Malfitano Anna Maria, Marasco Giuseppe, Proto Maria Chiara, Laezza Chiara, Gazzerro Patrizia, Bifulco Maurizio
Department of Medicine and Surgery, University of Salerno, Italy; Department of Pharmaceutical Sciences, University of Salerno, Italy.
Neurologia-Stroke Unit, Azienda Ospedaliera dei Colli Napoli, Italy; Brain and Vision Research Laboratory Boston University, Boston, MA, USA.
Pharmacol Res. 2014 Oct;88:74-83. doi: 10.1016/j.phrs.2014.06.007. Epub 2014 Jun 19.
Statins have, at present, the potential to provide a new therapeutic target for various neurological diseases. It is well established that statins reduce cholesterol levels and prevent coronary heart disease. Moreover, evidence suggest that statins have additional properties such as endothelial protection via action on the nitric oxide synthase system as well as antioxidant, anti-inflammatory and anti-platelet effects. These properties might have potential therapeutic implication not only in stroke but also in neurological disorders such as Alzheimer disease, Parkinson's disease, multiple sclerosis and primary brain tumors. In addition to their potent anti-atherosclerotic and cardio-protective effects, compelling clinical and preclinical studies delineate the neuro-protective efficacy of statins in all these neurological disorders. It is apparent from these studies that most patients with central nervous system disorders probably benefit to some extent from lipid-lowering therapy. But data are not univocal, and we must also consider the adverse effects due to the administration of lipid-lowering therapy. Thus, in these scenarios the effectiveness of statins in treating stroke, Alzheimer's disease, Parkinson disease, multiple sclerosis, and primary brain tumors have to be conclusively proven in vivo and/or in adequate clinical trials.
目前，他汀类药物有潜力为各种神经系统疾病提供新的治疗靶点。他汀类药物可降低胆固醇水平并预防冠心病，这一点已得到充分证实。此外，有证据表明，他汀类药物还具有其他特性，如通过作用于一氧化氮合酶系统实现内皮保护以及抗氧化、抗炎和抗血小板作用。这些特性可能不仅对中风有潜在治疗意义，对阿尔茨海默病、帕金森病、多发性硬化症和原发性脑肿瘤等神经系统疾病也有潜在治疗意义。除了其强大的抗动脉粥样硬化和心脏保护作用外，令人信服的临床和临床前研究表明了他汀类药物在所有这些神经系统疾病中的神经保护功效。从这些研究中可以明显看出，大多数中枢神经系统疾病患者可能在一定程度上受益于降脂治疗。但数据并不一致，我们还必须考虑降脂治疗带来的不良反应。因此，在这些情况下，他汀类药物治疗中风、阿尔茨海默病、帕金森病、多发性硬化症和原发性脑肿瘤的有效性必须在体内和/或充分的临床试验中得到确凿证明。
