to Statins
Another Side
Heart-healthy drugs
show promise against
inflammation,
cancer and the flu
It’s been quite a ride for statins. Lipitor, Zocor, Crestor and their rel- atives are fast becoming household names. These cholesterol-lowering
drugs have delivered a body blow to
heart disease and stroke, two of the
top four killers in Western society.
All success comes with a price:
Some scientists express con-
cerns over the widespread use
and possible overprescription
of statins. Still, there’s no deny-
ing the evidence that they have
cardiovascular benefits in many
people. The drugs’ track record
has earned high praise for the
research team that first devised
them — and even higher rewards
for the companies cranking
them out.
Just when it seems that busi-
ness can’t get any better, another
upside to statins is now emerg-
ing. Research suggests that the
drugs have potent effects against
diseases they weren’t designed
to fight. Statins might make
people less susceptible to fatal
pneumonia, better able to sur-
vive a head injury and more apt
to dodge a nasty case of the flu.
No one is dancing in the
streets just yet. These and many
other findings arise from studies
that track comparable popula-
tions but don’t randomly assign
participants to one treatment or
another. While useful for picking
up trends, such population analy-
ses can’t always be trusted, says
Recently, though, laboratory research
by Lipkin and others is adding weight
to population findings. Cell-based work
shows that aside from slowing cholesterol
production, statins derail compounds
that exacerbate inflammation — an all-
around pain in the neck, and elsewhere.
What’s more, randomized trials in which
people get statins or dummy pills, the gold
standard for testing drugs, have shown a
knockdown of rheumatoid arthritis and
improvements in other immune-related
ailments. Such findings are boosting
enthusiasm among some researchers.
When statins first hit pharmacy
shelves in the late 1980s, the tone was
decidedly different. Many scientists
worried that the drugs might cause
cancer or have other unforgivable side
effects. The discussion has come full
circle now as scientists seek to sort out
whether the drugs might treat cancer.
“It’s definitely heartening. It’s exciting,” says Carol Prives, a molecular biologist at Columbia University. “But it’s a
large jump from [laboratory] data to any
clinical changes.”
Tackling inflammation
Statins have already made one giant
leap, from the early days of drug development to today’s broadening interest.
Japanese biochemist Akira Endo and his
colleagues devised the first rudimentary
statin in the 1970s, building on earlier
work that had deciphered how the body
makes cholesterol. His team screened
thousands of fungal components to see
if any of them bogged down cholesterol
manufacture in cells. The painstaking effort unearthed a compound that
reduced LDL — the “bad” form of cholesterol. The compound works by neutralizing an enzyme called HMGCR (for
3-hydroxy-3-methylglutaryl coenzyme-A reductase), halting the chain reaction
that leads to cholesterol production
inside cells. Scientists at Merck later
devised their own version of this first
statin, and the rest is Big Pharma history.
But over time it became clear that lowering cholesterol was only part of the
story. Although some patients still got
heart attacks, statins consistently overachieved: The drugs prevented more
heart attacks than would be attributable to cholesterol alone. Paul Ridker,
a cardiologist at the Harvard School of
Public Health and Brigham and Women’s Hospital in Boston, thought statins’
success might speak to a central puzzle
ICONS: DTERMINAL/ISTOCKPHOTO, ADAPTED BY E. FELICIANO
www.sciencenews.org
