The effect of statin therapy on allergic patients with asthma

Ostroukhova, Marina; Kouides, Ruth; Friedman, Elizabeth

doi:10.1016/s1081-1206(10)60261-x

Cited by 41 publications

(29 citation statements)

References 14 publications

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“…They evaluated statin use in N=50 patients (24 statin exposed and 26 control/unexposed) with mostly mild allergic asthma 27. They found that over a span of 6, 12 and 24 months, starting statin therapy was associated with reduced FEV 1 , increased medication use and more symptoms than controls who never started statins.…”

Section: Discussionmentioning

confidence: 99%

Statin use and asthma control in patients with severe asthma

et al. 2013

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ObjectivesWe hypothesised that severe asthmatics taking a statin drug, in addition to inhaled corticosteroids/long-acting β-agonist inhaler therapy, would have better asthma symptom control and improved lung function compared to their controls.Study designA retrospective, cross-sectional study of 165 patients with severe asthma seen from 2001–2008. Hierarchical linear and logistic regression models were used for modelling fitting.SettingUniversity of California, Davis Medical Center (Sacramento, California, USA). Academic, single-centre, severe asthma subspecialty clinic.Participants612 screened, 223 eligible and 165 adult patients were included in the final study (N=165; 31 statin users and 134 non-users).Primary and secondary outcome measuresThe primary endpoint was asthma control as measured by the Asthma Control Test (ACT). The secondary endpoints included lung function, symptoms and the need for corticosteroid burst and peripheral eosinophil count.ResultsAt baseline, statin users compared to non-users were older, had lower lung function (FEV1% predicted, FEV1, forced vital capacity and FEF25–75%) and had a higher prevalence of comorbid conditions. Statin use was associated with more aspirin and ipratropium inhaler use than in non-users. Patients in both groups were obese (body mass index ≥ 30). Statin users had better asthma symptom control compared to non-users (higher adjusted mean ACT score by 2.2±0.94 points, p<0.02). Median statin use was for 1 year. There were no statistically significant differences in lung function, corticosteroid or rescue bronchodilator use or peripheral eosinophilia between the two groups.ConclusionsIn our severe asthma referral population, statin users already taking inhaled controller therapy achieved better asthma control compared to non-users. The implications of this study is that patients with severe asthma could potentially benefit from added statin treatment. Because our study population was on average obese, the obese severe asthmatic may be a viable asthma subphenotype for further studies. Prospective randomised clinical trials evaluating the safety and efficacy of statins in severe asthma are warranted.

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Section: Discussionmentioning

confidence: 99%

Statin use and asthma control in patients with severe asthma

et al. 2013

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“…Little is known about the effects of cholesterol on asthma severity, but it has been shown that a high fat diet leads to increased airway inflammation post-prandially [52]. Moreover, the ability of cholesterol to inhibit NK function could explain the earlier described positive effects of statin therapy on asthmatic symptoms [53], [54]. The possible beneficial effects of statin treatment in asthma patients may also be due to a decrease in IL-17a production, caused by reduced serum cholesterol concentrations, as we here show that cholesterol incubation significantly increases IL-17a production, which is consistent with findings in mice that a high-fat diet leads to increased IL-17a production.…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Sitostanol on the Attenuated Immune Function in Asthma Patients: Results of an In Vitro Approach

et al. 2012

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BackgroundIn vitro and animal studies have suggested that plant sterols and stanols increase cytokine production by T-helper-1 cells. This may be beneficial for patient groups characterized by a T-helper-2 dominant immune response, e.g. asthma patients. (1) to evaluate whether sitostanol induces a T-helper-1 shift in peripheral blood mononuclear cells (PBMCs) from asthma patients, and (2) to unravel the role of regulatory T-cells in this respect.Methodology/Principal FindingsPBMCs from 10 asthma patients and 10 healthy subjects were isolated and incubated with 1.2 µM sitostanol, while stimulated with 5 µg/ml PHA. Similar amounts of cholesterol were used to determine whether effects were specific for plant stanols or for sterols in general. Changes in cytokine production were measured using antibody arrays and ELISAs. Changes in regulatory T-cell population size were measured by flow cytometry, using intracellular Foxp3 staining. Sitostanol increased production of IFNγ by 6.5% and IL-2 by 6.0% compared to cholesterol (p<0.01). No changes in IL-4 and IL-13 were found. Interestingly, this effect was only present in PBMCs from asthma patients. The number of Foxp3+ cells tended to increase and their activity, measured by IL-10 production, increased after sitostanol treatment in PBMCs from asthma patients compared to controls by 32.3% (p = 0.077) and 13.3% (p<0.05), respectively.Conclusions/SignificanceAltogether, the sitostanol-induced Thelper-1 shift in PBMCs from asthma patients and the stimulating effects of sitostanol on Treg cell numbers and activity indicate a possible novel approach for plant stanol ester enriched functional foods in the amelioration of asthmatic symptoms. Functional effects, however, require further evaluation.

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“…A 1-year retrospective study showed that there was a significant worsening of FEV 1 at every time point for the statin group compared with the controls. 25 At 6 months, more patients in the statin group needed increased maintenance medications, used albuterol more frequently, had more nocturnal awakenings and visited the clinic more frequently for acute asthma symptoms. 25 In contrast, a population-based study in 3965 patients using the Taiwan National Health Insurance Database indicated that statins may have contributed to reduced hospitalization rates due to asthma attacks, in patients with asthma.…”

Section: Journal Of International Medical Research 41(2)mentioning

confidence: 97%

“…25 At 6 months, more patients in the statin group needed increased maintenance medications, used albuterol more frequently, had more nocturnal awakenings and visited the clinic more frequently for acute asthma symptoms. 25 In contrast, a population-based study in 3965 patients using the Taiwan National Health Insurance Database indicated that statins may have contributed to reduced hospitalization rates due to asthma attacks, in patients with asthma. 26 Rates of adverse events and side-effects associated with the use of statin medications in asthma patients has been another controversial subject.…”

Section: Journal Of International Medical Research 41(2)mentioning

confidence: 97%

Statin therapy does not improve lung function in asthma: A meta-analysis of randomized controlled trials

Zhang

Huo

et al. 2013

J Int Med Res

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Objective: To assess the efficacy of statins in the treatment of asthma. Methods: Electronic databases were searched to identify randomized controlled trials that measured the efficacy of statins in the treatment of asthma, and a meta-analysis of the pooled data was performed. Results: Five trials were identified; four met the inclusion criteria (total number of patients 200). Compared with controls, patients in the statin groups had higher forced expiratory volume in 1 s (FEV 1 ) values before inhaled corticosteroids (0.09 l, 95% confidence interval [CI] À0.06, 0.23), higher FEV 1 values after inhaled corticosteroids (0.06 l, 95% CI À0.09, 0.22), and higher morning peak expiratory flow rates (9.87 l, 95% CI À15.66, 35.40). These results were not statistically significant and, furthermore, publication bias was detected. Conclusion: In conclusion, there is currently insufficient evidence to show that statins improve lung function in patients with asthma.

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The effect of statin therapy on allergic patients with asthma

Cited by 41 publications

References 14 publications

Statin use and asthma control in patients with severe asthma

Statin use and asthma control in patients with severe asthma

Beneficial Effects of Sitostanol on the Attenuated Immune Function in Asthma Patients: Results of an In Vitro Approach

Statin therapy does not improve lung function in asthma: A meta-analysis of randomized controlled trials

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