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Pleiotropic effects of statins include improvement of endothelial dysfunction, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory responses, and stabilization of atherosclerotic plaques.
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Beneficial Cardiovascular Pleiotropic Effects of Statins
Jean Davignon
Originally published15 Jun 2004
https://www.ahajournals.org/doi/full/10.1161/...%20plaques.
Abstract
Pleiotropic effects of a drug are actions other than those for which the agent was specifically developed. These effects may be related or unrelated to the primary mechanism of action of the drug, and they are usually unanticipated.
Pleiotropic effects may be undesirable (such as side effects or toxicity), neutral, or, as is especially the case with HMG-CoA reductase inhibitors (statins), beneficial.
Pleiotropic effects of statins include improvement of endothelial dysfunction, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory responses, and stabilization of atherosclerotic plaques.
These and several other emergent properties could act in concert with the potent low-density lipoprotein cholesterol-lowering effects of statins to exert early as well as lasting cardiovascular protective effects. Understanding the pleiotropic effects of statins is important to optimize their use in treatment and prevention of cardiovascular disease.
Conclusions
Although the possibility that statins might have pleiotropic effects was met at first with a healthy skepticism, the vast amount of knowledge accrued over the past few years has moved these effects into the spotlight.
Many of the statin pleiotropic effects operate independently of LDL-cholesterol reduction, correlate poorly or not at all with LDL-cholesterol changes, take place rapidly, and are rapidly reversible on discontinuation of the drug.
Direct effects in the absence of LDL or total cholesterol modification have been shown both in vitro and in vivo. The pleiotropic effects of statins and other drugs are under continued investigation to fully establish their role in the prevention of cardiovascular events. The results of several ongoing clinical trials aimed more specifically at pleiotropic effects should enlighten us on their relative clinical relevance and importance.
Published: 07 March 2022
The pleiotropic benefits of statins include the ability to reduce CD47 and amplify the effect of pro-efferocytic therapies in atherosclerosis
https://www.nature.com/articles/s44161-022-00023-x
Abstract
The pleiotropic benefits of statins may result from their impact on vascular inflammation. The molecular process underlying this phenomenon is not fully elucidated. In the present study, RNA-sequencing designed to investigate gene expression patterns after CD47–SIRPα inhibition identifies a link of statins, efferocytosis and vascular inflammation.
In vivo and in vitro studies provide evidence that statins augment programmed cell removal by inhibiting the nuclear translocation of NF-κB1 p50 and suppressing the expression of the critical ‘don’t-eat-me’ molecule, CD47.
Statins amplify the phagocytic capacity of macrophages, and thus the anti-atherosclerotic effects of CD47–SIRPα blockade, in an additive manner. Analyses of clinical biobank specimens suggest a similar link between statins and CD47 expression in humans, highlighting the potential translational implications.
Taken together, our findings identify efferocytosis and CD47 as pivotal mediators of statin pleiotropy. In turn, statins amplify the anti-atherosclerotic effects of prophagocytic therapies independently of any lipid-lowering effect.