Emerging Indications for Statins: A Pluripotent Family of Agents with Several Potential Applications

Abstract

Statins are pluripotent agents exhibiting multiple non-lipid-lowering actions. Besides their established role in the management of hypercholesterolemia, statins may also have beneficial actions in other pathological conditions, namely: a) osteoporosis and osteoporosis-related bone fractures, b) cancer, c) solid organ transplantation, d) cerebrovascular events (transient ischemic attack and stroke episodes), e) various neurological disorders, such as Alzheimer's disease, Parkinson's disease and multiple sclerosis, f) cardiac arrhythmias and heart failure, g) renal diseases, h) rheumatoid arthritis, i) autoimmune diseases, j) sepsis, and k) allergic asthma. We reviewed the literature searching for studies that support or oppose the use of statins in each proposed indication. In some of these emerging indications, a role for statin treatment is more firmly set; for others, current evidence is more controversial. Future trials may reveal more convincing evidence that will make statin use necessary in the therapeutic management of several diseases.

Pravastatin prevents miscarriages in mice: role of tissue factor in placental and fetal injury

“…20,[47][48][49] In abortion-prone CBA/J ϫ DBA/2 mice, statins by down-regulating TF expression, prevented sFlt-1 release from monocytes and restored the levels of angiogenic factors necessary for trophoblast proliferation, placental vessel formation, and good pregnancy outcomes. Moreover, statins prevented oxidative stress in trophoblasts incubated with sFlt-1.…”

Systemic manifestations and comorbidities of COPD

“…All of these studies on the pleiotropic effects of statins suggest that they may have a beneficial effect in COPD and this may contribute to the reduction in exacerbations in COPD patients treated with statins in observational studies [178][179][180]190]. Through their pleiotropic effects, statins may have beneficial effects not only on cardiovascular disease but also other comorbidities associated with COPD, including diabetes, osteoporosis and lung cancer [191]. Prospective controlled trials are now needed to establish whether statins have beneficial effects in COPD patients, especially those with systemic complications and comorbidities.…”

Neutrophil activation by the tissue factor/Factor VIIa/PAR2 axis mediates fetal death in a mouse model of antiphospholipid syndrome

“…Besides their established role in the management of hypercholesterolemia, statins may also have beneficial actions in other pathological conditions, including (but not limited to) cancer, solid organ transplantation, cerebrovascular ischemic events, renal diseases, rheumatoid arthritis, autoimmune diseases, and sepsis (42). Statins reduce TF synthesis, expression, and activity in many different cells, such as blood monocytes, endothelial cells, and breast carcinoma cells (18,19,42). In our present study, simvastatin and pravastatin decreased TF and PAR2 expression on neutrophils and prevented pregnancy loss induced by aPL-IgG.…”