Published online before print July 14, 2003, doi: 10.1161/01.CIR.0000080895.05158.8B
(Circulation. 2003;108:426.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Statins Promote Potent Systemic Antioxidant Effects Through Specific Inflammatory Pathways
From the Departments of Cell Biology, Cardiovascular Medicine, and the Center for Cardiovascular Diagnostics and Prevention, Cleveland Clinic Foundation, Cleveland, Ohio.
Correspondence to Stanley L. Hazen, MD, PhD, Cleveland Clinic Foundation, 9500 Euclid Ave, NC10, Cleveland, OH 44195. E-mail hazens{at}ccf.org
Received March 19, 2003; revision received May 6, 2003; accepted May 7, 2003.
Background— The pleiotropic actions of hydroxymethylglutaryl CoA reductase inhibitors (statins) include antiinflammatory and antioxidant actions. We recently reported that statins induce reductions in plasma protein levels of nitrotyrosine (NO2Tyr), a modification generated by nitric oxide–derived oxidants. Whether alternative oxidative pathways are suppressed in vivo after statin administration has not yet been reported.
Methods and Results— As an extension of our prior study, hypercholesterolemic subjects with no known coronary artery disease were evaluated at baseline and after 12 weeks of atorvastatin therapy (10 mg/d). Plasma levels of protein-bound chlorotyrosine, NO2Tyr, dityrosine, and orthotyrosine, specific molecular fingerprints for distinct oxidative pathways upregulated in atheroma, were determined by mass spectrometry. In parallel, alterations in lipoproteins and C-reactive protein were determined. Statin therapy caused significant reductions in chlorotyrosine, NO2Tyr, and dityrosine (30%, 25%, and 32%, respectively; P<0.02 each) that were similar in magnitude to reductions in total cholesterol and apolipoprotein B-100 (25% and 29%, P<0.001 each). Nonsignificant decreases in orthotyrosine and C-reactive protein levels were observed (9% and 11%, respectively; P>0.10 each). Statin-induced reductions in oxidation markers were independent of decreases in lipids and lipoproteins.
Conclusions— Statins promote potent systemic antioxidant effects through suppression of distinct oxidation pathways. The major pathways inhibited include formation of myeloperoxidase-derived and nitric oxide–derived oxidants, species implicated in atherogenesis. The present results suggest potential mechanisms that may contribute to the beneficial actions of statins. They also have important implications for monitoring the antiinflammatory and antioxidant actions of these agents.
Key Words: statins • antioxidants • hypercholesterolemia • atherosclerosis • inflammation
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