Acute renal allograft rejections, a role for statins?
Acute rejection of kidney allografts during the first months following transplantation is one of the most important risk factor for long-term graft failure. Some small open studies have indicated that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-Co-A), statins, might act as immunosuppressive agents, and reduce acute rejection rates. Moreover, the use of statin in transplant recipients is quite common, despite no data from prospective large multi-centre studies are available to demonstrate any beneficial effect for acute rejections or long-term cardiovascular protection in this population. In this overview, recent clinical and experimental data will be provided for assessing statins as immunosuppressive agents. Although in vitro studies have provided a theoretical basis for the use of statins as immunosuppressive agents, more recent clinical placebo controlled studies have failed to confirm the initial optimism of this effect of statins.
Holdaas
H
H
Department of Medicine, National Hospital, Oslo, Norway. hallvard.holdaas@rikshospitalet.no
Jardine
A
A
D000208:Acute Disease; D000818:Animals; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D008078:Cholesterol, LDL / Q000097:blood; D002986:Clinical Trials as Topic; D016572:Cyclosporine / Q000494:pharmacology / Q000627:therapeutic use; D004353:Drug Evaluation, Preclinical; D004347:Drug Interactions; D006084:Graft Rejection / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008213:Lymphocyte Activation / Q000187:drug effects; D009281:Naphthalenes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy; D017368:Protein Prenylation / Q000187:drug effects; D011499:Protein Processing, Post-Translational / Q000187:drug effects
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents; D009281:Naphthalenes; D016572:Cyclosporine