Oxidative stress as a possible mechanism of statin-induced myopathy
Statins, inhibitors of hydroxy methyl glutaryl coenzyme-A (HMG-CoA) reductase, are the most widely used drugs for treating hypercholesterolemia. However, statins can cause disabling myopathy as their main adverse effect. Several molecular mechanisms underlie the statin-induced myopathy including the decrease in the levels of essential mevalonate and cholesterol derivatives. This review discusses a further mechanism involving the loss of other anti-oxidant defenses besides ubiquinone (Co-Q) in skeletal muscles which produce a significant amount of reactive oxygen species (ROS). Therefore, to maintain their function, skeletal muscles need a high level of anti-oxidants.
KeywordsCholesterol Myopathy Oxidative stress Statins Ubiquinone
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All authors declare that they have no conflict of interest.
- Anto RJ, Kuttan G, Babu K, Rajasekharan K, Kuttan R (1998) Anti-inflammatory activity of natural and synthetic curcuminoids. Pharm Pharmacol Commun 4:103–106Google Scholar
- Bloor W (1936) The cholesterol content of muscle. J Biol Chem 114:639–648Google Scholar
- Cerda A, Hirata MH, Hirata RDC (2012) Molecular mechanisms underlying statin effects on genes involved in the reverse cholesterol transport. Drug Metab Personal Ther 27:101–111Google Scholar
- Inoue I et al (2000) Lipophilic HMG-CoA reductase inhibitor has an anti-inflammatory effect: reduction of mRNA levels for interleukin-1β, interleukin-6, cyclooxygenase-2, and p22phox by regulation of peroxisome proliferator-activated receptor α (PPARα) in primary endothelial cells. Life Sci 67:863–876PubMedCrossRefGoogle Scholar
- Jadhav S, Nimbalkar S, Kulkarni A, Madhavi D (1995) Lipid oxidation in biological and food systems. Food science and technology. Marcel Dekker, New York. pp 5–64Google Scholar
- Kalra S (2009) The role of Coenzyme Q10 in statin-associated myopathy. Electron Physician 1:2–8Google Scholar
- Lowther WT, Weissbach H, Etienne F, Brot N, Matthews BW (2002) The mirrored methionine sulfoxide reductases of Neisseria gonorrhoeae pilB. Nat Struct Mol Biol 9:348Google Scholar
- 三浦進司, 渡辺順一, 佐藤満昭, 富田多嘉子, 大澤俊彦, 原征彦, 富田勲 (1995) Effects of various natural antioxidants on the Cu2+ -mediated oxidative modification of low density lipoprotein. Biol Pharm Bull 18:1–4Google Scholar