A Rapidly Progressive Case of Statin-induced Necrotizing Autoimmune Myopathy

Ahmed, S. Ashraf; Capric, Violeta; Khan, Muhammad Ashraf; Koneru, Prabash

doi:10.7759/cureus.7021

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…The first one has the potential to be used as a tool for “precision medicine.” Among the 1677 single NCBI of hHMGR, 176 are missense variants and 11 are frame-shift variants, which alters the amino acid sequence of hHMGR. Statins are one of the most commonly used medications to lower cholesterol ( Ahmed et al, 2020 ), which have been known to cause various side effects such as muscle pain, muscle weakness, rhabdomyolysis, especially high-dosage statins ( Bitzur et al, 2013 ; Ahmed et al, 2020 ; Won et al, 2020 ). By replacing the thHMGR gene with the individual’s variant in the statin-efficacy testing sensor, we can test which statin drug has the best inhibition effect on his/her HMGR activity, and what is the best dosage.…”

Section: Discussionmentioning

confidence: 99%

Construction of Escherichia coli Whole-Cell Biosensors for Statin Efficacy and Production Test

Wang

Zhao

et al. 2020

Front. Cell Dev. Biol.

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Statins are widely used cholesterol-lowering drugs. Their potential application in anticancer treatment is also under investigation. The individual variance in statin response has been observed, which may be caused by the variation in human HMG-CoA reductase (hHMGR)-the inhibition target of statin drugs. Herein, we reported the design and construction of two Escherichia coli whole-cell biosensors. The first one is statin-efficacy testing sensor, which is composed of two separate modules: a hybrid mevalonate (MVA) pathway and a HMG-CoA sensing system. A truncated hHMGR was used as the key enzyme of the MVA pathway and a promiscuous transcription factor (TF) BsFapR was used as the HMG-CoA sensor. When hHMGR was inhibited by statins, HMG-CoA accumulated intracellularly and was sensed by BsFapR, which subsequently turned on its cognate promoter. This biosensor has the potential to be used as a "precision medicine" tool-selecting potent statin drugs for individual patients. The second one is a statin-production testing sensor, which is based on another promiscuous TF AraCM that can sense statins. This biosensor can be used in optimization of statin-producing strains. The prototypes of these two biosensors were successfully constructed and their further optimization is highly expected.

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Section: Discussionmentioning

confidence: 99%

Construction of Escherichia coli Whole-Cell Biosensors for Statin Efficacy and Production Test

Wang

Zhao

et al. 2020

Front. Cell Dev. Biol.

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Statin-induced necrotizing autoimmune myopathy: a systematic review

Somagutta¹,

Shama²,

Pormento³

et al. 2022

Reumatologia

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Statins are a class of lipid-lowering medications used worldwide by millions of people and are safe for frequent use in most patients. However, they cause necrotizing autoimmune myopathy in some patients. We reviewed case reports of 80 patients from 2010 to present diagnosed with statin-induced necrotizing autoimmune myopathy (SINAM), aiming to analyze the clinical, physiological, serologic characteristics and outcomes of SINAM. The mean age of these patients was 66 ±9.4, the majority being male (61.3%). All patients reported proximal muscle weakness, and a few had myalgias, extra muscular symptoms such as dysphagia, and pulmonary complications. Most of the patients were on atorvastatin, simvastatin, or rosuvastatin. The mean creatine kinase was 10,094.2 ±7,351.7 U/l, and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase enzyme was positive for 93.8% of patients. The majority of patients were started on steroids; other treatments were also used. Prompt cessation of statins and initiation of immunosuppressants reduced morbidity and mortality.

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A Rapidly Progressive Case of Statin-induced Necrotizing Autoimmune Myopathy

Cited by 2 publications

References 14 publications

Construction of Escherichia coli Whole-Cell Biosensors for Statin Efficacy and Production Test

Construction of Escherichia coli Whole-Cell Biosensors for Statin Efficacy and Production Test

Statin-induced necrotizing autoimmune myopathy: a systematic review

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