title: The role of HMGCR alternative splicing in statin efficacy.
abstract: Statins, or 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) inhibitors, are widely prescribed to lower plasma cholesterol levels and reduce cardiovascular disease risk. Despite the well-documented efficacy of statins, there is large interindividual variation in response. Using a panel of immortalized lymphocyte cell lines incubated with simvastatin, we recently found that the magnitude of expression of an alternatively spliced HMGCR transcript lacking exon 13 was inversely correlated with in vivo reductions of total cholesterol, low-density lipoprotein cholesterol, apoB, and triglycerides after statin treatment of the individuals from whom the cells were derived. This review will discuss the potential significance of alternative splicing as a mechanism contributing to variation in statin efficacy as well as the use of immortalized lymphocyte cell lines for identifying pharmacogenetically relevant polymorphisms and molecular mechanisms.
authors.affiliation: Children's Hospital Oakland Research Institute, CA 94609, USA. mwmedina@chori.org
authors.forename: Marisa Wong
authors.initials: MW
authors.lastname: Medina
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Krauss
mesh_terms: D017398:Alternative Splicing; D002461:Cell Line, Transformed; D008078:Cholesterol, LDL / Q000097:blood; D005091:Exons; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000235:genetics*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D008214:Lymphocytes; D020641:Polymorphism, Single Nucleotide; D020033:Protein Isoforms / Q000235:genetics
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D020033:Protein Isoforms; D006903:Hydroxymethylglutaryl CoA Reductases