Statins and myositis: the role of anti-HMGCR antibodies.
Muscle toxicity is a recognized adverse effect of statin use. Recently, a new myositis syndrome was described in association with antibodies directed against the pharmacologic target of statins, anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR antibody). The patient's genetic background, characteristic histologic patterns (immune-mediated necrotizing myopathy), and presence of anti-HMGCR antibodies define the syndrome. In most patients, statin discontinuation is insufficient to reverse the myositis symptoms, and immunosuppressive therapy is needed. The mechanisms by which these antibodies may lead to disease are not fully elucidated. Several important questions remain unsolved and warrant further research.
a Internal Medicine Department, Vall D'hebron General Hospital , Universitat Autonoma de Barcelona , Barcelona , Spain.
Albert
A
Selva-O'Callaghan
a Internal Medicine Department, Vall D'hebron General Hospital , Universitat Autonoma de Barcelona , Barcelona , Spain.
Marcelo
M
Alvarado-Cardenas
b Immunology Department Vall D'hebron General Hospital , Universitat Autonoma de Barcelona , Barcelona , Spain.
Ana
A
Marin
a Internal Medicine Department, Vall D'hebron General Hospital , Universitat Autonoma de Barcelona , Barcelona , Spain.|c National Institute of Arthritis and Musculoskeletal and Skin Diseases , National Institutes of Health , Bethesda , MD , USA.
Iago
I
Pinal-Fernandez
D000818:Animals; D001323:Autoantibodies / Q000276:immunology* / Q000378:metabolism; D001327:Autoimmune Diseases / Q000201:enzymology / Q000276:immunology* / Q000473:pathology; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000276:immunology* / Q000378:metabolism; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009220:Myositis / Q000201:enzymology / Q000276:immunology* / Q000473:pathology
D001323:Autoantibodies; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C553220:HMGCR protein, human; D006903:Hydroxymethylglutaryl CoA Reductases
anti-HMGCR; immune mediated necrotizing myopathy; myalgia; myositis; statins