Statins for influenza. Why don't we know if it works yet?
Note from Jeannine: Dr Rosenfeld (Fox news Sunday morning medical show) said this morning that the use of statins can cut your risk of catching the flu by 50%
Category: Infectious disease ? Influenza treatment
Posted on: October 31, 2009 6:49 AM, by revere
Statins for influenza are in the news again, this time because of a paper given at the Annual Meeting of the Infectious Disease Society of America (IDSA). We'll get to it in a moment, but first a little background.
Statins are cholesterol lowering drugs that are taken by tens of millions of people (including me; I take 20 mg of generic simvastatin a day). The statins are a group of drugs that competitively inhibit an enzyme, 3 hydroxy 3 methylglutaryl coenzyme A reductase (HMG-CoA reductase). They are quite effective in lowering cholesterol and have an excellent safety profile (not perfect, but no drug is perfect except the ones that don't do anything, and even then a placebo effect can give an adverse reaction). But these drugs also seem to do a lot of other things beside lower cholesterol, some of which seem to modify the way your immune system works. That's why they are also referred to as immunomodulators. One immune system effect seems to prevent activation of a transcription factor (a signal to your DNA to make specific proteins) called NF-kappaB. Somehow this produces an anti-inflammatory effect.
Some severe cases of influenza are complicated by an immune dysregulation (sometimes called a cytokine storm) characterized by runaway production of inflammation-associated chemicals in the lung and other organs. Hence the thought that an immunomodulator might be of use. We first posted on the suggestion that statins might be helpful in this way as far back as 2005 when we were still on our old site at Blogger.com (remember, you heard it here first):
In an extremely interesting article in the Clinicians Biosecurity Network Weekly Bulletin (issue of 9/27/05) Borio and Bartlett review a suggestion of David Fedson, an expert on vaccines (and former Director of Medical Affairs at Aventis Pasteur), that statins (tradenames Zocor or Lipitor) might be helpful in preventing serious complications of influenza, perhaps by dampening the cytokine response.
[snip]
The idea that statins might be helpful for sepsis or influenza is based on more than speculation about mechanism. In 2004 Almog et al. (Circulation, Aug 17 2004;110(7):880-885) reported that patients admitted to the hospital with acute bacterial infections and who were on statins for more than a month for other reasons had a dramatically reduced incidence of severe sepsis (19% versus 2.2%) and reduced admission to the Intensive Care Unit (12.2% vs. 3.7%). [NB: sepsis is a similar immune dysregulation to the one caused by influenza.] An interesting point is that patients on statins might be expected to be at greater risk because they are taking a medication for a pre-existing medical condition.
continues...
http://scienceblogs.com/effectmeasure/2009...za_why_dont.php
Note from Jeannine: Dr Rosenfeld (Fox news Sunday morning medical show) said this morning that the use of statins can cut your risk of catching the flu by 50%
Category: Infectious disease ? Influenza treatment
Posted on: October 31, 2009 6:49 AM, by revere
Statins for influenza are in the news again, this time because of a paper given at the Annual Meeting of the Infectious Disease Society of America (IDSA). We'll get to it in a moment, but first a little background.
Statins are cholesterol lowering drugs that are taken by tens of millions of people (including me; I take 20 mg of generic simvastatin a day). The statins are a group of drugs that competitively inhibit an enzyme, 3 hydroxy 3 methylglutaryl coenzyme A reductase (HMG-CoA reductase). They are quite effective in lowering cholesterol and have an excellent safety profile (not perfect, but no drug is perfect except the ones that don't do anything, and even then a placebo effect can give an adverse reaction). But these drugs also seem to do a lot of other things beside lower cholesterol, some of which seem to modify the way your immune system works. That's why they are also referred to as immunomodulators. One immune system effect seems to prevent activation of a transcription factor (a signal to your DNA to make specific proteins) called NF-kappaB. Somehow this produces an anti-inflammatory effect.
Some severe cases of influenza are complicated by an immune dysregulation (sometimes called a cytokine storm) characterized by runaway production of inflammation-associated chemicals in the lung and other organs. Hence the thought that an immunomodulator might be of use. We first posted on the suggestion that statins might be helpful in this way as far back as 2005 when we were still on our old site at Blogger.com (remember, you heard it here first):
In an extremely interesting article in the Clinicians Biosecurity Network Weekly Bulletin (issue of 9/27/05) Borio and Bartlett review a suggestion of David Fedson, an expert on vaccines (and former Director of Medical Affairs at Aventis Pasteur), that statins (tradenames Zocor or Lipitor) might be helpful in preventing serious complications of influenza, perhaps by dampening the cytokine response.
[snip]
The idea that statins might be helpful for sepsis or influenza is based on more than speculation about mechanism. In 2004 Almog et al. (Circulation, Aug 17 2004;110(7):880-885) reported that patients admitted to the hospital with acute bacterial infections and who were on statins for more than a month for other reasons had a dramatically reduced incidence of severe sepsis (19% versus 2.2%) and reduced admission to the Intensive Care Unit (12.2% vs. 3.7%). [NB: sepsis is a similar immune dysregulation to the one caused by influenza.] An interesting point is that patients on statins might be expected to be at greater risk because they are taking a medication for a pre-existing medical condition.
continues...
http://scienceblogs.com/effectmeasure/2009...za_why_dont.php