title: Red yeast rice and coenzyme Q10 as safe alternatives to surmount atorvastatin-induced myopathy in hyperlipidemic rats.
abstract: Statins are the first line treatment for the management of hyperlipidemia. However, the primary adverse effect limiting their use is myopathy. This study examines the efficacy and safety of red yeast rice (RYR), a source of natural statins, as compared with atorvastatin, which is the most widely used synthetic statin. Statin interference with the endogenous synthesis of coenzyme Q10 (CoQ10) prompted the hypothesis that its deficiency may be implicated in the pathogenesis of statin-associated myopathy. Hence, the effects of combination of CoQ10 with either statin have been evaluated. Rats were rendered hyperlipidemic through feeding them a high-fat diet for 90 days, during the last 30 days of the diet they were treated daily with either atorvastatin, RYR, CoQ10, or combined regimens. Lipid profile, liver function tests, and creatine kinase were monitored after 15 and 30 days of drug treatments. Heart contents of CoQ9 and CoQ10 were assessed and histopathological examination of the liver and aortic wall was performed. RYR and CoQ10 had the advantage over atorvastatin in that they lower cholesterol without elevating creatine kinase, a hallmark of myopathy. RYR maintained normal levels of heart ubiquinones, which are essential components for energy production in muscles. In conclusion, RYR and CoQ10 may offer alternatives to overcome atorvastatin-associated myopathy.
authors.affiliation: a Department of Pharmacology, Medical Research Division, National Research Centre, El Tahrir Street, 12622 Giza, Egypt.
authors.forename: Marwan
authors.initials: M
authors.lastname: Abdelbaset
authors.forename: Marwa M
authors.initials: MM
authors.lastname: Safar
authors.forename: Sawsan S
authors.initials: SS
authors.lastname: Mahmoud
authors.forename: Seham A
authors.initials: SA
authors.lastname: Negm
authors.forename: Azza M
authors.initials: AM
authors.lastname: Agha
mesh_terms: D000818:Animals; D001011:Aorta / Q000187:drug effects / Q000473:pathology; D000069059:Atorvastatin; D001688:Biological Products / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003402:Creatine Kinase / Q000097:blood; D059305:Diet, High-Fat; D006538:Heptanoic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008074:Lipoproteins / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000473:pathology; D008297:Male; D009135:Muscular Diseases / Q000139:chemically induced* / Q000150:complications / Q000378:metabolism; D009206:Myocardium / Q000378:metabolism; D011758:Pyrroles / Q000009:adverse effects* / Q000627:therapeutic use; D051381:Rats; D014451:Ubiquinone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D001688:Biological Products; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D011758:Pyrroles; C117343:red yeast rice; D014451:Ubiquinone; D000069059:Atorvastatin; D003402:Creatine Kinase; C024989:coenzyme Q10
keywords: atorvastatin; atorvastatine; coenzyme Q10; hyperlipidemia; hyperlipémie; levure de riz rouge; myopathie; myopathy; red yeast rice; ubiquinones