Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, 50300 Kuala Lumpur, Malaysia.
Curr Drug Targets. 2013 Dec;14(13):1524-32. doi: 10.2174/13894501113149990195.
Fracture healing is a process of recovering injured bone tissue forms and functions. Osteoporosis can delay the healing process, which contributes to personal suffering and loss of activities. Osteoporosis patients tend to lose bone mass at the metaphyseal region which require treatment to increase bone mass. Postmenopausal osteoporosis is the most common osteoporosis that occurs in women which subsequently resulted in fractures even under slight trauma. Estrogen Replacement Therapy (ERT), the recommended therapy for postmenopausal osteoporosis, is associated with higher risk of breast cancer, ovarian cancer and cardiovascular diseases. As osteoporotic fractures are becoming a public health issue, alternative treatment is now being thoroughly explored. The potential agent is statins, the HMG-CoA reductase inhibitor which is widely used for hypercholesterolemia treatment. Statins have been found to increase bone mass by stimulation of Bone morphogenetic protein-2 (BMP-2) expression and Vascular Endothelial Growth Factor (VEGF) production. However, these bone forming effects were achieved at very high systemic doses. Therefore, studies on locally applied statins are required to further explore the ability of statins to stimulate bone formation at acceptable doses for better fracture healing. This review highlights the animal and clinical studies on fracture healing promotions by statins and the mechanisms involved.
骨折愈合是一个恢复受伤骨组织形态和功能的过程。骨质疏松症会延迟愈合过程，导致患者身体不适和活动能力丧失。骨质疏松症患者的干骺端区域往往会流失骨量，需要治疗来增加骨量。绝经后骨质疏松症是最常见的骨质疏松症，发生在女性中，随后即使在轻微创伤下也会导致骨折。雌激素替代疗法（ERT）是绝经后骨质疏松症的推荐疗法，但与乳腺癌、卵巢癌和心血管疾病的风险增加相关。由于骨质疏松性骨折已成为一个公共卫生问题，目前正在深入探索替代治疗方法。潜在的治疗药物是他汀类药物，即羟甲基戊二酰辅酶 A 还原酶抑制剂，广泛用于治疗高胆固醇血症。研究发现，他汀类药物通过刺激骨形态发生蛋白 2（BMP-2）表达和血管内皮生长因子（VEGF）的产生来增加骨量。然而，这些成骨作用是在非常高的全身剂量下实现的。因此，需要进行局部应用他汀类药物的研究，以进一步探索他汀类药物在可接受剂量下刺激骨形成的能力，从而促进更好的骨折愈合。本综述强调了他汀类药物促进骨折愈合的动物和临床研究及其涉及的机制。
