Bruni Fulvio, Pasqui Anna Laura, Pastorelli Marcello, Bova Giovanni, Cercignani Michela, Palazzuoli Alberto, Sawamura Tatsuya, Gioffre W R, Auteri Alberto, Puccetti Luca
Department of Clinical Medicine and Immunological Sciences, Internal Medicine Division, Center for Atherosclerosis Research, University of Siena, Siena, Italy.
Clin Appl Thromb Hemost. 2005 Oct;11(4):417-28. doi: 10.1177/107602960501100408.
Hydroxymethyl-glutaryl-CoA-reductase inhibitors (statins) reduce cardiovascular mortality by decreasing cholesterol as well as by non-lipid-related actions. Oxidized low-density lipoproteins (ox-LDL) are pro-atherogenic molecules and potent platelet agonists. CD36 and lectin-like ox-LDL receptor-1 (LOX-1) are specific ox-LDL receptors also expressed in platelets. This study was planned to address whether treatment with atorvastatin 10 mg/day, pravastatin 40 mg/day or simvastatin 20 mg/day could affect platelet CD36 and LOX-1 expression. Twenty-four patients for each treatment were evaluated after 3, 6, and 9 days and at 6 weeks for complete lipid profile (chromogenic), ox-LDL (ELISA), platelet P-selectin (P-sel), CD36, LOX-1 (FACS), and intracellular citrullin recovery (iCit) (HPLC). Data show hyperactivated platelets (P-sel absolute values, percent variation in activated cells, all p < 0.001), and CD36 and LOX-1 overexpression (all p < 0.001) in patients at baseline. P-sel, CD36, and LOX-1 were significantly decreased by atorvastatin and simvastatin (all p < 0.01) and related with iCit increase (r = 0.58, p < 0.001) and platelet-associated ox-LDL (r = 0.51, p < 0.01) at 9 days. Pravastatin reduced LOX-1 and P-sel (p < 0.05) at 6 weeks in relation with decreased LDL and ox-LDL (r = 0.39, p < 0.01 and r = 0.37, p < 0.01, respectively). These data suggest that atorvastatin and simvastatin reduce platelet activity by exposure of CD36 and LOX-1 before significant LDL reduction, whereas pravastatin action is detected later and in relation with LDL and ox-LDL lowering. Rapid and consistent reduction of CD36 and LOX-1 could be considered a direct anti-atherothrombotic mechanism related to the role of ox-LDL in platelet activation, platelet-endothelium interactions, and NO synthase activity.
羟甲基戊二酰辅酶A还原酶抑制剂(他汀类药物)通过降低胆固醇以及非脂质相关作用来降低心血管疾病死亡率。氧化型低密度脂蛋白(ox-LDL)是促动脉粥样硬化分子和强效血小板激动剂。CD36和凝集素样ox-LDL受体1(LOX-1)是也在血小板中表达的特异性ox-LDL受体。本研究旨在探讨每日服用10毫克阿托伐他汀、40毫克普伐他汀或20毫克辛伐他汀是否会影响血小板CD36和LOX-1的表达。在3天、6天、9天以及6周后对每种治疗的24例患者进行评估,检测其完整血脂谱(比色法)、ox-LDL(酶联免疫吸附测定法)、血小板P-选择素(P-sel)、CD36、LOX-1(荧光激活细胞分选法)以及细胞内瓜氨酸回收率(iCit)(高效液相色谱法)。数据显示,基线时患者的血小板处于高激活状态(P-sel绝对值、激活细胞的百分比变化,均p<0.001),且CD36和LOX-1过表达(均p<0.001)。阿托伐他汀和辛伐他汀可使P-sel、CD36和LOX-1显著降低(均p<0.01),并在9天时与iCit增加(r = 0.58,p<0.001)以及血小板相关ox-LDL(r = 0.51,p<0.01)相关。普伐他汀在第6周时可降低LOX-1和P-sel(p<0.05),这与LDL和ox-LDL降低有关(分别为r = 0.39,p<0.01和r = 0.37,p<0.01)。这些数据表明,阿托伐他汀和辛伐他汀在显著降低LDL之前,通过暴露CD36和LOX-1来降低血小板活性,而普伐他汀的作用在后期检测到,且与LDL和ox-LDL降低有关。CD36和LOX-1的快速且持续降低可被视为一种直接的抗动脉粥样硬化血栓形成机制,这与ox-LDL在血小板激活、血小板-内皮相互作用以及一氧化氮合酶活性中的作用有关。