Abstract
Purpose: Statins, in addition to lower cholesterol levels, have anti-thrombotic, anti-inflammatory and cardiovascular protective effects. Cardiovascular morbidity and accelerated atherosclerosis occur with increased frequency in SLE, but it is unclear whether statins have beneficial effects in these patients beyond their effects in cholesterol levels.
Objectives: To assess longitudinally the impact of statins on levels of biomarkers (cytokines/ chemokines) and SLAM-R scores.
Methods: Sera from 21 SLE patients (ACR criteria) from a multi-ethnic, multi-center cohort were assessed at baseline and at a subsequent visit after statin treatment started. Patients on >10 mg prednisone/day, hydroxychlorquine or immunosuppressants were excluded (age range: 16—67; mean age: 44.6 yrs); 38% African American, 9% Caucasians and 4% Puerto Rican Hispanics; 86% female. Serum levels of IL1b, IL-6, IL-8, IFN-α, IP-10, MCP-1. VEGF, sCD40L and TNF-α, were measured using a Millipore MillliplexTM Multiplex Assay; titers of soluble (s) E-selectin (E-sel), intercellular cell adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1). High sensitive C reactive protein (hsCRP) was measured by nephelometry. Changes in the levels of biomarkers were tested using a signed rank test. The relationship between the levels of biomarkers and SLAM-R scores were compared with Spearman correlations. SLAM-R scores before and after statin treatment were compared with a paired Student’s t test.
Results: IL1b, IL6, IL8, TNF-alpha, VEGF, IP-10, sCD40L and sVCAM-1 levels were reduced after treatment by 28%, 28%, 52%, 43%, 57%, 42%, 52%, and 62%, respectively, but these differences were not statistically significant; hsCRP was increased in 50% of the patients at baseline and reduced by 37% after treatment with statins. SLAM-R scores diminished significantly after statin treatment [mean difference 1.9 (±0.67), p = 0.013].
Conclusions: A decrease in the levels of some cytokines and chemokines and of hsCRP after statin treatment was observed in these patients. Importantly, SLAM-R scores were significantly reduced by statins. These data need to be interpreted with caution given the small number of patients studied.
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