Statins: Complex outcomes but increasingly helpful treatment options for patients

Abstract

Statins are long known class of medicines and the most frequently prescribed drugs in cardiovascular pharmacotherapy, widely ordered not only in patients suffering from dyslipidemia, but also in patients with coronary artery disease, acute coronary syndromes, diabetes mellitus, stroke, hypertension, and chronic kidney disease, with or without coexisting dyslipidemia. However, several clinical trials have shown, that the advantages of statins goes beyond their reduction of the cholesterol level. Some crucial isoprenoid mediators which are highly essential for the activation of different intracellular/signaling proteins, that play important roles in multiple cellular mechanisms, are regulated by statins in addition to the inhibition of cholesterol biosynthesis. Moreover, anti-inflammatory intermediates and cytokines such as c-reactive protein, IL1, IL6, IL8, TNFA are affected downstream targets. Still, these numerous effects of statins such as anti-inflammatory effects, antioxidant effects, anti-proliferative, apoptotic, cell cycle regulatory and immunomodulatory effects, are primarily seen in conjunction with the inhibition of the HMG-CoA reductase. Other direct targets are missing. Beyond the classical application of statins, they were also tested to treat cancer with promising prospects, but still on a level of an adjuvant therapy option. Nevertheless the growing number of cancer studies and the increasing number of molecular players in affected pathways illustrates, that statins might be helpful in cancer therapeutics, despite the major part of the biological reaction network, which is regulated by statins, remains sketchy. It seems, that the statins still have some potential to improve established therapeutic procedures.

Keywords: Cancer; Pleiotropic effects; Statin; Therapy.