מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – The use of statins to treat hypercholesterolemia appears to be associated with a decreased prevalence of Alzheimer's disease, according to a report in the September 25th issue of Neurology.
Dr. Mikael Simons, of the University of T?bingen, Germany, and colleagues describe two recent retrospective clinical studies which showed that statins "cross the blood-brain barrier efficiently and reduce de novo cholesterol synthesis by inhibition of the ubiquitously expressed enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMG-CoA reductase)."
The first study compared the prevalence of Alzheimer's disease in patients who received HMG-CoA reductase inhibitors with that in patients who received drugs for hypertension or cardiovascular disease. The researchers found that patients taking statins were 60% to 73% less likely to develop Alzheimer's disease than the other patients.
In the second study, the investigators found that patients taking statins were 70% less likely to develop dementia than were patients with untreated hyperlipidemia or those taking other lipid-lowering drugs, such as fibrates, cholestyramine, or nicotinic acid.
The results of cell culture and in vivo experiments also indicate that statin treatment reduces the production of the A-beta-amyloid peptide, the authors explain. They speculate that cholesterol might modulate A-beta-amyloid peptide deposit formation. "As neurons receive only small amounts of exogenous cholesterol, statins that efficiently cross the blood-brain barrier may reduce the amount of neuronal cholesterol below a critical level," they write.
"Decreased neuronal cholesterol levels inhibit the A-beta-amyloid peptide-forming amyloidogenic pathway possibly by removing amyloid precursor protein from cholesterol- and sphingolipid-enriched membrane microdomains," the team explains. In addition, the ability of A-beta-amyloid peptide to act as a seed for further fibril formation is decreased by depletion of cellular cholesterol levels.
"These intriguing relationships raise the hopes that cholesterol-lowering strategies may influence the progression of Alzheimer's disease," Dr. Simons and colleagues conclude.
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