Related Experiment Videos
Levels of adhesion molecules do not decrease after 3 months of statin therapy in moderate hypercholesterolaemia
Bernd Jilma1, Christian Joukhadar, Ulla Derhaschnig
1Department of Clinical Pharmacology-TARGET, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. bernd.jilma@univie.ac.at
Insights
Statins do not reduce circulating adhesion molecules (cAM) in hypercholesterolemic patients. Even with significant cholesterol reduction, levels of E-selectin, ICAM-1, and VCAM-1 did not decrease after three months of therapy.
Area of Science:
- Cardiovascular Research
- Molecular Biology
- Pharmacology
Background:
- Adhesion molecules (AMs) play a key role in atherosclerosis development.
- The relationship between hypercholesterolemia and AM expression is not fully understood.
- It remains unclear if cholesterol-lowering therapies impact AM levels.
Purpose of the Study:
- To investigate the effect of three different statins on plasma levels of circulating adhesion molecules (cAM).
- To determine if statin therapy reduces cAM in hypercholesterolemic patients.
- To assess the impact of significant low-density lipoprotein cholesterol reduction on cAM.
Main Methods:
- A randomized clinical trial involving 75 hypercholesterolemic patients.
- Three-month treatment with standard doses of atorvastatin, simvastatin, and pravastatin.
- Measurement of plasma levels of circulating E-selectin, ICAM-1, and VCAM-1 before and after statin therapy.
Main Results:
- None of the statins significantly lowered plasma cAM levels.
- Pooled analysis showed non-significant increases in cE-selectin, cICAM-1, and cVCAM-1.
- cAM levels remained unchanged even in patients with >50% reduction in LDL cholesterol.
Conclusions:
- Three months of statin therapy does not decrease circulating adhesion molecule levels in moderate hypercholesterolemia.
- Cholesterol normalization does not appear to reduce AM levels within this timeframe.
- Further research may be needed to explore longer-term effects or different therapeutic strategies.
Abstract:
Studies in animals and humans indicate a pivotal role for adhesion molecules (AMs) in the pathogenesis of atherosclerosis. Whereas an association between hypercholesterolaemia and AM expression has been suggested, it is unclear whether lowering cholesterol decreases AM expression and release. We compared the effects of a 3-month treatment with standard doses of three different statins (atorvastatin, simvastatin and pravastatin) on plasma levels of circulating AM (cAM) in 75 hypercholesterolaemic patients in a randomized clinical trial. Plasma levels of circulating (c)E-selectin, circulating intercellular adhesion molecule-1 (cICAM-1) and circulating vascular cell adhesion molecule-1 (cVCAM-1) were measured before and after 3 months of therapy. None of the statins lowered plasma cAM levels and pooled analyses of all patients showed a 1.7% [95% confidence interval (CI), -1.4-4.9%] increase in cE-selectin, a 2.1% (95% CI, -0.2-4.4%) increase in cICAM-1, and a 2.7% (95% CI, -0.6-6.1%) increase in cVCAM-1 levels. cAM levels did not decrease, even in patients with a >50% decrease ( n =19) in low-density lipoprotein cholesterol levels. This study provides strong evidence that 3 months of therapy with three different statins does not decrease cAM levels, despite normalization of cholesterol levels, and a minor decrease in C-reactive protein levels in patients with moderate hypercholesterolaemia.