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Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Lipid-lowering-independent effects of simvastatin on the kidney in experimental hypercholesterolaemia
Stephanie H Wilson1, Alejandro R Chade, Ariel Feldstein
1Division of Hypertension, Mayo Clinic, Rochester, MN 55905, USA.
Insights
Simvastatin treatment improved kidney blood flow and reduced inflammation and oxidative stress in pigs with high cholesterol. These findings suggest statins offer novel kidney protection beyond cholesterol lowering in hypercholesterolemia.
Area of Science:
- Nephrology
- Cardiovascular Research
- Pharmacology
Background:
- Hypercholesterolemia (HC) is a significant risk factor for kidney injury, linked to oxidized LDL, oxidative stress, and renal inflammation.
- The impact of HMG-CoA-reductase inhibitors (statins) on renal hemodynamics and function in HC remains unclear.
Purpose of the Study:
- To investigate the effects of simvastatin on renal hemodynamics and function in a pig model of diet-induced hypercholesterolemia.
Main Methods:
- Pigs were fed a normal diet, a high-cholesterol (HC) diet, or an HC diet with simvastatin for 12 weeks.
- Renal hemodynamics and function were assessed using electron-beam computed tomography (EBCT).
- Renal tissue was analyzed via immunohistochemistry.
Main Results:
- Simvastatin treatment increased endothelial nitric-oxide-synthase (eNOS) expression and decreased LOX-1 receptor expression.
- Reduced markers of oxidative stress and inflammation (inducible-NOS, nitrotyrosine, NF-κB) were observed in simvastatin-treated pigs.
- Cortical and medullary renal perfusion significantly increased in the simvastatin group compared to HC and normal groups.
Conclusions:
- Simvastatin mitigated renal inflammation, oxidative stress, and fibrosis in hypercholesterolemic pigs.
- These renoprotective effects occurred alongside enhanced renal perfusion, independent of cholesterol-lowering effects.
- Statins may offer novel renoprotective benefits in hypercholesterolemia and atherosclerosis settings.
Background:
Hypercholesterolaemia (HC), an independent risk factor for renal injury, is associated with formation of oxidized low-density-lipoprotein (ox-LDL), increased oxidative-stress and renal inflammation. HMG-CoA-reductase inhibitors are commonly used in HC, but their effects on renal haemodynamics and function in HC are poorly understood.
Methods:
Pigs were studied after a 12-week normal diet, a 2% high-cholesterol diet (HC) or an HC diet supplemented with simvastatin (HC+simvastatin, 80 mg/day) (n=6-8 each group). Renal haemodynamics and function were quantified in vivo with electron-beam computed tomography (EBCT). Shock-frozen renal tissue was subsequently studied using immunohistochemistry.
Results:
LDL cholesterol was similarly increased in HC and HC+simvastatin. Simvastatin-treated animals showed increased expression of endothelial nitric-oxide-synthase (eNOS), and decreased expression of the ox-LDL receptor LOX-1 in renal endothelial cells. Simvastatin also decreased tubular immunoreactivity of inducible-NOS, nitrotyrosine, nuclear-factor-kappaB, and tubuloglomerular trichrome staining. These were associated with a significant increase in cortical (6.1+/-0.1 vs 5.0+/-0.3 and 5.0+/-0.1 ml/min/cc, respectively, P<0.001) and medullary perfusion in HC+simvastatin compared to normal and HC.
Conclusions:
Simvastatin attenuated the inflammatory and pro-oxidative environment as well as fibrosis in kidneys in pigs with diet-induced HC, in association with enhanced renal perfusion. These cholesterol-lowering-independent changes imply novel renoprotective effects of statins in the setting of HC and atherosclerosis.
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