title: Effect of rosuvastatin on cytokines after traumatic head injury.
abstract: OBJECTIVE
  The favorable effect of statin treatment after traumatic brain injury (TBI) has been shown in animal studies and is probably true in humans as well. The objective of this study was to determine whether acute statin treatment following TBI could reduce inflammatory cytokines and improve functional outcomes in humans.
  
  
  METHODS
  The authors performed a double-blind randomized clinical trial in patients with moderate to severe TBI. Exclusion criteria were as follows: prior severe disability; use of modifiers of statin metabolism; multisystem trauma; prior use of mannitol, barbiturates, corticosteroids, or calcium channel blockers; isolated brainstem lesions; allergy to statins; previous hepatopathy or myopathy; previous treatment at another clinic; and pregnancy. Patients were randomly selected to receive 20 mg of rosuvastatin or placebo for 10 days. The main goal was to determine the effect of rosuvastatin on plasma levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-10 after 72 hours of TBI. Amnesia, disorientation, and disability were assessed 3 and 6 months after TBI.
  
  
  RESULTS
  Thirty-six patients were analyzed according to intention-to-treat analysis; 19 patients received rosuvastatin and 17 received placebo. The best-fit mixed model showed a significant effect of rosuvastatin on the reduction of tumor necrosis factor-α levels (p = 0.004). Rosuvastatin treatment did not appear to affect the levels of IL-1β, IL-6, and IL-10. The treatment was associated with a reduction in disability scores (p = 0.03), indicating a favorable functional outcome. Life-threatening adverse effects were not observed.
  
  
  CONCLUSIONS
  The authors' data suggest that statins may induce an antiinflammatory effect and may promote recovery after TBI. The role of statins in TBI therapy should be confirmed in larger clinical trials.
authors.affiliation: Department of Clinical Epidemiology, Universidad Autónoma de San Luis Potosí, San Luis Potosí 78210, México. jemarsan7@hotmail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Sánchez-Aguilar
authors.forename: J Humberto
authors.initials: JH
authors.lastname: Tapia-Pérez
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Sánchez-Rodríguez
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Viñas-Ríos
authors.forename: Patricia
authors.initials: P
authors.lastname: Martínez-Pérez
authors.forename: Esperanza
authors.initials: E
authors.lastname: de la Cruz-Mendoza
authors.forename: Martin
authors.initials: M
authors.lastname: Sánchez-Reyna
authors.forename: Jaime Gerardo
authors.initials: JG
authors.lastname: Torres-Corzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Gordillo-Moscoso
mesh_terms: D000328:Adult; D000368:Aged; D000647:Amnesia / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001930:Brain Injuries / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D003221:Confusion / Q000209:etiology; D016207:Cytokines / Q000097:blood* / Q000187:drug effects*; D004185:Disability Evaluation; D004311:Double-Blind Method; D005260:Female; D005464:Fluorobenzenes / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D016753:Interleukin-10 / Q000097:blood; D053583:Interleukin-1beta / Q000097:blood / Q000187:drug effects; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000494:pharmacology* / Q000627:therapeutic use; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000494:pharmacology* / Q000627:therapeutic use; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D053583:Interleukin-1beta; D015850:Interleukin-6; D011743:Pyrimidines; D013449:Sulfonamides; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000068718:Rosuvastatin Calcium