Menzies Daniel, Nair Arun, Meldrum Karen T, Fleming Dawn, Barnes Martyn, Lipworth Brian J
Asthma and Allergy Research Group, Ninewells Hospital and Medical School, Dundee, UK.
J Allergy Clin Immunol. 2007 Feb;119(2):328-35. doi: 10.1016/j.jaci.2006.10.014. Epub 2006 Dec 4.
Statins lower cholesterol and also exhibit anti-inflammatory properties. In vitro and animal studies have suggested they may be useful for the treatment of a number of inflammatory conditions.
To evaluate the in vivo therapeutic potential of simvastatin as an anti-inflammatory agent in patients with asthma.
Potential signal from treatment effect was optimized by withdrawing all anti-inflammatory treatment for the duration of the study. Participants received 1 month of daily simvastatin and 1 month of daily placebo in a randomized, double-blind crossover trial. A total of 16 patients completed per protocol. Asthmatic inflammation was evaluated by measuring exhaled tidal nitric oxide, alveolar nitric oxide, sputum and peripheral eosinophil count, methacholine hyperresponsiveness, salivary eosinophilic cationic protein, and C-reactive protein. Measurements of dynamic and static lung volumes and of cholesterol were also made.
After initial withdrawal of usual asthma medication, there was a 1.43 geometric mean fold increase (ie, 43% difference) in fraction of exhaled nitric oxide (95% CI, 1.15 to 1.78; P = .004). Compared with placebo, simvastatin led to a 0.86 geometric mean fold decrease (95% CI, 0.7 to 1.04; P = .15) in exhaled nitric oxide (ie, a 14% difference), and a -0.18 doubling dilution shift (95% CI, -1.90 to 1.55; P = 1.0) in methacholine hyperresponsiveness. There were no significant differences in other inflammatory outcomes, lung volumes, or airway resistance between simvastatin and placebo. Treatment with simvastatin led to a significant reduction (P < .005) of total and low-density lipoprotein cholesterol.
There is no evidence to suggest simvastatin has anti-inflammatory activity in patients with asthma.
Simvastatin is not useful for the treatment of asthma.
他汀类药物可降低胆固醇，还具有抗炎特性。体外和动物研究表明，它们可能对多种炎症性疾病的治疗有用。
评估辛伐他汀作为抗炎药物在哮喘患者中的体内治疗潜力。
在研究期间停用所有抗炎治疗以优化治疗效果的潜在信号。在一项随机、双盲交叉试验中，参与者接受了1个月的每日辛伐他汀治疗和1个月的每日安慰剂治疗。共有16名患者按方案完成研究。通过测量呼出潮气一氧化氮、肺泡一氧化氮、痰液和外周嗜酸性粒细胞计数、乙酰甲胆碱高反应性、唾液嗜酸性粒细胞阳离子蛋白和C反应蛋白来评估哮喘炎症。还进行了动态和静态肺容量以及胆固醇的测量。
在最初停用常规哮喘药物后，呼出一氧化氮分数有1.43的几何平均倍数增加（即43%的差异）（95%CI，1.15至1.78；P = 0.004）。与安慰剂相比，辛伐他汀使呼出一氧化氮有0.86的几何平均倍数降低（95%CI，0.7至1.04；P = 0.15）（即14%的差异），乙酰甲胆碱高反应性有-0.18的倍增稀释变化（95%CI，-1.90至1.55；P = 1.0）。辛伐他汀和安慰剂在其他炎症结果、肺容量或气道阻力方面没有显著差异。辛伐他汀治疗导致总胆固醇和低密度脂蛋白胆固醇显著降低（P < 0.005）。
没有证据表明辛伐他汀对哮喘患者具有抗炎活性。
辛伐他汀对哮喘治疗无用。
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