Medizinische Universität Graz - Research portal
Selected Publication:
März, W; Wieland, H.
HMG-CoA reductase inhibition: anti-inflammatory effects beyond lipid lowering?
Herz. 2000; 25(2):117-125
Doi: 10.1007/PL00001949
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- Leading authors Med Uni Graz
- März Winfried
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- Abstract:
- Atherosclerosis has many features of a chronic inflammatory disease. Atherosclerotic lesions contain inflammatory cells like activated T-lymphocytes and macrophages. Systemic markers of inflammation such as white blood cells, C-reactive protein, serum amyloid A, interleukin 6 and soluble adhesion molecules are predictive of future cardiovascular events, even after adjustment for the contribution of established cardiovascular risk factors. Atherogenic lipoprotein particles, in particular modified low-density lipoproteins (LDL), elicit pro-inflammatory responses of cellular elements of the vessel wall, including endothelial dysfunction and activation of monocyte-derived macrophages. Treatment, with HMG-CoA reductase inhibitors has proven the most successful strategy to reduce the concentration of LDL in the circulatory system. These compounds lower LDL cholesterol by inhibiting the mevalonate pathway in the liver, which in turn depletes the regulatory pool of cholesterol and enhances the activity of LDL receptors. Five prospective clinical trials have convincingly demonstrated that HMG-CoA reductase inhibitors can effectively lower the incidence of cardiovascular events in primary and secondary prevention. Post hoc analyses of these trials suggest that the clinical benefit brought about by HMG-CoA reductase inhibitors may not entirely be due to their effect on the levels of circulating lipoproteins. In-vitro observations of anti-inflammatory actions of HMG-CoA reductase inhibitors on vascular cells have been suggested to explain effects beyond lipid-lowering. It is, however, not clear whether these findings are relevant to the in-vivo situation. Further investigation is now necessary in order to determine the relative significance of cholesterol lowering and of ancillary effects to the overall clinical benefit of statin treatment.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Inflammatory Agents - pharmacology
- Anticholesteremic Agents - therapeutic use
- Arteriosclerosis - drug therapy
- C-Reactive Protein - analysis
- Cholesterol - blood
- Cholesterol, LDL - blood
- Clinical Trials - blood
- Coronary Disease - drug therapy
- Female - drug therapy
- Follow-Up Studies - drug therapy
- Humans - drug therapy
- Hydroxymethylglutaryl-CoA Reductase Inhibitors - pharmacology
- Lipoproteins, LDL - blood
- Male - blood
- Meta-Analysis - blood
- Middle Aged - blood
- Prospective Studies - blood
- Randomized Controlled Trials - blood
- Risk Factors - blood
- Smoking - adverse effects
- Social Class - adverse effects
- Time Factors - adverse effects
- Find related publications in this database (Keywords)
- atherosclerosis
- coronary artery disease
- inflammation
- cholesterol
- HMG-CoA reductase inhibitor