Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, Center for Comparative Respiratory Biology & Medicine, Davis, CA 95616, USA.
Transl Res. 2010 Dec;156(6):335-49. doi: 10.1016/j.trsl.2010.09.003.
Airway remodeling in asthma contributes to airway hyperreactivity, loss of lung function, and persistent symptoms. Current therapies do not adequately treat the structural airway changes associated with asthma. The statins are cholesterol-lowering drugs that inhibit the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase, which is the rate-limiting step of cholesterol biosynthesis in the mevalonate (MA) pathway. These drugs have been associated with improved respiratory health, and ongoing clinical trials are testing their therapeutic potential in asthma. We hypothesized that simvastatin treatment of ovalbumin (OVA)-exposed mice would attenuate early features of airway remodeling by a mevalonate-dependent mechanism. BALB/c mice initially were sensitized to OVA and then exposed to 1% OVA aerosol for 2 weeks after sensitization for 6 exposures. Simvastatin (40 mg/kg) or simvastatin plus MA (20 mg/kg) were injected intraperitoneally before each OVA exposure. Treatment with simvastatin attenuated goblet cell hyperplasia, arginase-1 protein expression, and total arginase enzyme activity, but it did not alter airway hydroxyproline content or transforming growth factor-β1. Inhibition of goblet cell hyperplasia by simvastatin was mevalonate-dependent. No appreciable changes to airway smooth muscle cells were observed in any control or treatment groups. In conclusion, in an acute mouse model of allergic asthma, simvastatin inhibited early hallmarks of airway remodeling, which are indicators that can lead to airway thickening and fibrosis. Statins are potentially novel treatments for airway remodeling in asthma. Additional studies using subchronic or chronic allergen exposure models are needed to extend these initial findings.
哮喘中的气道重塑导致气道高反应性、肺功能丧失和持续症状。目前的治疗方法不能充分治疗与哮喘相关的结构性气道变化。他汀类药物是降低胆固醇的药物,可抑制酶 3-羟-3-甲基戊二酰辅酶 A 还原酶,这是甲羟戊酸(MA)途径中胆固醇生物合成的限速步骤。这些药物与改善呼吸健康有关,正在进行的临床试验正在测试它们在哮喘中的治疗潜力。我们假设辛伐他汀治疗卵清蛋白(OVA)暴露的小鼠,通过甲羟戊酸依赖性机制,减轻气道重塑的早期特征。最初,BALB/c 小鼠对 OVA 致敏,然后在致敏后 6 次暴露的第 2 周,用 1%OVA 气溶胶暴露。在每次 OVA 暴露前,辛伐他汀(40mg/kg)或辛伐他汀加 MA(20mg/kg)通过腹腔注射。辛伐他汀治疗减轻了杯状细胞增生、精氨酸酶-1 蛋白表达和总精氨酸酶活性,但没有改变气道羟脯氨酸含量或转化生长因子-β1。辛伐他汀抑制杯状细胞增生是甲羟戊酸依赖性的。在任何对照组或治疗组中,都没有观察到气道平滑肌细胞的明显变化。总之,在急性变应性哮喘小鼠模型中,辛伐他汀抑制了气道重塑的早期特征,这些特征是导致气道增厚和纤维化的指标。他汀类药物可能是哮喘气道重塑的新疗法。需要使用亚慢性或慢性变应原暴露模型进行更多研究,以扩展这些初步发现。