A study found that statins have beneficial effect on rheumatoid arthritis cells in vitro.

Statins, a class of drugs widely used to treat high cholesterol, have also been studied for their potential role in inflammation and other cell processes, including immune response.
They have also been shown to induce apoptosis ( cell death ) in normal cells and tumor cells.

Rheumatoid arthritis causes proliferation of synovial tissue, which lines the joints, but little is known about the effect of statins on this type of tissue.

A study examined whether statins are able to induce apoptosis in synovial cells of patients with rheumatoid arthritis and found that they have potential as a novel way of treating the disease.

The activation and proliferation of synovial cells, which is thought to play a key role in rheumatoid arthritis, may be exacerbated when apoptosis of synovial cells is either insufficient or resistant to treatment.

In the first study to demonstrate whether statins can induce apoptosis in synovial cells of rheumatoid arthritis patients, researchers led by Takao Nagashima of Jichi Medical School, Tochigi, Japan measured the effect in vitro of two statins, Fluvastatin ( Lescol ) ( a fat-soluble statin ) and Pravastatin ( Pravachol ) ( a water-soluble statin ) on human synovial cells from patients with rheumatoid arthritis and osteoarthropathy.

" In the present study, we demonstrated that Fluvastatin induced apoptosis in synoviocytes from patients with rheumatoid arthritis, but not in those from patients with osteoarthropathy, suggesting that the apoptotic effect of Fluvastatin is a mechanism for suppression of inflammatory arthritis such as rheumatoid arthritis by statins," the authors state

. They were also able to determine the pathway by which apoptosis occurred: the inhibition of protein geranygeranylation ( a process involving the metabolism of certain proteins that is essential for proper cell function, including the survival of vascular smooth muscle cells ) was shown to be necessary for apoptosis to occur in these cells. Specifically, the pathway involves inhibition of the geranylgeranylated protein RhoA/RhoA kinase, which has already been shown to be involved in apoptosis.

The researchers point out that the in vitro concentrations they used of the statins were much higher than amounts that would normally be prescribed to patients. Although they note that it is possible that in the human body relatively low, but sustained, blood levels of statins would exert an effect similar to that seen in vitro with higher concentrations and short incubation times, they acknowledge that the therapeutic effect of fluvastatins in patients remains to be determined.

The authors conclude: “ The induction of apoptosis in rheumatoid arthritis synovial cells by Fluvastatin and the biologic antiatherosclerotic properties of the statins suggest that they may turn out to be ideal therapeutic agents in rheumatoid arthritis. Based on these results, we propose that the statins warrant clinical trials as potential modifiers of rheumatoid arthritis."

Source: Arthritis & Rheumatism, 2006


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