Journal
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Volume 172, Issue 8, Pages 987-993Publisher
AMER THORACIC SOC
DOI: 10.1164/rccm.200501-041OC
Keywords
emphysema; pulmonary hypertension; smoking; statin
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Rationale: In cigarette smoking-induced chronic obstructive pulmonary disease, structural and functional derangements are characterized by parenchymal destruction and pulmonary hypertension. Statins are 3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase inhibitors that have been used as lipid-lowering agents. These drugs also have additional pharmacologic properties, including antiinflammation, scavenging reactive oxygen species, restoring endothelial function, and antithrombogenesis, all of which can counteract the harmful effects of cigarette smoking. Objective: We performed assays to determine whether simvastatin could attenuate lung damage induced by chronic cigarette smoking in rats. Methods: In Sprague-Dawley rats exposed to cigarette smoke for 16 weeks, morphologic changes in the lungs and pulmonary arterial pressure were examined. Main Results: Simvastatin inhibited lung parenchymal destruction and development of pulmonary hypertension, and also inhibited peribronchial and perivascular infiltration of inflammatory cells and induction of matrix metalloprotelnase-9 activity in lung tissue. Simvastatin additionally prevented pulmonary vascular remodeling and the changes in enclothelial nitric oxide synthase expression induced by smoking. In human lung microvascular enclothelial cells, simvastatin increased expression of endothelial nitric oxide synthase mRNA. Conclusions: Simvastatin ameliorated the structural and functional derangements of the lungs caused by cigarette smoking, partly by suppressing inflammation and matrix metalloproteinase-9 induction and preventing pulmonary vascular abnormality. These findings indicate that statins may play a role in the treatment of cigarette smoking-induced chronic obstructive pulmonary disease.
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