | - Bong Soo Cha
- a Division of Endocrinology and Metabolism ; Department of Internal Medicine ; Yonsei University College of Medicine ; Seoul , Korea.,b Institute of Endocrine Research; Yonsei University College of Medicine ; Seoul , Korea.,c Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine ; Seoul , Korea
| | - Young-Bum Kim
- j Division of Endocrinology , Diabetes, and Metabolism ; Department of Medicine ; Beth Israel Deaconess Medical Center and Harvard Medical School ; Boston , MA USA
| | - Hyangkyu Lee
- d Department of Clinical Nursing Science ; Yonsei University College of Nursing ; Seoul , Korea.,e Nursing Policy and Research Institute; Biobehavioral Research Center; Yonsei University ; Seoul , Korea
| | - Eun Seok Kang
- a Division of Endocrinology and Metabolism ; Department of Internal Medicine ; Yonsei University College of Medicine ; Seoul , Korea.,b Institute of Endocrine Research; Yonsei University College of Medicine ; Seoul , Korea.,c Brain Korea 21 PLUS Project for Medical Science; Yonsei University College of Medicine ; Seoul , Korea
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Zand L, Torres VE, Larson TS, King BF, Sethi S, Bergstralh EJ, Angioi A, Fervenza FC. Renal hemodynamic effects of the HMG-CoA reductase inhibitors in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant 2015; 31:1290-5. [PMID: 26614268 DOI: 10.1093/ndt/gfv394] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/27/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To determine the effect of statins on renal hemodynamics in normal volunteers and those with autosomal dominant polycystic kidney disease either with mild or moderate renal dysfunction. METHODS Thirty-two study subjects were enrolled in this study: 11 normal volunteers, 11 study subjects with autosomal dominant polycystic kidney disease (ADPKD) and mild kidney disease and 10 study subjects with ADPKD and moderate kidney disease. Subjects in each group received simvastatin 40 mg once daily for a period of 4 weeks. Renal blood flow was measured based on para-amino-hippurate (PAH) clearance and with the use of a magnetic resonance (MR) scanner at the beginning and following 4 weeks of therapy with statins. RESULTS At the end of the study, except for the lipid profile, which was significantly lower in all groups, other laboratory results showed no change. Four weeks of therapy with simvastatin resulted in no change in serum creatinine, 24-h urinary protein, sodium, iothalamate clearance, PAH clearance or renal blood flow as measured by MRI or based on PAH clearance. CONCLUSIONS Four weeks of therapy with simvastatin did not change renal blood flow in the study subjects with ADPKD with mild-to-moderate renal dysfunction or in healthy volunteers. CLINICAL TRIAL REGISTRATION NUMBER NCT02511418.
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Affiliation(s)
- Ladan Zand
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Vicente E Torres
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Timothy S Larson
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Bernard F King
- Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sanjeev Sethi
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Eric J Bergstralh
- Department of Statistics, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Andrea Angioi
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Fernando C Fervenza
- Department of Medicine, Division of Nephrology and Hypertension, Mayo Clinic College of Medicine, Rochester, MN, USA
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Abstract
The incidence of hypercholesterolemia and its possible relationship with clinical course were determined by reviewing the records of 231 consecutive patients presenting to a specialized Chronic Lymphocytic Leukemia (CLL) clinic. Evidence for elevated cholesterol was found in up to 174/231 patients (75%) based on existing use of statins (107 patients) or non-fasting low-density lipoprotein cholesterol levels greater than 2.5 mM. Excluding patients with 17p deletions, time to first treatment (TFT) was prolonged if patients were taking cholesterol-lowering statins (57.5 (IQR = 32, 77) vs 36 (IQR = 11, 100) months, p < 0.02). If patients were prescribed statins after being diagnosed with CLL, TFT was longer than if they were taking statins before the diagnosis. These observations suggest there is a high incidence of hypercholesterolemia in CLL patients and cholesterol-lowering may impact the disease course.
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Affiliation(s)
- Signy Chow
- a Odette Cancer Centre and Sunnybrook Health Sciences Centre , Toronto , ON , Canada .,b Division of Hematology and Oncology, Department of Medicine , University of Toronto , Toronto , ON , Canada , and
| | - Rena Buckstein
- a Odette Cancer Centre and Sunnybrook Health Sciences Centre , Toronto , ON , Canada .,b Division of Hematology and Oncology, Department of Medicine , University of Toronto , Toronto , ON , Canada , and
| | - David E Spaner
- a Odette Cancer Centre and Sunnybrook Health Sciences Centre , Toronto , ON , Canada .,b Division of Hematology and Oncology, Department of Medicine , University of Toronto , Toronto , ON , Canada , and.,c Division of Molecular and Cellular Biology , Sunnybrook Research Institute, University of Toronto , Toronto , ON , Canada
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Özyilmaz A, Boersma C, Visser ST, Postma MJ, de Jong-van den Berg LT, Lambers-Heerspink HJ, de Jong PE, Gansevoort RT. The association of albuminuria and high-sensitivity C-reactive protein with the efficacy of HMG-coenzyme A reductase inhibitors for cardiovascular event prevention. Eur J Prev Cardiol 2015; 23:847-55. [PMID: 26358992 DOI: 10.1177/2047487315604310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is not clear which hypercholesterolemic patients benefit most from β-hydroxy-β-methylglutaryl coenzyme A reductase inhibitors with respect to the prevention of cardiovascular events. Early signs of atherosclerotic vascular damage may identify high-risk patients. DESIGN We studied whether subjects with hypercholesterolemia will benefit more from starting statin treatment in the case of high albuminuria and/or high-sensitivity C-reactive protein (hsCRP). METHODS Included were subjects who had hypercholesterolemia at baseline, a negative cardiovascular disease history and who were not treated with statins. In total, 2011 subjects were analysed, of whom 695 started with a statin during a follow-up of 7.0 ± 1.7 years. Adjusted hazard ratios (HRs) for cardiovascular events were calculated in subjects who started versus those who did not start a statin stratified for albuminuria less than or ≥ 15 mg/day and/or hsCRP less than or ≥ 3 mg/L. RESULTS The start of a statin was associated with a beneficial effect on cardiovascular risk in subjects with high albuminuria (HR 0.38 (0.23-0.60)), while the effect of starting a statin was non-significant in subjects with low albuminuria (HR 0.74 (0.44-1.24), P for interaction < 0.05). The effect of starting a statin was similar in subgroups with high and low hsCRP (P for interaction 0.34). When combining albuminuria and hsCRP subgroups, the start of statin treatment was associated with a lower risk of cardiovascular events dependent on albuminuria and not on the hsCRP level. CONCLUSIONS The start of statin treatment is associated with a significantly lower absolute as well as relative risk of cardiovascular events in subjects with hypercholesterolemia and elevated albuminuria, whereas these drugs had less effect in subjects with normal albuminuria.
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Affiliation(s)
- Akin Özyilmaz
- Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Cornelis Boersma
- Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, The Netherlands
| | - Sipke T Visser
- Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, The Netherlands
| | - Maarten J Postma
- Department of Pharmacoepidemiology and Pharmacoeconomics, University of Groningen, The Netherlands
| | | | - Hiddo J Lambers-Heerspink
- Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Paul E de Jong
- Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Ron T Gansevoort
- Department of Nephrology, University Medical Center Groningen, University of Groningen, The Netherlands
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Nishikido T, Oyama JI, Keida T, Ohira H, Node K. High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial. J Cardiol 2015; 67:340-6. [PMID: 26162946 DOI: 10.1016/j.jjcc.2015.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/13/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cardiovascular events (CV) continue to occur due to residual risks in high-risk patients in spite of substantial reductions in the low-density lipoprotein cholesterol (LDL) with statins. It has been reported that the small-dense LDL (sd-LDL) components of high atherogenic particles are associated with an increased risk of CV, more than large buoyant LDL. However, there are few reports regarding the effects of high-dose statin therapy in improving atherogenic lipoproteins. METHODS AND RESULTS In this prospective, randomized, open-label, multicenter study, a total of 111 high-risk patients were randomly assigned to two groups. In the high-dose therapy group, 58 patients were administered 5mg of rosuvastatin per day for four weeks, after which the dose was titrated to 10mg for the following eight weeks. In the low-dose therapy group, 53 patients were given 2.5mg for 12 weeks. We evaluated the lipid profiles, including the levels of sd-LDL, malondialdehyde-modified LDL-cholesterol (C) (MDA-LDL) as oxidized-LDL, and remnant-like particle-cholesterol. The LDL-C, non-high-density lipoprotein (HDL), and LDL-C/HDL-C ratio were decreased in the high-dose therapy group (p<0.01). Moreover, the sd-LDL and MDA-LDL levels were significantly reduced in the high-dose therapy group (p<0.05). There were no serious adverse events in either group. CONCLUSIONS High-dose statin therapy significantly reduced the sd-LDL and MDA-LDL components of atherosclerotic lipoproteins without adverse events in comparison with low-dose statin therapy.
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Affiliation(s)
- Toshiyuki Nishikido
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
| | - Jun-Ichi Oyama
- Department of Advanced Cardiology, Saga University, Saga, Japan.
| | - Takehiko Keida
- Department of Cardiovascular Medicine, Edogawa Hospital, Tokyo, Japan
| | - Hiroshi Ohira
- Department of Cardiovascular Medicine, Edogawa Hospital, Tokyo, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University Hospital, Saga, Japan
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Pawelczyk M, Chmielewski H, Kaczorowska B, Przybyła M, Baj Z. The influence of statin therapy on platelet activity markers in hyperlipidemic patients after ischemic stroke. Arch Med Sci 2015; 11:115-21. [PMID: 25861297 PMCID: PMC4379378 DOI: 10.5114/aoms.2015.49216] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/26/2013] [Accepted: 09/06/2013] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Low-density lipoprotein cholesterol (LDL-C) has been reported to increase platelet activation. Reducing the level of LDL-C with statins induces important pleiotropic effects such as platelet inhibition. This association between platelet activity and statin therapy may be clinically important in reducing the risk of ischemic stroke. We investigated the effect of simvastatin therapy on platelet activation markers (platelet CD62P, sP-selectin, and platelet-derived microparticles (PDMPs)) in hyperlipidemic patients after ischemic stroke. MATERIAL AND METHODS The study group consisted of 21 hyperlipidemic patients after ischemic stroke confirmed by CT, and 20 healthy subjects served as controls. We assessed the CD62P expression on resting and thrombin-activated blood platelets. CD62P and PDMPs were analyzed by the use of monoclonal antibodies anti-CD61 and anti-CD62 on a flow cytometer. The level of sP-selectin in serum was measured by the ELISA (enzyme-linked immunosorbent assay) method. All markers were re-analyzed after 6 months of treatment with simvastatin (20 mg/day). RESULTS Hyperlipidemic patients presented a significantly higher percentage of CD62+ platelets and higher reactivity to thrombin compared to control subjects. After simvastatin therapy hyperlipidemic patients showed a reduction of the percentage of resting CD62P(+) platelets (p = 0.005) and a reduction of expression and percentage of CD62P(+) platelets after activation by thrombin (median p < 0.05; percentage: p = 0.001). A decrease of sP-selectin levels (p = 0.001) and percentage of PDMPs (p < 0.05) in this group was also observed. CONCLUSIONS HMG-CoA reductase inhibitor therapy in stroke patients with hyperlipidemia may be useful not only due to the lipid-lowering effect but also because of a significant role in reduction of platelet activation and reactivity.
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Affiliation(s)
| | - Henryk Chmielewski
- Department of Neurology and Strokes, Medical University of Lodz, Lodz, Poland
| | - Beata Kaczorowska
- Department of Neurology and Strokes, Medical University of Lodz, Lodz, Poland
| | - Monika Przybyła
- Department of Neurology and Strokes, Medical University of Lodz, Lodz, Poland
| | - Zbigniew Baj
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
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Luo Z, Zhang Y, Gu J, Feng P, Wang Y. Pharmacokinetic Properties of Single- and Multiple-Dose Pitavastatin Calcium Tablets in Healthy Chinese Volunteers. Curr Ther Res Clin Exp 2015; 77:52-7. [PMID: 26082816 DOI: 10.1016/j.curtheres.2015.02.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 02/05/2023]
Abstract
Background Pitavastatin is a newly developed 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor approved for the treatment of hyperlipidemia. Pharmacokinetic properties of pitavastatin have been studied previously. Objective To investigate the pharmacokinetic properties of pitavastatin in healthy Chinese volunteers after single-dose and multiple-dose administration. Methods An open-label, randomized, single-dose and multiple-dose study was conducted in healthy Chinese volunteers. The study included 4 stages, each separated with a 5-day washout period. A randomized, 3-way crossover design was carried out in Stages 1 to 3 for the single-dose study. Eligible subjects were randomized to receive a single 1 mg, 2 mg, or 4 mg pitavastatin calcium tablet. Blood samples were obtained predose and up to 36 hours following dosing. In Stage 4 the subjects received a 2-mg pitavastatin calcium tablet once daily for 6 days. At the last day of multiple dosing, blood samples were collected predose and up to 48 hours following dosing. Plasma pitavastatin was quantified by a validated liquid chromatography tandem mass spectrometry method. Tolerability was assessed by the adverse events, physical examination, 12-lead ECG, and laboratory tests. Results Twelve volunteers (6 male and 6 female) were enrolled in the study and 11 of them completed all 4 study stages. Following a single dose of 1 mg, 2 mg, and 4 mg, the mean (SD) Tmax values were 0.63 (0.17) hours, 0.65 (0.17) hours, and 0.79 (0.36) hours, respectively; the corresponding Cmax values were 66.80 (16.32) ng/mL, 106.09 (31.59) ng/mL, and 232.91 (66.42) ng/mL, respectively. AUC0−36 values were 190.04 (38.97) ng/mL/h, 307.87 (57.94) ng/mL/h, and 785.10 (166.08) ng/mL/h, respectively, whereas t1/2 values were 10.99 (2.70) hours, 9.52 (2.58) hours, and 10.38 (4.28) hours, respectively. The AUC and Cmax showed dose proportionality after single dosing according to linear-regression analysis. In the multiple-dose study, a rapid absorption (Tmax of 0.68 [0.20] hours) and marked peak concentration of 90.99 (36.88) ng/mL were observed. AUC0−48 and AUCss were 306.28 (130.02) ng/mL/h and 256.16 (116.34) ng/mL/h, respectively. The elimination half-life after multiple dosing was significantly prolonged, which amounted to 13.31 (2.58) hours. Comparison of the pharmacokinetic parameters between the male and female groups revealed no significant differences. Conclusions In healthy Chinese volunteers, single dosing of 1 mg, 2 mg, and 4 mg pitavastatin resulted in linear plasma pharmacokinetic properties. Compared with single dosing, multiple dosing of pitavastatin showed different distribution and elimination characteristics. Sex did not appear to affect the pharmacokinetic properties of pitavastatin. Chictr.org identifier: ChiCTR-OO-13004294.
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Davis ME, Korn MA, Gumucio JP, Harning JA, Saripalli AL, Bedi A, Mendias CL. Simvastatin reduces fibrosis and protects against muscle weakness after massive rotator cuff tear. J Shoulder Elbow Surg 2015; 24:280-7. [PMID: 25213828 DOI: 10.1016/j.jse.2014.06.048] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 06/14/2014] [Accepted: 06/27/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic rotator cuff tears are a common source of shoulder pain and disability, and patients with chronic cuff tears often have substantial weakness, fibrosis, inflammation, and fat accumulation. Identifying therapies to prevent the development of these pathologic processes will likely have a positive impact on clinical outcomes. Simvastatin is a drug with demonstrated anti-inflammatory and antifibrotic effects in many tissues but had not previously been studied in the context of rotator cuff tears. We hypothesized that after the induction of a massive supraspinatus tear, simvastatin would protect muscles from a loss of force production and fibrosis. METHODS We measured changes in muscle fiber contractility, histology, and biochemical markers of fibrosis and fatty infiltration in rats that received a full-thickness supraspinatus tear and were treated with either carrier alone or simvastatin. RESULTS Compared with vehicle-treated controls, simvastatin did not have an appreciable effect on muscle fiber size, but treatment did increase muscle fiber specific force by 20%. Simvastatin also reduced collagen accumulation by 50% but did not affect triglyceride content of muscles. Several favorable changes in the expression of genes and other markers of inflammation, fibrosis, and regeneration were also observed. CONCLUSIONS Simvastatin partially protected muscles from the weakness that occurs as a result of chronic rotator cuff tear. Fibrosis was also markedly reduced in simvastatin-treated animals. Whereas further studies are necessary, statin medication could potentially help improve outcomes for patients with rotator cuff tears.
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Song C, Park S, Park J, Shim M, Kim A, Jeong IG, Hong JH, Kim CS, Ahn H. Statin use after radical prostatectomy reduces biochemical recurrence in men with prostate cancer. Prostate 2015; 75:211-7. [PMID: 25327522 DOI: 10.1002/pros.22907] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/27/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact of statin use on biochemical recurrence (BCR) of prostate cancer after radical prostatectomy (RP) is controversial. METHODS In 2,137 consecutive RP patients between 1998 and 2011 at Asan Medical Center, we aimed to assess the presence and impact of statin use according to types (hydrophilic vs. hydrophobic), dose equivalents (DEs), and postoperative duration of usage (<18, 18-36, >36 months). Between non-users and preoperative or postoperative users, clinicopathological characteristics, and impact of statin use on BCR were analyzed using Cox proportional hazards model. Mean (range) follow-up was 39.4 (8-183) months. RESULTS Compared to non-users, preoperative users had lower PSA (5.8 vs. 7 ng/ml), but the rates of organ confined disease, pathologic Gleason score (GS) or positive surgical margin (PSM) were not different. After adjusting for pathologic stage, postoperative statin use was associated with a higher BCR-free survival. In multivariate analysis, ≤36 months' statin use independently decreased the risk of BCR along with PSA, pathologic GS, pathologic stage, and PSM. Risk reduction was observed especially in patients with pathologic GS ≥ 7 (HR 0.27, 95% CI 0.13-0.59, P = 0.001), NSM disease (HR 0.18, 95% CI 0.05-0.63, P = 0.007), or PSA ≥ 10.0 ng/ml (HR 0.30, 95% CI 0.11-0.81, P = 0.018). Increasing duration of use nullified the effect. Preoperative statin use did not demonstrate significant risk reduction for BCR in any of the stratified multivariate models. CONCLUSION In Korean men undergoing RP, preoperative statin use was not associated with different pathologic outcome. However, postoperative statin use until 36 months decreased the risk of BCR independently especially in patients with high-risk disease.
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Affiliation(s)
- Cheryn Song
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Deng L, Ding Y, Peng Y, Wu Y, Fan J, Li W, Yang R, Yang M, Fu Q. γ-Tocotrienol protects against ovariectomy-induced bone loss via mevalonate pathway as HMG-CoA reductase inhibitor. Bone 2014; 67:200-7. [PMID: 25019595 DOI: 10.1016/j.bone.2014.07.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 01/12/2023]
Abstract
γ-Tocotrienol (GT3), an analogue of vitamin E, has gained increasing scientific interest recently as it provides significant health benefits. GT3 exerts its biological effects not only by virtue of antioxidant properties but also by inhibiting hydroxy-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. Studies have reported that the mevalonate pathway is relevant for bone metabolism and HMG-CoA reductase inhibitors can increase bone mass and are useful in osteoporosis therapy. However, whether it is involved in the bone anabolic activity of GT3 is not clear. This study was conducted to investigate the ability of GT3 to protect against ovariectomy-induced bone loss, as well as the correlation between the protections and mevalonate pathway. Results showed that mice supplemented with 100mg/kg emulsified GT3 via subcutaneous injection once per month for three months were significantly protected from ovariectomy-induced bone loss as evaluated by various bone structural parameters, bone metabolic gene expression levels and serum levels of biochemical markers for bone resorption and bone formation. Importantly, the effect of GT3 on preventing against ovariectomy-induced bone loss could be reversed by daily supplementation with mevalonate, indicating that GT3 may via an HMG-CoA reductase-dependent mechanism to protect against ovariectomy-induced bone loss. Our results suggest that GT3 is suitable as dietary supplement and has potential as an alternative drug to treat or prevent osteoporosis.
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Affiliation(s)
- Lili Deng
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China.
| | - Yuedi Ding
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Ying Peng
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Yu Wu
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Jun Fan
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Wenxin Li
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Runlin Yang
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China
| | - Meiling Yang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qiang Fu
- Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi, Jiangsu, China.
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Björkhem-Bergman L, Backheden M, Söderberg Löfdal K. Statin treatment reduces the risk of hepatocellular carcinoma but not colon cancer-results from a nationwide case-control study in Sweden. Pharmacoepidemiol Drug Saf 2014; 23:1101-6. [PMID: 25074765 DOI: 10.1002/pds.3685] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 06/02/2014] [Accepted: 07/07/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Several studies have indicated that statins may have anticarcinogenic effects. The aim of the present study was to investigate if statin treatment was associated with a reduced risk of hepatocellular carcinoma (HCC) or colon cancer. METHODS A nationwide case-control study was carried out in which all cases of HCC and colon cancer in the Swedish population above 40 years of age between 1 July 2006 and 31 December 2010 were identified in the Swedish Cancer Register. For every case, five controls were selected and matched on age and sex. Data on statin use was extracted from the Swedish Prescribed Drug Register. We estimated risks using conditional logistic regression and adjusted for educational level, concomitant medications and comorbidity. RESULTS Identified were 3994 cases of HCC and matched with 19.970 controls, and 21.143 cases of colon cancer were identified and matched with 105.715 controls. In the adjusted analysis, the odds ratio (OR) for HCC among statin users was 0.88 (95% confidence interval (CI) 0.81-0.96), and the OR for colon cancer was 1.04 (95%CI 1.00-1.08) compared with non-users. CONCLUSION Statin use was associated with a modest decreased risk of HCC but did not influence the risk of colon cancer. Future randomized placebo-controlled trials in HCC high-risk patients are warranted to further investigate the possible prophylactic effect of statins in HCC.
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Affiliation(s)
- Linda Björkhem-Bergman
- Division of Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden; Division of Clinical Microbiology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Livingstone E, Hollestein LM, van Herk-Sukel MPP, van de Poll-Franse L, Joosse A, Schilling B, Nijsten T, Schadendorf D, de Vries E. Statin use and its effect on all-cause mortality of melanoma patients: a population-based Dutch cohort study. Cancer Med 2014; 3:1284-93. [PMID: 24935402 PMCID: PMC4302678 DOI: 10.1002/cam4.285] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 01/01/2023] Open
Abstract
Preclinical data showed anticancer effects of statins in melanoma, but meta-analyses could not demonstrate a reduced melanoma incidence in statin users. Rather than preventing occurrence, statins might reduce growth and metastatic spread of melanomas and ultimately improve survival. In this population-based study, we investigated the relationship between statin use and survival of melanoma patients. Patients ≥18 years who were diagnosed with cutaneous melanoma (Breslow thickness >1 mm) and registered in the Eindhoven Cancer Registry and in PHARMO Database Network between 1 January 1998 and 31 December 2010 were eligible. The hazard ratio (HR) of all-cause mortality was calculated by employing adjusted time-dependent and time-fixed Cox proportional hazard models. Disease-specific survival was estimated by means of 3-year relative survival rates (RSR). A control cohort of randomly selected patients using statins from PHARMO Database Network matched on age and gender was used to compare RSR of statin users to the general population. After melanoma diagnosis, 171 of 709 patients used statins. Use of statins showed a nonsignificantly decreased hazard of death (adjusted HR 0.76, 95% confidence interval [CI] 0.50–1.61). After stratification for gender, male but not female statin users showed a favorable outcome compared to nonusers (HR 0.57, 95% CI 0.32–0.99; HR 1.22, 95% CI 0.62–2.38, respectively). Three-year RSR for male statin users tended to be higher than for nonusers (91% vs. 80.5%, P = 0.06), no differences were observed in women (87.1% vs. 92.5%, P = 0.76). Statin use was not associated with an improved survival of melanoma patients. The trend for better survival of male in contrast to female statin users warrants further research.
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Altunal C, Agalar F, Agalar C, Daphan C, Saygun O, Aydinuraz K, Sahiner T, Atasoy P, Caglayan O, Dom S. The Effect of Simvastatin on Pulmonary Damage in Experimental Peritonitis in Rats. Indian J Surg 2013; 77:370-5. [PMID: 26730028 DOI: 10.1007/s12262-013-0845-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 01/16/2013] [Indexed: 01/11/2023] Open
Abstract
Statins are widely used in the treatment of hyperlipidemia, as they inhibit cholesterol synthesis. They also have anti-inflammatory, antioxidant, immunomodulatory, and positive endothelial-functional effects. It is hypothesized that simvastatin ameliorates pulmonary damage secondary to peritonitis in rats. Forty Wistar albino rats were divided into four groups. In sham group, laparotomy was the standard procedure. In simvastatin group, simvastatin was given perorally before laparotomy. In sepsis group, peritoneal sepsis was constituted by cecal ligation and puncture technique. In sepsis + simvastatin group, the procedures of simvastatin and sepsis groups were applied together. After sacrification at the 72nd hour, tissue samples from lungs were harvested for histopathological examination, wet and dry weight measurements, and tissue culture, tissue malondialdehyde, and nitric oxide tests. Blood samples were taken for C-reactive protein and whole blood count. While the malondialdehyde levels were found to be significantly higher in sepsis group, nitric oxide levels were found to be significantly lower in simvastatin + sepsis group. Alveolar hemorrhage was highest in simvastatin + sepsis group. There was no difference for C-reactive protein, leukocyte levels, and histopathological examination between any groups. The ratios of wet and dry lung weights were higher in simvastatin-given groups. Simvastatin has no positive effect in terms of lung dysfunction on experimental sepsis model. For a better understanding of the effects of simvastatin on lung injury in peritoneal sepsis, experimental models of longer duration that enable to search the effects of simvastatin beyond 3 days will be more useful.
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Affiliation(s)
- Cetin Altunal
- Department of General Surgery, Muş State Hospital, Muş, Turkey
| | - Fatih Agalar
- Department of General Surgery, Anadolu Medical Center, Kocaeli, Turkey
| | - Canan Agalar
- Departments of Infectious Diseases, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Cagatay Daphan
- Departments of General Surgery, Kırıkkale University School of Medicine, Kırıkkale, Turkey ; Tip Fakultesi Genel Cerrahi A.D, Kırıkkale Universitesi, Sağlık Cad, 71100 Kırıkkale, Turkey
| | - Oral Saygun
- Departments of General Surgery, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Kuzey Aydinuraz
- Departments of General Surgery, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Tayfun Sahiner
- Department of General Surgery, Kırşehir State Hospital, Kırşehir, Turkey
| | - Pinar Atasoy
- Departments of Pathology, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Osman Caglayan
- Departments of Biochemistry, Kırıkkale University School of Medicine, Kırıkkale, Turkey
| | - Sedat Dom
- Departments of General Surgery, Kırıkkale University School of Medicine, Kırıkkale, Turkey
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Shimojima M, Kawashiri MA, Nitta Y, Yoshida T, Katsuda S, Kaku B, Taguchi T, Hasegawa A, Konno T, Hayashi K, Yamagishi M. Rapid changes in plaque composition and morphology after intensive lipid lowering therapy: study with serial coronary CT angiography. Am J Cardiovasc Dis 2012; 2:84-88. [PMID: 22720196 PMCID: PMC3371621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 04/25/2012] [Indexed: 06/01/2023]
Abstract
Although intensive lipid lowering by statins can enhance plaque stability, few data exist regarding how early statins change plaque composition and morphology in clinical setting. Therefore, to examine early changes in plaque composition and morphology by intensive lipid lowering with statins, we evaluate coronary plaques from acute coronary syndrome (ACS) before and 3 weeks after lipid lowering by coronary CT angiography. We enrolled 110 patients with suspected ACS and underwent coronary CT. We defined plaque as unstable when CT number of plaque< 50HU and remodeling index (lesion diameter/reference diameter) >1.10. Rosuvastatin (5 mg/day) or atorvastatin (20 mg/day) were introduced to reduce low density lipoprotein cholesterol (LDL-C). Then, CT was again performed by the same condition 3 weeks after lipid lowering therapy. Total 10 patients (8 men, mean age 72.0 years), in whom informed consent regarding serial CT examination was obtained, were analyzed. Among them, 4 patients who denied to have intensive lipid lowering were served as controls. In remaining 6 patients, LDL-C reduced from 129.5±26.9 mg/dl to 68.5±11.1 mg/dl after statin treatment. Under these conditions, CT number of the targeted plaque significantly increased from 16.0±15.9 to 50.8±35.0 HU (p<0.05) and remodeling index decreased from 1.22±0.11 to 1.11±0.06 (p<0.05), although these values substantially unchanged in controls. These results demonstrate that MDCT-determined plaque composition as well as volume could be changed within 3 weeks after intensive lipid lowering. This may explain acute effects of statins in treatment of acute coronary syndrome.
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Affiliation(s)
- Masaya Shimojima
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of MedicineKanazawa, Japan
| | - Masa-aki Kawashiri
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of MedicineKanazawa, Japan
| | - Yutaka Nitta
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
| | - Taiji Yoshida
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
| | - Shouji Katsuda
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
| | - Bunji Kaku
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
| | - Tomio Taguchi
- Division of Cardiology, Toyama Red Cross HospitalToyama, Japan
| | - Akira Hasegawa
- Division of Radiology, Toyama Red Cross HospitalToyama, Japan
| | - Tetsuo Konno
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of MedicineKanazawa, Japan
| | - Kenshi Hayashi
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of MedicineKanazawa, Japan
| | - Masakazu Yamagishi
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of MedicineKanazawa, Japan
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Lee BJ, Lee HS, Kim CD, Jung SW, Seo YS, Kim YS, Jeen YT, Chun HJ, Um SH, Lee SW, Choi JH, Ryu HS. The Effects of Combined Treatment with an HMG-CoA Reductase Inhibitor and PPARγ Agonist on the Activation of Rat Pancreatic Stellate Cells. Gut Liver 2012; 6:262-9. [PMID: 22570758 PMCID: PMC3343167 DOI: 10.5009/gnl.2012.6.2.262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 09/15/2011] [Accepted: 10/13/2011] [Indexed: 12/13/2022] Open
Abstract
Background/Aims Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) and peroxisome proliferator-activated receptor gamma (PPARγ) ligands can modulate cellular differentiation, proliferation, and apoptosis through various pathways. It has been shown that HMG-CoA reductase inhibitors and PPARγ agonists separately inhibit pancreatic stellate cell (PaSC) activation. We studied the effects of a combination of both types of drugs on activated PaSCs via platelet-derived growth factor (PDGF), which has not previously been reported. The present study was performed to elucidate the underlying mechanisms of these effects by focusing on the impact of the signaling associated with cell-cycle progression. Methods Primary cultures of rat PaSCs were exposed to simvastatin and troglitazone. Proliferation was quantified using the BrdU method, and cell-cycle analysis was performed using a fluorescent activated cell sorter. The protein expression levels of smooth muscle actin (SMA), extracellular signal-regulated kinase (ERK), and a cell cycle machinery protein (p27Kip1) were investigated using Western blot analysis. Results Simvastatin reversed the effects of PDGF on cell proliferation in a dose-dependent manner. The combination of a low concentration of simvastatin (1 mM) and troglitazone (10 mM) synergistically reversed the effects of PDGF on cell proliferation but had no effect on cell viability. The expression of a-SMA was markedly attenuated by combining the two drugs, which blocked the cell cycle beyond the G0/G1 phase by reducing the levels of phosphorylated ERK and reversed the expression of p27Kip1 interrupted by PDGF. Conclusions Simvastatin and troglitazone synergistically inhibited cell proliferation in activated PaSCs by blocking the cell cycle beyond the G0/G1 phase. This inhibition was due to the synergistic modulation of the ERK pathway and the cell cycle machinery protein p27Kip1.
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Affiliation(s)
- Beom Jae Lee
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Kettawan A, Takahashi T, Kongkachuichai R, Charoenkiatkul S, Kishi T, Okamoto T. Protective effects of coenzyme q(10) on decreased oxidative stress resistance induced by simvastatin. J Clin Biochem Nutr 2011; 40:194-202. [PMID: 18398496 PMCID: PMC2275764 DOI: 10.3164/jcbn.40.194] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Accepted: 10/25/2006] [Indexed: 11/29/2022] Open
Abstract
The effects of simvastatin, an inhibitor of 3-hydroxy-3-methylglutaryl CoA reductase (HMG-CoA reductase), on oxidative stress resistance and the protective effects of coenzyme Q (CoQ) were investigated. When simvastatin was administered orally to mice, the levels of oxidized and reduced CoQ9 and CoQ10 in serum, liver, and heart, decreased significantly when compared to those of control. The levels of thiobarbituric acid reactive substances induced by Fe2+-ascorbate in liver and heart mitochondria also increased significantly with simvastatin. Furthermore, cultured cardiac myocytes treated with simvastatin exhibited less resistance to oxidative stress, decreased time to the cessation of spontaneous beating in response to H2O2 addition, and decreased responsiveness to electrical field stimulation. These results suggested that oral administration of simvastatin suppresses the biosynthesis of CoQ, which shares the same biosynthesis pathway as cholesterol up to farnesyl pyrophosphate, thus compromising the physiological function of reduced CoQ, which possesses antioxidant activity. However, these undesirable effects induced by simvastatin were alleviated by coadministering CoQ10 with simvastatin to mice. Simvastatin also reduced the activity of NADPH-CoQ reductase, a biological enzyme that converts oxidized CoQ to the corresponding reduced CoQ, while CoQ10 administration improved it. These findings may also support the efficacy of coadministering CoQ10 with statins.
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Affiliation(s)
- Aikkarach Kettawan
- Laboratory of Biochemistry, Division of Health Sciences and Social Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, Kobe 650-8586, Japan
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Kawai Y, Sato-Ishida R, Motoyama A, Kajinami K. Place of pitavastatin in the statin armamentarium: promising evidence for a role in diabetes mellitus. Drug Des Devel Ther 2011; 5:283-97. [PMID: 21625418 PMCID: PMC3100224 DOI: 10.2147/dddt.s13492] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Indexed: 12/13/2022]
Abstract
Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, known as statins, have revolutionized the treatment of hypercholesterolemia and coronary artery disease prevention. However, there are considerable issues regarding statin safety and further development of residual risk control, particularly for diabetic and metabolic syndrome patients. Pitavastatin is a potent statin with low-density lipoprotein (LDL) cholesterol-lowering effects comparable to those of atorvastatin or rosuvastatin. Pitavastatin has a high-density lipoprotein (HDL) cholesterol raising effect, may improve insulin resistance, and has little influence on glucose metabolism. Considering these factors along with its unique pharmacokinetic properties, which suggest minimal drug–drug interaction, pitavastatin could provide an alternative treatment choice, especially in patients with glucose intolerance or diabetes mellitus. Many clinical trials are now underway to test the clinical efficacy of pitavastatin in various settings and are expected to provide further information.
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Affiliation(s)
- Yasuyuki Kawai
- Department of Cardiology, Kanazawa Medical University, Uchinada, Japan
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Abstract
Pitavastatin is a potent HMG-CoA reductase inhibitor and efficient hepatocyte low-density lipoprotein cholesterol (LDL-C) receptor inducer, producing robust reduction of the serum LDL-C levels, even at a low dose. Pitavastatin and its lactone form are minimally metabolized by CYP enzymes, and are therefore associated with minimal drug-drug interactions (DDIs). Pitavastatin 2 to 4 mg has potent LDL-C-reducing activity, equivalent to that of atorvastatin 10 to 20 mg; several clinical trials have revealed consistently superior high-density lipoprotein cholesterol (HDL-C) elevating activity of pitavastatin than that of atorvastatin. Pitavastatin-induced HDL-C elevation has been shown to be sustained, even incremental, in long-term clinical trials. Pitavastatin was as well-tolerated as atorvastatin or simvastatin in double-blind randomized clinical trials. Two-year long-term safety and effectiveness of pitavastain has been confirmed in a large-scale, prospective post-marketing surveillance. The safety and efficacy profile of pitavastatin is favorable for the treatment of dyslipidemia, especially in metabolic syndrome patients. In addition to control of LDL-C, adequate control of triglyceride (TG) and HDL-C, hypertension and hyperglycemia is also necessary in metabolic syndrome patients. Pitavastatin produces adequate control of LDL-C and TG, along with potent and incremental HDL-C elevation, with a low frequency of DDIs.
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Abstract
Atherosclerosis represents a disease that begins in childhood, and alterations in lipid concentration play a fundamental role in the development of this condition. Children and adolescents with high cholesterol levels are more likely than their peers in the general population to present with dyslipidemia in adulthood. Precocious identification of dyslipidemias associated with premature cardiovascular disease is crucial during childhood to delay or prevent the atherosclerotic process. The National Cholesterol Education Program has established guidelines for the diagnosis and treatment of dyslipidemia during pediatric age. It has been suggested that a heart-healthy diet should begin at 2 years of age, and no adverse effects on psychological aspects, growth, pubertal development and nutritional status in children and adolescents limiting total and saturated fat intake have been demonstrated. Pharmacotherapy should be considered in children aged 10 years or older when low-density lipoprotein cholesterol concentrations remain very high despite dietary therapy, especially when multiple risk factors are present. The lipid-lowering drugs recommended for childhood and adolescence are resins and statins. The increasing use of statins is dependent on their effectiveness and safety. Ezetimibe, a selective cholesterol absorption inhibitor, may provide a similar cholesterol-lowering effect as that reached with statin treatment. This review provides an update on recent advances in the therapy of dyslipidemia, especially hypercholesterolemia, during pediatric age and adolescence.
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Affiliation(s)
- Lorenzo Iughetti
- a Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy.
| | - Barbara Predieri
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
| | - Patrizia Bruzzi
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
| | - Fiorella Balli
- b Department of Pediatrics, University of Modena and Reggio Emilia, Via del Pozzo, 71-41.100 Modena, Italy
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