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Current Respiratory Medicine Reviews

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ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

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Research Article

Effect of Statin Supplementation on Pulmonary Function and Inflammatory Markers in Patients of Chronic Obstructive Pulmonary Disease

Author(s): Mradul K. Daga*, Ankit Chhoda, Shashank Singh, Govind Mawari, Naresh Kumar, Tarun K. Mishra and Harmanjit S. Hira

Volume 15, Issue 1, 2019

Page: [45 - 50] Pages: 6

DOI: 10.2174/1573398X15666190614154338

Abstract

Background: COPD being a systemic inflammatory disease is accompanied by alteration of various inflammatory cytokines which affect the metabolic equilibrium of body. Some therapeutic options, mainly statins via their wide range of pharmacologic actions alter the level of proinflammatory cytokines hence, helpful in attenuating various extra-pulmonary consequences of COPD. We did a randomised case-control study to study the effect of statin supplementation on pulmonary function and inflammatory markers in patients of COPD.

Methods: We included 40 stable COPD subjects & randomized them in two groups, Intervention & Non-intervention. Intervention group received 40 mg atorvastatin once daily for 3 months in addition to the conventional treatment of COPD similar to the prior one. We studied levels of IL-6 & CRP and correlated them with disease severity before and after the aforementioned intervention.

Results: We observed that CRP levels decreased in both the groups after a follow up of 3 months, but neither of them was statistically significant (p=0.57 & 0.63 respectively) nor the mean of their difference (p=0.969). IL-6 levels showed a persistent decline in intervention group but, was not significant (p=0.91). In this study, we noticed statistically significant improvement in FEV1 (p=0.008) in the intervention group which was in contrast to non-intervention group. Similarly, the exercise capacity also statistically increased in the intervention group (p=0.002). There was also evident negative correlation between exercise capacity and IL-6 as well CRP levels. FEV1 also showed statistically significant negative correlation with IL-6 levels (p=0.023).

Conclusion: We can improve the disease outcome and alter its natural progression by altering the levels of inflammatory markers with the aid of some additional pharmacological interventions i.e., in this study was atorvastatin.

Keywords: COPD = Chronic obstructive pulmonary disease, CRP = C-reactive protein, E.C. = Exercise capacity, FEV1 = Forced expiratory volume in one second, IL-6 = Interleukin-6, inflammatory markers.

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[1]
Global Initiative for chronic obstructive lung disease Available at:. http://www.gold.org [last updated jan 23, 2014].
[2]
World Health Organization Burden of COPD Available from:. http://www.who.int/respiratory/copd/burden/en/
[3]
Jindal SK, Aggarwal AN, Chaudhry K, et al. A multicentric study on epidemiology of chronic obstructive pulmonary disease & its relationship with tobacco smoking and environmental tobacco exposure. Indian J Chest Dis Allied Sci 2006; 48(1): 23-9.
[4]
Anthonisen NR, Connett JE, Murray RP. Smoking and lung function of Lung Health Study participants after 11 years. Am J Respir Crit Care Med 2002; 166(5): 675-9.
[5]
Schönbeck U, Libby P. Inflammation, immunity, and HMG-CoA reductase inhibitors: Statins as antiinflammatory agents? Circulation 2004; 109(21)(Suppl. 1): II18-26.
[6]
Fessler MB, Young SK, Jeyaseelan S, et al. A role for hydroxy-methylglutaryl coenzyme a reductase in pulmonary inflammation and host defense. Am J Respir Crit Care Med 2005; 171(6): 606-15.
[7]
Rosenson RS, Tangney CC, Casey LC. Inhibition of proinflammatory cytokine production by pravastatin. Lancet 1999; 353(9157): 983-4.
[8]
Pahan K, Sheikh FG, Namboodiri AM, Singh I. Lovastatin and phenylacetate inhibit the induction of nitric oxide synthase and cytokines in rat primary astrocytes, microglia, and macrophages. J Clin Invest 1997; 100(11): 2671-9.
[9]
Bellosta S, Via D, Canavesi M, et al. HMG-CoA reductase inhibitors reduce MMP-9 secretion by macrophages. Arterioscler Thromb Vasc Biol 1998; 18(11): 1671-8.
[10]
Laufs U, Liao JK. Post-transcriptional regulation of endothelial nitric oxide synthase mRNA stability by Rho GTPase. J Biol Chem 1998; 273(37): 24266-71.
[11]
Martin G, Duez H, Blanquart C, et al. Statin-induced inhibition of the Rho-signaling pathway activates PPARalpha and induces HDL apoA-I. J Clin Invest 2001; 107(11): 1423-32.
[12]
Baccante G, Mincione G, Di Marcantonio MC, Piccirelli A, Cuccurullo F, Porreca E. Pravastatin up-regulates transforming growth factor-beta1 in THP-1 human macrophages: Effect on scavenger receptor class A expression. Biochem Biophys Res Commun 2004; 314(3): 704-10.
[13]
Schönbeck U, Gerdes N, Varo N, et al. Oxidized low-density lipoprotein augments and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors limit CD40 and CD40L expression in human vascular cells. Circulation 2002; 106(23): 2888-93.
[14]
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet 1997; 349(9063): 1436-42.
[15]
Rennard SI. Inflammation in COPD: A link to systemic comorbidities. Eur Respir Rev 2007; 16: 91-7.
[16]
Soriano JB, Maier WC, Egger P, et al. Recent trends in physician diagnosed. COPD in women and men in the UK Thorax 2000; 55: 789-94.
[17]
Pauwels RA, Löfdahl CG, Pride NB, Postma DS, Laitinen LA, Ohlsson SV. European Respiratory Society study on chronic obstructive pulmonary disease (EUROSCOP): Hypothesis and design. Eur Respir J 1992; 5(10): 1254-61.
[18]
Kaczmarek P, Sladek K, Skucha W, Rzeszutko M, et al. The influence of simvastatin on selected inflammatory markers in patients with COPD. Pol Arch Med Wewn 2010; 120: 1-2.
[19]
Lee TM, Lin MS, Chang NC. Usefulness of CRP and IL-6 as predictors of outcomes in patients with COPD receiving pravastatin. Am J Cardiol 2008; 101: 530-5.
[20]
Vestbo J, Prescott E, Almdal T, et al. Body mass, fat-free body mass, and prognosis in patients with chronic obstructive pulmonary disease from a random population sample: Findings from the Copenhagen City Heart Study. Am J Respir Crit Care Med 2006; 173(1): 79-83.
[21]
Lee TM, Chen CC, Shen HN, Chang NC. Effects of pravastatin on functional capacity in patients with COPD and pulmonary hypertension. Clin Sci (Lond) 2009; 116: 497-505.
[22]
Broekhuizen R, Wouters EFM, Creutzberg EC, Schols AMW. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax 2006; 61(1): 17-22.

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