Systematic review of the in vitro effects of statins on oral and perioral microorganisms

Abstract

Statins are medications administered orally and are widely used for lowering the blood cholesterol level. The aim of this study was to investigate the effects of orally administered statins on microorganisms infecting oral and perioral tissues. We performed a systematic review of published studies of the in vitro antimicrobial effects of statins on bacteria, viruses, and fungi, and searched PubMed, Web of Science, Cochrane Central, and Google scholar. Studies show that most statins exhibit antimicrobial effects against various oral microorganisms. Simvastatin is most effective against the periodontal pathogens Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, and against most dental plaque bacteria, including Streptococcus mutans. Statins also exhibit antiviral properties against human cytomegalovirus, hepatitis B virus, and hepatitis C virus, and have antifungal properties against Candida albicans, Aspergillus fumigatus, and Zygomycetes spp. There were notable differences in the minimum inhibitory concentrations (MICs) between different studies, which may be attributed to differences in study design. Further studies are warranted to ascertain if statins can be solubilized so that patients, who have been prescribed statins for cardiovascular diseases, can use the medication as a swish and swallow, giving patients the added benefit of the antimicrobial action topically in the mouth against infectious oral diseases.

Local application of statins in the treatment of experimental periodontal disease in rats

“…Statin drugs are inhibitors of the enzyme 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, leading to the production management of cholesterol 24 , 25 , 27 . Among the various statins, Simvastatin, which has been widely used in clinical practice to control cholesterol, has proven to be pharmacologically safe.…”

“…However, mechanical therapy alone may be unsuccessful to eliminate pathogenic bacteria for they are usually located within either soft or hard tissues, or even in areas that are inaccessible to periodontal instruments, such as areas of furcation and root depressions 2 . Due to these limitations, supporting methods for conventional periodontal therapy have been studied 7 , 27 . Given the prominent role of the host as a main destruction component of soft and hard tissues seen in periodontitis, therapeutic strategies, such as pharmacological agents, have been highlighted as a new treatment approach 7 , 27 .…”

“…Due to these limitations, supporting methods for conventional periodontal therapy have been studied 7 , 27 . Given the prominent role of the host as a main destruction component of soft and hard tissues seen in periodontitis, therapeutic strategies, such as pharmacological agents, have been highlighted as a new treatment approach 7 , 27 .…”

“…Despite, in addition to its lipid-lowering function, this statin is notable for other side effects, including anti-inflammatory 27 , immunomodulatory, and antioxidant properties, besides the promotion of angiogenesis and increased differentiation of osteoblasts, leading to bone formation 20 , 27 . These properties provide great potential for statins to modify the course of chronic inflammatory diseases 3 , among which periodontal diseases can be included.…”

Antimicrobial activity of the chloroform fraction of <i>Drynaria <i>fortunei</i></i> against oral pathogens

“…The human oral microbiome contains approximately 700 predominant bacterial species that protect the oral cavity (1,2). However, the oral microbiota are often involved in the pathogenesis of a variety of systemic diseases including respiratory infections, cancer, diabetes mellitus, rheumatoid arthritis, cardiovascular diseases, brain abscess, and premature birth (3)(4)(5).…”