40 - Statins in multiple sclerosis

Summary

The current understanding regarding the therapeutic potential of statins in central nervous system (CNS) autoimmune diseases evolved from studies in mice with experimental autoimmune encephalomyelitis (EAE). Migration of leukocytes from the blood into the CNS involves multiple steps, including chemo-attraction, cell adhesion, extravasation, and proteolytic degradation of biological membranes. Statin-mediated immunomodulation observed in mice may translate to humans. In vitro, statins inhibit the expression of intracellular adhesion molecule (ICAM)-1 and various chemokine receptors on activated peripheral mononuclear cells from both patients with multiple sclerosis (MS) and controls. Although statins are considered safe and well-tolerated drugs, they have side effects that should be considered. Statins have been shown to target key elements of the immunological cascade associated with glial and neural tissue damage in MS. In a recent placebo-controlled trial in patients with early MS, Statin treatment reduced development of newly occurring CNS inflammatory lesions.