Medicinal Safety Research Laboratories, Daiichi Sankyo Co., Ltd., Tokyo, Japan.
J Toxicol Sci. 2011 Aug;36(4):445-52. doi: 10.2131/jts.36.445.
3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are associated with adverse skeletal muscle toxicity, but the underlying mechanism remains unclear. To investigate the pathological mechanism of statin-induced myotoxicity, cerivastatin (20 ppm; corresponding to 2 mg/kg/day) was dietarily administered to young male F344 rats for 10 days, and time-course clinical observations, measurement of plasma creatine kinase activity, and light and electron microscopy of type I fiber-predominant skeletal muscle (soleus) or type II fiber-predominant skeletal muscles (extensor digitorum longus and tibialis anterior), were performed. Clinical symptoms including weakness of hind limbs, staggering gait and body weight loss, accompanied by marked plasma creatinine kinase elevation in rats fed cerivastatin at around Day 6 to 8. Interestingly, microscopic examination revealed that cerivastatin-induced muscle damages characterized by hypercontraction (opaque) and necrosis of the fibers were of particular abundance in the soleus muscle at Day 8, whereas these histological lesions in the extensor digitorum longus and tibialis anterior were negligible, even at Day 9. Prior to manifestation of muscle damage, swollen mitochondria and autophagic vacuoles in the soleus were observed as the earliest ultra structural changes at Day 6; then activated lysosomes, disarray of myofibril and dilated sarcoplasmic reticulum vesicles became ubiquitous at Day 8. These results demonstrate that cerivastatin induces type I fiber-predominant muscles injury, which is associated with mitochondrial damage, in young male F344 rats. Since the rat exhibiting type I fiber-targeted injury is a unique animal model for statin-induced myotoxicity, it will be useful for gaining insight into mechanisms of statin-induced myotoxicity.
3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂(他汀类药物)与不良的骨骼肌毒性相关,但潜在的机制尚不清楚。为了研究他汀类药物引起的肌毒性的病理机制,将西立伐他汀(20ppm;相当于 2mg/kg/天)添加到年轻雄性 F344 大鼠的饮食中,连续喂养 10 天,同时进行临床症状观察、血浆肌酸激酶活性测定以及 I 型纤维占优势的骨骼肌(比目鱼肌)或 II 型纤维占优势的骨骼肌(趾长伸肌和胫骨前肌)的光镜和电镜检查。在喂养西立伐他汀的大鼠中,在大约第 6 至 8 天,会出现包括后肢无力、蹒跚步态和体重减轻等临床症状,同时伴有明显的血浆肌酸激酶升高。有趣的是,显微镜检查显示,西立伐他汀诱导的肌肉损伤特征是纤维的高度收缩(混浊)和坏死,在第 8 天比目鱼肌中特别丰富,而在趾长伸肌和胫骨前肌中,这些组织学病变则可以忽略不计,甚至在第 9 天也是如此。在肌肉损伤表现之前,在第 6 天就观察到比目鱼肌中肿胀的线粒体和自噬空泡,这是最早的超微结构变化;然后在第 8 天,溶酶体激活、肌原纤维排列紊乱和扩张的肌浆网囊泡变得普遍存在。这些结果表明,西立伐他汀在年轻雄性 F344 大鼠中诱导 I 型纤维占优势的肌肉损伤,这与线粒体损伤有关。由于表现出 I 型纤维靶向损伤的大鼠是他汀类药物引起肌毒性的独特动物模型,因此该模型将有助于深入了解他汀类药物引起肌毒性的机制。