title: Simvastatin attenuates the endothelial pro-thrombotic shift in saphenous vein grafts induced by Advanced glycation endproducts.
abstract: BACKGROUND
  Advanced glycation endproducts (AGEs) and its receptors (RAGEs) are heterogeneous signaling proteins associated to diabetes and responsible of endothelial alterations leading to atherosclerosis progression and graft failure. The aim of this study was to investigate the role of statin in reducing AGEs related endothelial damage.
  
  
  METHODS
  Endothelial cell(EC) obtained from leftovers of saphenous vein grafts of non-diabetic patients were incubated with AGEs (2 and 20 μM) and subsequently treated with Simvastatin. Neutrophils (PNM) adherence, ROS production and RAGE and peroxisome proliferator-activated receptors-gamma (PPAR-γ) expression were analyzed. As clinical validation of the in vitro findings, ECs of diabetic patients in optimized glycaemic control administered with a 3 weeks Simvastatin regimen were similarly processed.
  
  
  RESULTS
  Simvastatin blunted the rise in PMN adhesion and ROS generation following stimulation of saphenous vein EC culture with AGEs in vitro. This effect was time dependent and was associated to an increase in PPAR-γ induction paralleled by a decrease in RAGEs expression. Parallely, data from diabetic patients administered with Simvastatin showed a similar significant reduction in PNM adhesion and ROS generation. Simvastatin treatment significantly decreased RAGEs expression in ECs from diabetic patients and determined a slight increase in PPAR-γ expression but the latter failed to reach statistical significance. Interference in the function of these two crucial pathways might be at the root of the statin antinflammatory and antithrombotic effect in the context of AGEs-associated damage.
  
  
  CONCLUSIONS
  Despite the recently raised warning on the use of statins in the diabetic population, this study elucidates their cornerstone position in endothelial homeostasis of saphenous grafts in patients with controlled diabetes.
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy; Department of Cardiac Surgery, University Hospital UZ Leuven, Belgium. Electronic address: cristianospadaccio@gmail.com.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spadaccio
authors.affiliation: Laboratory of Virology, Regina Elena Institute for Cancer Research, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: De Marco
authors.affiliation: Department of Biochemical Sciences, University La Sapienza, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Di Domenico
authors.affiliation: Department of Biochemical Sciences, University La Sapienza, Rome, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Coccia
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Lusini
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Barbato
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy.
authors.forename: Elvio
authors.initials: E
authors.lastname: Covino
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio Medico of Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Chello
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000378:metabolism*; D012501:Saphenous Vein / Q000187:drug effects / Q000378:metabolism / Q000601:surgery / Q000637:transplantation*; D019821:Simvastatin / Q000627:therapeutic use*; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy
chemical_list: D001786:Blood Glucose; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D019821:Simvastatin
keywords: Advanced Glycation Endproducts; CABG; Diabetes Mellitus; Graft failure; Saphenous graft