IMMUUNIJÄRJESTELMÄN MODULOINTI SIMVASTATIINILLA?

[Bb]

Lähettäjä: Soijuv Lähetetty: 1.9.2004 15:27

Aikaisemmin on ollut paljon puhetta simvastatiinista (kolesterolilääke) ja sen uusista käyttömahdollisuuksista erilaisissa tulehdustaudeissa. Myös tässä suhteellisen uudessa tutkimuksessa simvastatiinin todettiin vähentävän immuunikompleksien määrää. (Yksi unkarilainen lääkäri kirjoitti minulle juuri ja kertoi kokeilleensa simvastatiinia allergiaansa - hän sai lääkkeestä selkeää apua jo lyhyellä aikavälillä.) Lääkkeen hyödystä borrelioosissa ei ole vielä tutkimustietoa.


Diabetes Care. 2004 Apr;27(4):908-13.

Role of simvastatin as an immunomodulator in type 2 diabetes.

Lopes-Virella MF, Mironova M, Stephan E, Durazo-Arvizu R, Virella G.

Department of Medicine, Medical University of South Carolina, and Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina 29425, USA. virellam@musc.edu

OBJECTIVE: To test the hypothesis that simvastatin reduces the levels of circulating immune complexes (ICs) containing modified lipoproteins (mLDLs; mLDL-ICs), which may represent an additional mechanism for the reduced incidence of cardiovascular events in patients treated with simvastatin.

RESEARCH DESIGN AND METHODS: A total of 26 patients with type 2 diabetes and triglyceride levels <400 mg/dl who were not receiving lipid-lowering medications or CYP 3A4 inhibitors were enrolled in the study. After 2 weeks on a lipid-lowering diet and exercise, the patients were started on simvastatin 20 mg/day. The dose of simvastatin was adjusted until the levels of LDL cholesterol were < or =100 mg/dl. Blood was collected at baseline, 3 and 6 months after LDL cholesterol levels reached target, and 3 months after stopping simvastatin to measure advanced glycation end product LDL and oxidized LDL antibodies, mLDL-IC, intracellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1), E-selectin, metalloproteinase-1 (MMP-1), lipid profile, liver function tests, creatinine kinase, glucose, and HbA(1c).

RESULTS: Twenty-one patients completed the study.

Their HbA(1c) remained within 1% of baseline levels. There was a highly significant decrease in mLDL-IC levels after 3 and 6 months of treatment with simvastatin, with a return to near baseline levels after discontinuation.

CONCLUSIONS: Simvastatin significantly reduced the concentration of mLDL-IC, probably as a consequence of both a decrease in the formation of mLDL and to a reduction in the titers of mLDL antibodies. This effect is likely to have a beneficial impact in the inflammatory reaction associated with atherosclerosis.

PMID: 15047647 [PubMed - in process]