Hodgkinson Conrad P, Ye Shu
Centre of Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Charterhouse Square, London, UK.
Pharmacogenet Genomics. 2008 Sep;18(9):803-13. doi: 10.1097/FPC.0b013e3283050aff.
Toll-like receptor 4 (TLR4) is the main receptor for Lipopolysaccharide (LPS). Two relatively common variants of the TLR4 gene are present, resulting in changes from aspartic acid (D) to glycine (G) at residue 299 and from threonine (T) to isoleucine (I) at residue 399, respectively. It has been shown that statins have a greater effect on lowering risk of cardiovascular events in individuals carrying the 299G allele than in those not carrying this allele. We investigated possible mechanisms underlying this synergy of statin treatment and TLR4 genotype.
In cells expressing the 299D-399T TLR4, LPS activated the transcription factor NFkappaB and increased the expression of interleukin-6 and tumor necrosis factor-alpha, and these effects were reduced by pretreatment of the cells with pravastatin or simvastatin. LPS-induced NFkappaB activation and interleukin-6 and tumor necrosis factor-alpha expression were substantially reduced in cell expressing the 299G-399T or 299D-399I variant, and undetectable in cells expressing the 299G-399I TLR4. The 3-hydroxy-3-methylglutaryl coenzyme A pathway inhibitors, Y27632 and GGTI-286, exhibited a similar effect to statins, suggesting that the inhibitory effect of statins was mediated by the 3-hydroxy-3-methylglutaryl coenzyme A pathway.
The results of this study indicate that the TLR4 variations and statins have an additive inhibitory effect on TLR4-mediated inflammatory response, providing a potential explanation for the finding that the beneficial effect of statins on cardiovascular risk is dependent on TLR4 genotype.
Toll样受体4(TLR4)是脂多糖(LPS)的主要受体。TLR4基因存在两种相对常见的变体,分别导致第299位残基由天冬氨酸(D)变为甘氨酸(G),第399位残基由苏氨酸(T)变为异亮氨酸(I)。研究表明,与未携带299G等位基因的个体相比,他汀类药物对携带该等位基因个体降低心血管事件风险的作用更大。我们研究了他汀类药物治疗与TLR4基因型协同作用的潜在机制。
在表达299D-399T TLR4的细胞中,LPS激活转录因子NFκB并增加白细胞介素-6和肿瘤坏死因子-α的表达,而普伐他汀或辛伐他汀预处理细胞可降低这些作用。在表达299G-399T或299D-399I变体的细胞中,LPS诱导的NFκB激活以及白细胞介素-6和肿瘤坏死因子-α表达显著降低,而在表达299G-399I TLR4的细胞中则无法检测到。3-羟基-3-甲基戊二酰辅酶A途径抑制剂Y27632和GGTI-286表现出与他汀类药物相似的作用,提示他汀类药物的抑制作用是由3-羟基-3-甲基戊二酰辅酶A途径介导的。
本研究结果表明,TLR4变异与他汀类药物对TLR4介导的炎症反应具有累加抑制作用,为他汀类药物对心血管风险的有益作用取决于TLR4基因型这一发现提供了潜在解释。