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Sherafat A, Sahebnasagh A, Rahmany R, Mohammadi F, Saghafi F. The preventive effect of the combination of atorvastatin and nortriptyline in migraine-type headache: a randomized, triple-blind, placebo-controlled trial. Neurol Res 2022; 44:311-317. [PMID: 35037597 DOI: 10.1080/01616412.2021.1981105] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Migraine ranked as the eighth cause of disability worldwide. Statins with anti-inflammatory and vasodilatory endothelial effects have been introduced as an option for the prevention of migraine-type headaches. The current study aimed to assess the efficacy and tolerability of atorvastatin for the prevention of migraine in adults. METHOD This prospective, triple-blind, randomized controlled clinical trial was performed in adult migraineurs from mid-July 2019 to late-April 2020. Patients were randomly assigned to receive atorvastatin or placebo in combination with nortriptyline for 24-weeks. The frequency of headache was the primary outcome, and intensity of the headache and quality of life (QOL) were the secondary outcomes for this study. RESULTS With 34 patients in each arm, 68 patients with migraines based on the International Headache Society (IHS) criteria were enrolled in the study. At week 24, patients in the atorvastatin group experienced significantly fewer migraine attacks than the placebo group (P-value = 0.004). Moreover, there were significant differences between the two groups in QOL at follow-up intervals of 14 (P-value = 0.001) and 24 (P-value < 0.001) weeks. However, no significant difference was observed in the intensity of headache was observed in both groups (P-value > 0.05). The most common adverse effects in intervention and control groups were constipation and insomnia, respectively. CONCLUSION In patients with migraine, prophylaxis with atorvastatin significantly improved the frequency of headache and QOL over 24 weeks compared with placebo with no effect on the intensity of headache. Statins seem to be a potential promising drug for prophylaxis of migraine headaches.
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Affiliation(s)
- Amir Sherafat
- Neurologist, Department of Neurology, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Adeleh Sahebnasagh
- Department of Internal Medicine, Clinical Research Center, Faculty of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Roya Rahmany
- Student Research Committee, Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Farhad Mohammadi
- Department of Pharmaceutics, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Fatemeh Saghafi
- Department of Clinical Pharmacy, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Ganji R, Majdinasab N, Hesam S, Rostami N, Sayyah M, Sahebnasagh A. Does atorvastatin have augmentative effects with sodium valproate in prevention of migraine with aura attacks? A triple-blind controlled clinical trial. J Pharm Health Care Sci 2021; 7:12. [PMID: 33789774 PMCID: PMC8015063 DOI: 10.1186/s40780-021-00198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/25/2021] [Indexed: 11/12/2022] Open
Abstract
Background Migraine is a painful and disabling nervous disorder which negatively affects the quality of life. Migraineurs may suffer from a generalized vasomotor dysfunction. Statins improve vasomotor and vascular function, with their pleiotropic effects. We aimed to assess efficacy and safety of adding Atorvastatin to prophylactic regimen in better control of migraine with aura. Methods This triple-blind controlled clinical trial was on 68 patients with migraine with aura. An interval of at least 1 month was given to evaluate vitamin D3 level and eligibility. In patients with vitamin D3 deficiency, the correction with vitamin D supplementation was provided. The patients were randomly assigned to receive atorvastatin 20 mg plus sodium valproate 500 mg or placebo plus sodium valproate 500 mg once a day for 2 months. The patients were evaluated based for the number of attacks and pain severity based on Visual Analogue Scale. Results There was a significant (p = 0.0001) improvement in severity of pain and number of migraine attacks by adding Atorvastin to the prophylactic regimen of patients with migraine with aura. After controlling for variable parameters, the differences between two arms of the study was yet statistically significant (p = 0.0001). A significant number of participants in intervention group were satisfied by their treatment (p = 0.001) with no remarkable side effects (P = 0.315). Conclusions Adding atorvastatin to migraine with aura preventive regimen may help reduce the number of acute attacks and pain severity without causing considerable side effects and led to a better patient satisfaction. Trial registration IRCT20180106038242N1. Registered: 7 February 2018.
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Affiliation(s)
- Reza Ganji
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nastaran Majdinasab
- Musculoskeletal Rehabilitation Research Center, Department of Neurology, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Hesam
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nazanin Rostami
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayyah
- Education Development Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran. .,Department of Surgical Medicine, Faculty of Medicine, North Khorasan University of Medical Sciences, Imam Ali Hospital, Shahriar Street, Bojnourd, North Khorasan Province, Iran.
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Molero Y, Cipriani A, Larsson H, Lichtenstein P, D'Onofrio BM, Fazel S. Associations between statin use and suicidality, depression, anxiety, and seizures: a Swedish total-population cohort study. Lancet Psychiatry 2020; 7:982-990. [PMID: 33069320 PMCID: PMC7606915 DOI: 10.1016/s2215-0366(20)30311-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/22/2020] [Accepted: 06/11/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Statins have shown both protective and adverse associations with neuropsychiatric outcomes. We aimed to examine the possible associations between statins and suicidality, depression, anxiety, and seizures. METHODS Using Swedish national registers, we linked data on dispensed statin prescriptions with data on unplanned (emergency) hospital visits or specialised outpatient care for four neuropsychiatric outcomes: suicidal behaviour (including deaths from suicide), depressive disorders, anxiety disorders, and seizures. We included all individuals in the registries who were dispensed statins and who were aged 15 years or older between Jan 1, 2006, and Dec 31, 2013. We applied a within-individual design using stratified Cox proportional hazards regression to compare the incidence of the defined outcomes during periods on statins and periods off statins within each individual, thus adjusting for time-invariant confounders. Non-specific effects of treatment were tested by investigating these outcomes in relation to thiazide diuretic use and antihistamine use in the same cohort. FINDINGS The statin-users cohort comprised 1 149 384 individuals, of whom 1 015 949 (88·4%) were aged 50 years or older, 625 616 (54·4%) were male, and 523 768 (45·6%) were female. The study period consisted of 2 053 310 non-treatment periods and 2 997 545 treatment periods, and 957 216 (83·3%) individuals had a medication status change (from on statins to off statins, or vice versa). Suicide outcomes were found in 6372 (0·6%) individuals, depressive disorders in 23 745 (2·1%), anxiety disorders in 30 100 (2·6%), and seizures in 28 844 (2·5%). There were no clear associations between periods of statin treatment and suicidal behaviour or deaths from suicide (hazard ratio 0·99 [95% CI 0·90-1·08]), anxiety disorders (0·99 [0·95-1·02]), or seizures (1·00 [0·97-1·04]). Statins were associated with reduced hazards of depressive disorders (0·91 [0·87-0·94]), which remained after adjustment for concurrent antidepressant use (0·91 [0·88-0·94]). Hazard ratios for depressive disorders were 0·61 (0·38-1·00; n=14 718) with thiazide diuretic use and 0·84 (0·67-1·06; n=23 715) with antihistamine use. INTERPRETATION Statin use is not associated with suicidality, anxiety disorders, or seizures. Whether the observed association between statin use and reduced diagnoses of clinical depression is confounded by non-specific benefits related to being prescribed medication needs further research. FUNDING Wellcome Trust, Swedish Research Council, National Institute for Health Research (NIHR) Research Professorship, NIHR Oxford Health Biomedical Research Centre, American Foundation for Suicide Prevention, Karolinska Institutet.
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Affiliation(s)
- Yasmina Molero
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Cipriani
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brian M D'Onofrio
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
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High dose simvastatin and rosuvastatin impair cognitive abilities of healthy rats via decreasing hippocampal neurotrophins and irisin. Brain Res Bull 2020; 165:81-89. [PMID: 33010350 DOI: 10.1016/j.brainresbull.2020.09.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/14/2020] [Accepted: 09/24/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Statins are cholesterol lowering drugs that decrease the risk of cardiovascular events, but they are related with a few unfavorable symptoms in skeletal muscle including myopathy, and mild to moderate fatigue. Additionally, there has been discrepancies about the impacts of statins on brain and cognition. This study aimed to examine the impacts of two different statins, lipophilic simvastatin and hydrophilic rosuvastatin on cognitive functions in normal healthy rats. Simultaneously, we investigated the alterations of neurotropins and irisin levels in hippocampus and myokine levels in skeletal muscle. METHODS The rats were dosed with 88 mg kg body weight-1 day-1 simvastatin (n = 8), 150 mg kg body weight-1 day-1 rosuvastatin (n = 8) or vehicle (n = 8) for 18 days via oral gavage. After that behavioral assessment was performed and hippocampus and skeletal muscle samples were taken for the analysis of neurotrophins and irisin levels. RESULTS Locomotion and learning and memory functions were lower, but anxiety levels were higher in the simvastatin and rosuvastatin groups than in the control group (P < 0.05). Hippocampal neurotrophins and irisin levels were lower, but skeletal muscle brain-derived neurotrophic factor (BDNF) and irisin levels were higher in the simvastatin and rosuvastatin groups than in the control group (P < 0.05). CONCLUSION These findings suggest that high dose simvastatin and rosuvastatin impair cognitive functions via decreasing BDNF, NGF and irisin levels in the hippocampus.
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De La Cruz JA, Mihos CG, Horvath SA, Santana O. The Pleiotropic Effects of Statins in Endocrine Disorders. Endocr Metab Immune Disord Drug Targets 2020; 19:787-793. [PMID: 30924424 DOI: 10.2174/1871530319666190329115003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The 3-Hydroxy-3-MethylGlutaryl-CoA reductase inhibitors, better known as statins, are used extensively in the treatment of dyslipidemia and cardiovascular risk reduction. They have also demonstrated a variety of non-lipid lowering, or pleiotropic effects. Pertaining to the endocrine system the benefits of statins can extend to patients with the polycystic ovarian syndrome and thyroid disease. However, there is also increasing evidence that statin use can lead to deleterious effects in different organs, including worsening glycemia and the development of diabetes mellitus. OBJECTIVE The aim of this review is to describe the most relevant and updated evidence regarding the pleiotropic effects of statins in endocrine disorders. METHODS We did a systematic review of scientific articles published in PubMed regarding the effects of statins on the different aspects of the endocrine system up until June 5th of 2018. RESULTS We identified preliminarily 61 publications, of which 4 were excluded due to having abstract format only, and 5 were excluded for not containing pertinent information to the study. CONCLUSION Several aspects of the endocrine system have been shown to be influenced by the pleiotropic effects that statins exert, however, the benefits of statins on cardiovascular morbidity and mortality largely outweigh this deleterious effect, and statin therapy should continue to be recommended.
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Affiliation(s)
- Javier A De La Cruz
- Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Christos G Mihos
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
| | - Sofia A Horvath
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
| | - Orlando Santana
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
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Biocatalyzed Synthesis of Statins: A Sustainable Strategy for the Preparation of Valuable Drugs. Catalysts 2019. [DOI: 10.3390/catal9030260] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, are the largest selling class of drugs prescribed for the pharmacological treatment of hypercholesterolemia and dyslipidaemia. Statins also possess other therapeutic effects, called pleiotropic, because the blockade of the conversion of HMG-CoA to (R)-mevalonate produces a concomitant inhibition of the biosynthesis of numerous isoprenoid metabolites (e.g., geranylgeranyl pyrophosphate (GGPP) or farnesyl pyrophosphate (FPP)). Thus, the prenylation of several cell signalling proteins (small GTPase family members: Ras, Rac, and Rho) is hampered, so that these molecular switches, controlling multiple pathways and cell functions (maintenance of cell shape, motility, factor secretion, differentiation, and proliferation) are regulated, leading to beneficial effects in cardiovascular health, regulation of the immune system, anti-inflammatory and immunosuppressive properties, prevention and treatment of sepsis, treatment of autoimmune diseases, osteoporosis, kidney and neurological disorders, or even in cancer therapy. Thus, there is a growing interest in developing more sustainable protocols for preparation of statins, and the introduction of biocatalyzed steps into the synthetic pathways is highly advantageous—synthetic routes are conducted under mild reaction conditions, at ambient temperature, and can use water as a reaction medium in many cases. Furthermore, their high selectivity avoids the need for functional group activation and protection/deprotection steps usually required in traditional organic synthesis. Therefore, biocatalysis provides shorter processes, produces less waste, and reduces manufacturing costs and environmental impact. In this review, we will comment on the pleiotropic effects of statins and will illustrate some biotransformations nowadays implemented for statin synthesis.
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Trivedi LU, Alvarez CA, Mansi IA. Association of Statin Therapy With Risk of Epilepsy in 2 Propensity Score-Matched Cohorts. Ann Pharmacother 2018; 52:546-553. [PMID: 29400081 DOI: 10.1177/1060028018756650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Studies have suggested that statins may have a neuroprotective effect against epilepsy. However, evidence from rat models and case reports have suggested an opposite effect. Overall data are limited. OBJECTIVE To examine the association between statin use and epilepsy risk in a general population and in a healthy population (individuals with no severe comorbidities). METHODS Patients were Tricare beneficiaries from October 2003 to March 2012. Based on patients' characteristics during baseline phase (fiscal year [FY] 2004-2005), 2 propensity score (PS)-matched cohorts of statin users and nonusers were formed: (1) a PS-matched general cohort and (2) a PS-matched healthy cohort. Our outcome was defined using inpatient or outpatient ICD-9 codes for epilepsy during the follow-up phase (FY 2006 to March 2012) in the cohorts of statin users and nonusers. RESULTS The study included a total of 43 438 patients (13 626 statin users and 29 812 nonusers). The PS-matched general cohort matched 6342 statin users to 6342 nonusers; the odds ratio (OR) of epilepsy in this cohort during follow-up was 0.91; 95% CI = 0.67-1.23. The PS-matched healthy cohort matched 3351 statin users to 3351 nonusers; OR in the PS-matched healthy cohort during follow-up was 1.08; 95% CI = 0.64-1.83. CONCLUSIONS This study did not demonstrate a significant beneficial or deleterious effect of statin use on risk of being diagnosed with epilepsy. Clinicians should not withhold statins, whenever indicated, in patients with epilepsy.
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Affiliation(s)
| | | | - Ishak A Mansi
- 1 University of Texas Southwestern Medical Center, Dallas, TX, USA.,3 VA North Texas Health Care System, Dallas, TX, USA
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Oliveira CVD, Zorzi VN, Fighera MR, Royes LFF, Furian AF, Oliveira MS. Subtle improvement of seizure susceptibility by atorvastatin treatment during epileptogenesis. Pharmacol Rep 2017; 70:364-371. [PMID: 29477945 DOI: 10.1016/j.pharep.2017.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 08/07/2017] [Accepted: 08/25/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The process by which a brain insult elicits epilepsy is termed epileptogenesis and it is characterized by numerous molecular and functional alterations. Statins are first-line drugs for hypercholesterolemia and related diseases, and display neuroprotective properties in clinical and experimental studies. Considering the importance in developing therapeutic strategies to prevent or modify epileptogenesis, we aimed the present study to test the hypothesis that atorvastatin modifies seizure susceptibility of mice after status epilepticus (SE). METHODS Male and female C57BL/6 mice were submitted to the pilocarpine-induced SE and then treated with atorvastatin (10 or 100mg/kg, once daily by gavage) for 14days. At days 7 and 14 post SE we evaluated the susceptibility of mice to the convulsant effects of a low dose of PTZ (30mg/kg). Cell loss in the hilus of dentate gyrus was evaluated by Giemsa staining. RESULTS Latencies to myoclonic jerks and to tonic-clonic seizures decreased between baseline (before SE) and days 7 and 14 after SE, confirming the development of seizure susceptibility. Atorvastatin protected against PTZ-induced tonic-clonic seizures in both sexes at day 14 post-SE. Protective effects were similar in both female and male mice, except that a high dose of atorvastatin was required for females (protection at 100mg/kg versus 10mg/kg in males). Giemsa staining did not reveal neuroprotective effects of atorvastatin. CONCLUSIONS Atorvastatin treatment during epileptogenesis had slight beneficial effects on seizure susceptibility. These seem not related to neuroprotection. Further studies are needed to determine the disease-modifying potential of atorvastatin in epilepsy.
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Affiliation(s)
| | - Viviane Nogueira Zorzi
- Graduate Program in Biological Sciences: Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
| | - Michele Rechia Fighera
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil; Graduate Program in Biological Sciences: Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
| | - Luiz Fernando Freire Royes
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil; Graduate Program in Biological Sciences: Biochemistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
| | - Ana Flávia Furian
- Graduate Program in Pharmacology, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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Buettner C, Nir RR, Bertisch SM, Bernstein C, Schain A, Mittleman MA, Burstein R. Simvastatin and vitamin D for migraine prevention: A randomized, controlled trial. Ann Neurol 2015; 78:970-81. [PMID: 26418341 DOI: 10.1002/ana.24534] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Revised: 08/21/2015] [Accepted: 09/18/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this work was to assess efficacy and tolerability of simvastatin plus vitamin D for migraine prevention in adults with episodic migraine. METHODS We performed a randomized, double-blind, placebo-controlled trial with a 12-week baseline period and 24-week intervention period in 57 adults with episodic migraine. Participants were randomly assigned to simvastatin 20 mg tablets twice-daily plus vitamin D3 1,000 international units capsules twice-daily or matching placebo tablets and capsules. RESULTS Compared to placebo, participants using simvastatin plus vitamin D3 demonstrated a greater decrease in number of migraine days from the baseline period to intervention weeks 1 to 12: a change of -8.0 (interquartile range [IQR]: -15.0 to -2.0) days in the active treatment group versus +1.0 (IQR: -1.0 to + 6.0) days in the placebo group, p < 0.001; and to intervention weeks 13 to 24: a change of -9.0 (IQR: -13 to -5) days in the active group versus +3.0 (IQR: -1.0 to + 5.0) days in the placebo group, p < 0.001. In the active treatment group, 8 patients (25%) experienced 50% reduction in the number of migraine days at 12 weeks and 9 (29%) at 24 weeks postrandomization. In comparison, only 1 patient (3%) in the placebo group (p = 0.03) experienced such a reduction. Adverse events were similar in both active treatment and placebo groups. INTERPRETATION The results demonstrate that simvastatin plus vitamin D is effective for prevention of headache in adults with episodic migraine. Given statins' ability to repair endothelial dysfunction, this economical approach may also reduce the increased risk for vascular diseases among migraineurs.
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Affiliation(s)
- Catherine Buettner
- Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
| | - Rony-Reuven Nir
- Department of Neurology, Rambam Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Suzanne M Bertisch
- Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
| | - Carolyn Bernstein
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
| | - Aaron Schain
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
| | - Murray A Mittleman
- Department of Epidemiology, Harvard School of Public Health, Department of Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
| | - Rami Burstein
- Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, MA
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Potey C, Ouk T, Petrault O, Petrault M, Berezowski V, Salleron J, Bordet R, Gautier S. Early treatment with atorvastatin exerts parenchymal and vascular protective effects in experimental cerebral ischaemia. Br J Pharmacol 2015; 172:5188-98. [PMID: 26289767 DOI: 10.1111/bph.13285] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND PURPOSE From the clinical and experimental data available, statins appear to be interesting drug candidates for preventive neuroprotection in ischaemic stroke. However, their acute protective effect is, as yet, unconfirmed. EXPERIMENTAL APPROACH Male C57Bl6/JRj mice were subjected to middle cerebral artery occlusion and treated acutely with atorvastatin (10-20 mg·kg(-1) day(-1) ; 24 or 72 h). Functional recovery (neuroscore, forelimb gripping strength and adhesive removal test) was assessed during follow-up and lesion volume measured at the end. Vasoreactivity of the middle cerebral artery (MCA), type IV collagen and FITC-dextran distribution were evaluated to assess macrovascular and microvascular protection. Activated microglia, leucocyte adhesion and infiltration were chosen as markers of inflammation. KEY RESULTS Acute treatment with atorvastatin provided parenchymal and cerebral protection only at the higher dose of 20 mg·kg(-1) ·day(-1) . In this treatment group, functional recovery was ameliorated, and lesion volumes were reduced as early as 24 h after experimental stroke. This was associated with vascular protection as endothelial function of the MCA and the density and patency of the microvascular network were preserved. Acute atorvastatin administration also induced an anti-inflammatory effect in association with parenchymal and vascular mechanisms; it reduced microglial activation, and decreased leucocyte adhesion and infiltration. CONCLUSIONS AND IMPLICATIONS Acute atorvastatin provides global cerebral protection, but only at the higher dose of 20 mg·kg(-1) ·day(-1) ; this was associated with a reduction in inflammation in both vascular and parenchymal compartments. Our results suggest that atorvastatin could also be beneficial when administered early after stroke.
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Affiliation(s)
- C Potey
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - T Ouk
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - O Petrault
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - M Petrault
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - V Berezowski
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - J Salleron
- EA2694 - Biostatistics Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - R Bordet
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
| | - S Gautier
- U1171 - Medical Pharmacology Department, Faculty of Medicine, University of Lille 2 - Lille University Hospital, Lille, France
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Churchward MA, Todd KG. Statin treatment affects cytokine release and phagocytic activity in primary cultured microglia through two separable mechanisms. Mol Brain 2014; 7:85. [PMID: 25424483 PMCID: PMC4247600 DOI: 10.1186/s13041-014-0085-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/08/2014] [Indexed: 12/14/2022] Open
Abstract
Background As the primary immune cells of the central nervous system, microglia contribute to development, homeostasis, and plasticity of the central nervous system, in addition to their well characterized roles in the foreign body and inflammatory responses. Increasingly, inappropriate activation of microglia is being reported as a component of inflammation in neurodegenerative and neuropsychiatric disorders. The statin class of cholesterol-lowering drugs have been observed to have anti-inflammatory and protective effects in both neurodegenerative diseases and ischemic stroke, and are suggested to act by attenuating microglial activity. Results We sought to investigate the effects of simvastatin treatment on the secretory profile and phagocytic activity of primary cultured rat microglia, and to dissect the mechanism of action of simvastatin on microglial activity. Simvastatin treatment altered the release of cytokines and trophic factors from microglia, including interleukin-1-β, tumour necrosis factor-α, and brain derived neurotrophic factor in a cholesterol-dependent manner. Conversely, simvastatin inhibited phagocytosis in microglia in a cholesterol-independent manner. Conclusions The disparity in cholesterol dependence of cytokine release and phagocytosis suggests the two effects occur through distinct molecular mechanisms. These two pathways may provide an opportunity for further refinement of pharmacotherapies for neuroinflammatory, neurodegenerative, and neuropsychiatric disorders.
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Affiliation(s)
- Matthew A Churchward
- Neurochemical Research Unit, University of Alberta Faculty of Medicine, Edmonton, AB, Canada, T6G 2R3. .,Department of Psychiatry, University of Alberta Faculty of Medicine, Edmonton, AB, Canada, T6G 2R3.
| | - Kathryn G Todd
- Neurochemical Research Unit, University of Alberta Faculty of Medicine, Edmonton, AB, Canada, T6G 2R3. .,Department of Psychiatry, University of Alberta Faculty of Medicine, Edmonton, AB, Canada, T6G 2R3. .,Neuroscience and Mental Health Institute, University of Alberta Faculty of Medicine, Edmonton, AB, Canada, T6G 2R3.
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Citraro R, Chimirri S, Aiello R, Gallelli L, Trimboli F, Britti D, De Sarro G, Russo E. Protective effects of some statins on epileptogenesis and depressive-like behavior in WAG/Rij rats, a genetic animal model of absence epilepsy. Epilepsia 2014; 55:1284-91. [DOI: 10.1111/epi.12686] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Rita Citraro
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Serafina Chimirri
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Rossana Aiello
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Luca Gallelli
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Francesca Trimboli
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Domenico Britti
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Giovambattista De Sarro
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
| | - Emilio Russo
- Science of Health Department; School of Medicine; University “Magna Graecia” of Catanzaro; Catanzaro Italy
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13
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Gomez SI, Mihos CG, Pineda AM, Santana O. The pleiotropic effects of the hydroxy-methyl-glutaryl-CoA reductase inhibitors in renal disease. Int J Nephrol Renovasc Dis 2014; 7:123-30. [PMID: 24729724 PMCID: PMC3974687 DOI: 10.2147/ijnrd.s55102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
It is well known that statins exert their main effect by inhibiting cholesterol synthesis through the inhibition of the 3-hydroxy-3-methyl-glutaryl-CoA reductase enzyme. The pleiotropic effects of statins, which are independent of their inhibition of cholesterol synthesis, have explained many of the beneficial effects of these drugs in a variety of disorders such as malignancies, infection, and sepsis, as well as in cardiovascular and rheumatologic disorders. However, the role of these drugs in renal disorders remains controversial. In the present review, we examine the most recent findings involving statins and renal disease among different clinical scenarios, including chronic kidney disease, contrast-induced nephropathy, renal injury after coronary artery bypass surgery, and renal transplant patients.
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Affiliation(s)
- Sabas I Gomez
- Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Christos G Mihos
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, USA
| | - Andres M Pineda
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, USA
| | - Orlando Santana
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, USA
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14
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Mihos CG, Pineda AM, Santana O. Cardiovascular effects of statins, beyond lipid-lowering properties. Pharmacol Res 2014; 88:12-9. [PMID: 24631782 DOI: 10.1016/j.phrs.2014.02.009] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 02/25/2014] [Accepted: 02/27/2014] [Indexed: 12/11/2022]
Abstract
The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors, better known as 'statins', are amongst the most widely used medications in the world. They have become a pivotal component in the primary and secondary prevention of coronary artery and vascular disease. However, a growing amount of evidence has suggested that statins also possess strong pleiotropic effects irrespective of their lipid-lowering properties, which include enhancement of endothelial function, anti-inflammatory and anti-atherothrombotic properties, and immunomodulation. The following provides a comprehensive and updated review of the clinical evidence regarding the pleiotropic effects of statins in cardiovascular disorders and their potential therapeutic benefits.
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Affiliation(s)
- Christos G Mihos
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States
| | - Andres M Pineda
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States
| | - Orlando Santana
- Columbia University, Division of Cardiology at the Mount Sinai Heart Institute, Miami Beach, FL, United States.
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15
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Kurzepa J, Kurzepa J, Golab P, Czerska S, Bielewicz J. The significance of matrix metalloproteinase (MMP)-2 and MMP-9 in the ischemic stroke. Int J Neurosci 2014; 124:707-16. [PMID: 24304146 DOI: 10.3109/00207454.2013.872102] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There is a continuous urgent need to explore the pathogenesis and biochemical changes within the infarcted area during acute ischemic stroke (IS). Matrix metalloproteinases (MMPs), prevailing extracellular endopeptideses, can digest proteins located extracellulary, e.g. collagen, proteoglycans, elastin or fibronectin. Among MMPs, gelatinases (MMP-2 and MMP-9) are the most investigated enzymes. Gelatinases possess the ability to active numerous pro-inflammatory agents as chemokine CXCL-8, interleukin 1β or tumor necrosis factor α. Moreover, due to digestion of collagen type IV (the component of basal membranes) and tight junction proteins (TJPs) they facilitate to cross the endothelium by leukocytes. Due to the significant role of gelatinases during brain ischemia, their selective inhibition seems to be an interesting kind of treatment of acute stroke. The synthetic inhibitors of gelatineses decrease the infarct volume in animal models of IS. In clinical practice statins, the lipid-lowering drugs possess the ability to inhibit the activity of MMP-9 during acute IS. This review briefly provides the most important information about the involvement of MMP-2 and MMP-9 in the pathogenesis of brain ischemia.
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Affiliation(s)
- Jacek Kurzepa
- 1Department of Medical Chemistry, Medical University of Lublin , Poland
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16
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Corrao G, Ibrahim B, Nicotra F, Zambon A, Merlino L, Pasini TS, Catapano AL, Mancia G. Long-term use of statins reduces the risk of hospitalization for dementia. Atherosclerosis 2013; 230:171-6. [DOI: 10.1016/j.atherosclerosis.2013.07.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 06/17/2013] [Accepted: 07/11/2013] [Indexed: 12/21/2022]
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17
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Tasat DR, Yakisich JS. Expanding the pleiotropic effects of statins: attenuation of air pollution-induced inflammatory response. Am J Physiol Lung Cell Mol Physiol 2012; 303:L640-1. [PMID: 22923638 DOI: 10.1152/ajplung.00280.2012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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