[Statins and brain protection mechanisms]

The 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitors or statins are drugs used in the treatment of dyslipidemies. The clinical trials performed for evaluation of the efficacy observed a reduced incidence of stroke and other trials have demonstrated a better outcome after stroke and subrachnoid hemorrhage.

In the last years, new actions of statins have been described (pleiotropics). The statins seem to originate neuroprotector effects, such as up-regulation of endothelial nitric oxide synthase; creation of a fibrinolytic profile with suppression of the intravascular stability of the clot; immunomodulation by regulation of cytokines and cellular adhesion molecules; anti-oxidation by reduction of lipidic peroxidation; induction of neuroplasticity by increment of neurotrophic factors and protection of neuroexcitotoxicity, maybe by regulation of intracellular calcium or depletion of intracellular sterols. All these actions can be explained by decreament of isoprenoids synthesis.

The pleiotropic properties of the statins offer the possibility to consider them as possible neuroprotectors, which should be evaluated in pathologies where the molecular ways interfered are involved, for example head injury and stroke.