title: The HMG-CoA reductase inhibitor, atorvastatin, promotes a Th2 bias and reverses paralysis in central nervous system autoimmune disease.
abstract: Statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, which are approved for cholesterol reduction, may also be beneficial in the treatment of inflammatory diseases. Atorvastatin (Lipitor) was tested in chronic and relapsing experimental autoimmune encephalomyelitis, a CD4(+) Th1-mediated central nervous system (CNS) demyelinating disease model of multiple sclerosis. Here we show that oral atorvastatin prevented or reversed chronic and relapsing paralysis. Atorvastatin induced STAT6 phosphorylation and secretion of Th2 cytokines (interleukin (IL)-4, IL-5 and IL-10) and transforming growth factor (TGF)-beta. Conversely, STAT4 phosphorylation was inhibited and secretion of Th1 cytokines (IL-2, IL-12, interferon (IFN)-gamma and tumour necrosis factor (TNF)-alpha) was suppressed. Atorvastatin promoted differentiation of Th0 cells into Th2 cells. In adoptive transfer, these Th2 cells protected recipient mice from EAE induction. Atorvastatin reduced CNS infiltration and major histocompatibility complex (MHC) class II expression. Treatment of microglia inhibited IFN-gamma-inducible transcription at multiple MHC class II transactivator (CIITA) promoters and suppressed class II upregulation. Atorvastatin suppressed IFN-gamma-inducible expression of CD40, CD80 and CD86 co-stimulatory molecules. l-Mevalonate, the product of HMG-CoA reductase, reversed atorvastatin's effects on antigen-presenting cells (APC) and T cells. Atorvastatin treatment of either APC or T cells suppressed antigen-specific T-cell activation. Thus, atorvastatin has pleiotropic immunomodulatory effects involving both APC and T-cell compartments. Statins may be beneficial for multiple sclerosis and other Th1-mediated autoimmune diseases.
authors.affiliation: Department of Neurology and Neurological Sciences, Beckman Center for Molecular Medicine, Stanford University, Stanford, California 94305, USA.
authors.forename: Sawsan
authors.initials: S
authors.lastname: Youssef
authors.forename: Olaf
authors.initials: O
authors.lastname: Stüve
authors.forename: Juan C
authors.initials: JC
authors.lastname: Patarroyo
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Ruiz
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Radosevich
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Hur
authors.forename: Manuel
authors.initials: M
authors.lastname: Bravo
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Mitchell
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Sobel
authors.forename: Lawrence
authors.initials: L
authors.lastname: Steinman
authors.forename: Scott S
authors.initials: SS
authors.lastname: Zamvil
mesh_terms: D019264:Adoptive Transfer; D000595:Amino Acid Sequence; D000818:Animals; D000938:Antigen-Presenting Cells / Q000187:drug effects / Q000276:immunology; D000069059:Atorvastatin; D002455:Cell Division / Q000187:drug effects; D002493:Central Nervous System Diseases / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D016207:Cytokines / Q000032:analysis / Q000276:immunology; D004268:DNA-Binding Proteins / Q000378:metabolism; D004681:Encephalomyelitis, Autoimmune, Experimental / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D015870:Gene Expression / Q000187:drug effects; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008264:Macrophages / Q000187:drug effects / Q000276:immunology; D051379:Mice; D017628:Microglia / Q000187:drug effects / Q000276:immunology; D008969:Molecular Sequence Data; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000276:immunology; D009687:Nuclear Proteins; D010243:Paralysis / Q000150:complications / Q000188:drug therapy*; D010766:Phosphorylation; D011758:Pyrroles / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D050797:STAT4 Transcription Factor; D050800:STAT6 Transcription Factor; D018418:Th2 Cells / Q000166:cytology / Q000187:drug effects* / Q000276:immunology*; D015534:Trans-Activators / Q000235:genetics / Q000378:metabolism
chemical_list: D016207:Cytokines; D004268:DNA-Binding Proteins; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C083728:MHC class II transactivator protein; D009687:Nuclear Proteins; D011758:Pyrroles; D012333:RNA, Messenger; D050797:STAT4 Transcription Factor; D050800:STAT6 Transcription Factor; C494091:Stat4 protein, mouse; C494100:Stat6 protein, mouse; D015534:Trans-Activators; D000069059:Atorvastatin