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Drug Insight: immunomodulatory effects of statins—potential benefits for renal patients?

Nature Clinical Practice Nephrology volume 2, pages 378–387 (2006)Cite this article

Abstract

Statins inhibit 3-hydroxyl-3-methylglutaryl coenzyme A reductase, an enzyme crucial to cholesterol synthesis. Drugs of this class reduce the risk of coronary heart disease and stroke, in large part through lipid modulation. Emerging evidence indicates that statins have additional modes of action. These actions, which encompass modification of endothelial function, plaque stability, thrombus formation and inflammatory pathways, are widely referred to as 'pleiotropic effects'. These pleiotropic effects indicate that the therapeutic potential of statins might extend beyond cholesterol lowering and cardiovascular disease to other inflammatory disorders or conditions such as transplantation, multiple sclerosis, rheumatoid arthritis and chronic kidney disease. Experimental and clinical data provide evidence to support these broader applications of statins; however, more large-scale trials are needed to clarify the therapeutic benefit.

Key Points

  • Statins reduce the risk of stroke and coronary heart disease by inhibiting cholesterol synthesis

  • Experimental and clinical evidence indicates that statins exert additional beneficial effects via modulation of immune processes

  • Statins improve clinical outcomes in rheumatoid arthritis and heart transplantation, and reduce the number of inflammatory lesions in multiple sclerosis

  • Preliminary data indicate that statins might reduce cardiovascular morbidity and mortality in people with chronic kidney disease or diabetic nephropathy, as well as slowing disease progression

  • There are conflicting data on the relevance of statins to graft and recipient survival following renal transplantation

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  1. S Steffens is a researcher and F Mach is a professor

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  1. the Division of Cardiology, Department of Medicine, University Hospital, Foundation for Medical Research, Geneva, Switzerland

    Sabine Steffens & François Mach

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Correspondence to François Mach.

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Steffens, S., Mach, F. Drug Insight: immunomodulatory effects of statins—potential benefits for renal patients?. Nat Rev Nephrol 2, 378–387 (2006). https://doi.org/10.1038/ncpneph0217

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