title: Simvastatin treatment ameliorates autoimmune disease associated with accelerated atherosclerosis in a murine lupus model.
abstract: Patients with systemic lupus erythematosus develop accelerated atherosclerosis independent of traditional risk factors. The 3-hydroxy-3-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors are widely prescribed for hyperlipidemia, but they also exhibit anti-inflammatory actions that appear to be independent of their suppressive actions on plasma cholesterol levels. In this study, we analyzed the effect of the HMG-CoA reductase inhibitor simvastatin on disease manifestations in gld.apoE-/- mice that lack functional Fas ligand and apolipoprotein E and exhibit accelerated atherosclerosis and aggravated lupus-like features. Wild-type, gld, apoE-/-, and gld.apoE-/- mice were maintained on a high cholesterol Western diet and received daily simvastatin (0.125 mg/kg) or saline for 12 wk. Serum cholesterol levels were unaffected by simvastatin treatment, but atherosclerotic lesion area was reduced in both apoE-/- and gld.apoE-/- mice treated with simvastatin. Simvastatin also reduced the lymphadenopathy, renal disease, and proinflammatory cytokine production seen in gld.apoE-/-, but not gld, mice. The immunomodulatory effects in gld.apoE-/- mice were associated with enhanced STAT6 and decreased STAT4 induction in submandibular lymph node cells. Along with reductions in serum TNF-alpha and IFN-gamma levels, there was also an increase in IL-4 and IL-10 transcript levels in lymph nodes. These data indicate that HMG-CoA reductase inhibitors ameliorate atherosclerosis and lupus-like autoimmunity independent of their cholesterol-lowering effects via a shift from a Th1 to a Th2 phenotype in the gld.apoE-/- model. Thus, the anti-inflammatory activities of statins may have utility for the treatment of both autoimmunity and atherosclerosis in patients with systemic lupus erythematosus.
authors.affiliation: Molecular Cardiology, Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Aprahamian
authors.forename: Ramon
authors.initials: R
authors.lastname: Bonegio
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rizzo
authors.forename: Harris
authors.initials: H
authors.lastname: Perlman
authors.forename: David J
authors.initials: DJ
authors.lastname: Lefer
authors.forename: Ian R
authors.initials: IR
authors.lastname: Rifkin
authors.forename: Kenneth
authors.initials: K
authors.lastname: Walsh
mesh_terms: D000818:Animals; D001057:Apolipoproteins E / Q000172:deficiency / Q000235:genetics / Q000378:metabolism; D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D049109:Cell Proliferation; D002784:Cholesterol / Q000097:blood; D004195:Disease Models, Animal; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D008198:Lymph Nodes / Q000166:cytology / Q000187:drug effects / Q000378:metabolism; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout; D010641:Phenotype; D019821:Simvastatin / Q000627:therapeutic use*; D018418:Th2 Cells / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D015854:Up-Regulation
chemical_list: D001057:Apolipoproteins E; D002784:Cholesterol; D019821:Simvastatin