RESUMO
HMG-CoA inhibitors (statins) are widely used for the prevention of cardiovascular events and the management of hypercholesterolemia. Recently, multiple cholesterol-independent properties of statins have been discovered. The present review focuses on immunomodulatory and anti-inflammatory effects of statins and their implications for the treatment of autoimmune diseases, such as rheumatoid arthritis, multiple sclerosis, and psoriasis.
Assuntos
Doenças Autoimunes/tratamento farmacológico , Autoimunidade/efeitos dos fármacos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Animais , Doenças Autoimunes/imunologia , Humanos , Resultado do TratamentoRESUMO
AIM: To study activity of rheumatoid arthritis (RA) and cholesterol content in subfractions of blood serum lipoproteins in the course of simvastatin treatment. MATERIAL AND METHODS: The pilot study enrolled 16 patients with active rheumatoid arthritis (RA) meeting ACR criteria. Any standard anti-RA medication in stable doses was supplemented with simvastatin in a dose 40 mg/day for 12 weeks. The response was assessed by contents of cholesterol in serum lipoprotein subfractions and DAS28 index. RESULTS: At the end of the treatment course there was a significant elevation of HDLP2 and HDLP3 cholesterol and reduction in the levels of LDLP1-3 and LDLP cholesterol. DAS28 decreased by 0.89 points to the end of the treatment. CONCLUSION: Administration of simvastatin in patients with active RA on standard disease-modulating drugs has an antiatherogenic action and attenuates the disease activity. These pilot data should be confirmed by further large-scale controlled trials.
Assuntos
Anticolesterolemiantes/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Colesterol/sangue , Lipoproteínas/sangue , Sinvastatina/uso terapêutico , Adulto , Idoso , Anticolesterolemiantes/administração & dosagem , Antirreumáticos/uso terapêutico , Artrite Reumatoide/sangue , Artrite Reumatoide/complicações , Aterosclerose/sangue , Aterosclerose/complicações , Aterosclerose/prevenção & controle , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Sinvastatina/administração & dosagem , Resultado do TratamentoRESUMO
Patients with rheumatoid arthritis (RA) are at risk of cardiovascular disorders. Pathogenesis of rapidly developing atherosclerosis in RA remains to be elucidated. The aim of this study was to compare cholesterol content in serum lipoprotein subfractions in patients with RA and healthy subjects and to establish relationship between lipid profile variations, severity of the disease, and plasma levels of anti-inflammatory cytokines. The study included 15 patients with active RA and 120 healthy subjects of comparable sex and age. RA was found to be associated with a significant decrease of cholesterol of high density (HDL2) and intermediate density (IDL) lipoproteins and its elevation in low density lipoproteins (LDL1-3). There was negative correlation between the latter parameter and disease activity index. No relationship between lipoprotein cholesterol and serum interleukins (IL-6, IL-8) TNF-alpha, and IFN-gamma) was documented. It is concluded that patients with RA exhibit proatherogenic changes of cholesterol content in different lipoprotein subfractions related to the severity of the disease. Further studies are needed to elucidate molecular mechanisms of dyslipidemia in RA and to ensure the choice of optimal targets for therapeutic modalities reducing the risk of cardiovascular disorders.
Assuntos
Artrite Reumatoide/sangue , Citocinas/sangue , Lipídeos/sangue , Idoso , Artrite Reumatoide/complicações , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de RiscoRESUMO
Circadian variations in the immune status and serum melatonin were studied in asthmatics during exacerbation stage before and after treatment. Deviations from the normal (donor) immunogram values at 9.00 and 21.00 and decreased correlations between immune values and blood melatonin level were detected. The correlations of immune values between each other and with melatonin over the circadian cycle increased after treatment.