Effects of atorvastatin on the inflammation regulation and elimination of subdural hematoma in rats

Li, Tuo; Wang, Dong; Tian, Ye; Yu, Huijie; Wang, Yi; Quan, Wei; Cui, Weiyun; Zhou, Lei; Chen, Jieli; Jiang, Rongcai; Zhang, Jianning

doi:10.1016/j.jns.2014.04.009

Cited by 76 publications

(60 citation statements)

References 46 publications

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“…Statins have been reported to confer neuroprotective effects after TBI (Lu et al, 2007; Li et al, 2014) and have been combined with other therapies. Vitamin C exhibits antioxidant properties, which have been shown to protect against a number of disease pathologies (Engler et al, 2003; Sánchez-Moreno, 2004).…”

Section: Inflammationmentioning

confidence: 99%

Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: Is more better?

Kline

Leary

Radabaugh

et al. 2016

Progress in Neurobiology

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Traumatic brain injury (TBI) is a significant health care crisis that affects two million individuals in the United Sates alone and over ten million worldwide each year. While numerous monotherapies have been evaluated and shown to be beneficial at the bench, similar results have not translated to the clinic. One reason for the lack of successful translation may be due to the fact that TBI is a heterogeneous disease that affects multiple mechanisms, thus requiring a therapeutic approach that can act on complementary, rather than single, targets. Hence, the use of combination therapies (i.e., polytherapy) has emerged as a viable approach. Stringent criteria, such as verification of each individual treatment plus the combination, a focus on behavioral outcome, and post-injury vs. pre-injury treatments, were employed to determine which studies were appropriate for review. The selection process resulted in 37 papers that fit the specifications. The review, which is the first to comprehensively assess the effects of combination therapies on behavioral outcomes after TBI, encompasses five broad categories (inflammation, oxidative stress, neurotransmitter dysregulation, neurotrophins, and stem cells, with and without rehabilitative therapies). Overall, the findings suggest that combination therapies can be more beneficial than monotherapies as indicated by 46% of the studies exhibiting an additive or synergistic positive effect versus on 19% reporting a negative interaction. These encouraging findings serve as an impetus for continued combination studies after TBI and ultimately for the development of successful clinically relevant therapies.

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Section: Inflammationmentioning

confidence: 99%

Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: Is more better?

Kline

Leary

Radabaugh

et al. 2016

Progress in Neurobiology

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“…In this animal study, Atorvastatin was suggested to have property of inhibiting inflammation by reducing the neutrophil counts in the neomembrane. 19 In a preliminary clinical trial, 75% of the patients with Atorvastatin had haematoma resolution in 3 months. 20 The aim of our study was to investigate the efficacy of Atorvastatin on CSDH and to generate a potential sample size for future randomised control trial.…”

Section: Introductionmentioning

confidence: 99%

The use of atorvastatin for chronic subdural haematoma: a retrospective cohort comparison study

Chan

Sun

et al. 2016

British Journal of Neurosurgery

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Chronic subdural haematoma (CSDH) is a common neurosurgical condition. Burr-hole for drainage is an effective treatment. However, recurrence can be up to 8-33% and is associated with morbidities and mortalities. The underlying pathogenesis was postulated to be localised inflammation and pathological aberrant vessels formation. Atorvastatin, an HMG-CoA reductase inhibitor, is a type of lipid-lowering medication. In animal studies and a preliminary clinical trial, Atorvastatin was shown to be effective in the treatment of CSDH. It was found to inhibit inflammation and promote vascular maturation at the neomembrane of CSDH. Our study aimed to investigate the efficacy of Atorvastatin in CSDH. During the study period from January to December 2014, Atorvastatin was used in 12 CSDH patients with Glasgow Coma Scale (GCS) 13-15 or Markwalder's Grading Scale (MGS) Grade 0-2. They were retrospectively compared with GCS-and MGS-matched controls who had not used statin. Improvement with haematoma resolution at 3 months was 75% (9/12) for the Atorvastatin group, versus 42% (5/12) for the Control group (p ¼ 0.0977). The risk of deterioration requiring burr-hole drainage was 16.7% (2/12) in the Atorvastatin group, versus 58.3% (7/12) in the Control group (p ¼ 0.0447). The Odds Ratio (OR) of deterioration requiring burr-hole drainage with Atorvastatin was 0.143 (95%CI: 0.021-0.958), which favours the use of Atorvastatin in CSDH (p ¼ 0.0451). The Number needed to treat (NNT) was 2.4 (p ¼ 0.0447; 95%CI: 1.31-14.93). In conclusion, this retrospective cohort comparison study has shown that CSDH with Atorvastatin had a lower rate of deterioration and burr-hole drainage.ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

“…Li et al has found that rats with subdermal hematomas (SDHs) treated by atorvastatin experienced better behavioral function recovery and rapid volume elimination, had more new CD31+ blood vessels and less neutrophilic granulocytes than rats treated with saline [52]. Atorvastatin treatment also significantly decreased TNF-α and IL-6 levels [52]. These studies suggest that statin-induced inflammation modulation significantly influences SDH elimination and functional recovery in rats [52], and may be beneficial in treating CSDH.…”

Section: Introductionmentioning

confidence: 99%

“…Atorvastatin treatment also significantly decreased TNF-α and IL-6 levels [52]. These studies suggest that statin-induced inflammation modulation significantly influences SDH elimination and functional recovery in rats [52], and may be beneficial in treating CSDH. More clinical research is needed to confirm the role and the mechanisms that inflammation plays in CSDH.…”

Section: Introductionmentioning

confidence: 99%

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Statins in conditions other than hypocholesterolemic effects for chronic subdural hematoma therapy, old drug, new tricks?

et al. 2017

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Chronic subdural hematoma (CSDH) is one of the most common intracranial hematomas worldwide with a high incidence in the general population. However, the optimum treatment for CSDH is Burr-hole drainage with or without rinse Considering the poor outcomes of CSDH in aged patients, and ambiguous prediction of recurrence in many sides of recurrent CSDHs who have been analyzed, new effective therapies are needed for those CSDHs who are predicated to have poor prognosis for surgery and/or have a higher risk of recurrence. Statins, which is the first-line treatment for patients with high cholesterol and coronary heart disease. However, statins are still not solely limited in the treatment of these diseases. It has been demonstrated that statins could improve CSDH due to its effect of regulation of angiogenesis and inflammation. In this review, in order to provide potential new treatment for CSDH we summarize the recent findings of statins in CSDH in order to try to clarify the mechanisms of this effect.

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Effects of atorvastatin on the inflammation regulation and elimination of subdural hematoma in rats

Abstract: Atorvastatin treatment may eliminate SDH and improve the neural function of the rats through its anti-inflammatory effects. Hence, it indicated that statin induced inflammatory modulation might play a significant role in rats' SDH elimination and the functional recovery.

Cited by 76 publications

References 46 publications

Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: Is more better?

Combination therapies for neurobehavioral and cognitive recovery after experimental traumatic brain injury: Is more better?

The use of atorvastatin for chronic subdural haematoma: a retrospective cohort comparison study

Statins in conditions other than hypocholesterolemic effects for chronic subdural hematoma therapy, old drug, new tricks?

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