Hydroxymethylglutaryl coenzyme A reductase inhibitors down-regulate chemokines and chemokine receptors in patients with coronary artery disease

OBJECTIVES We sought to investigate whether the activation of the chemokine network observed in patients with coronary artery disease (CAD) could - be modified by treatment with 3-hydroxy3-methylglutaryl coenzyme A reductase inhibitors (statins). BACKGROUND Chemokines and chemokine receptors are important mediators in atherogenesis, and we hypothesized that the statins could affect the chemokine network in CAD. METHODS Thirty CAD patients without previous statin therapy were randomized to receive atorvastatin (80 mg/day, n = 15) or simvastatin (20 mg/day, n = 15). Peripheral blood mononuclear cells (PBMCs) and plasma were obtained at baseline and after six months of statin therapy. Messenger ribonucleic acid (mRNA) expression of chemokines and chemokine receptors in PBMCs was analyzed by ribonuclease protection assay and real-time reverse-transcription polymerase chain reaction. Chemokines were also examined in the supernatants from unstimulated and lipopolysaccharide-stimulated PBMCs (and in plasma). RESULTS Our main findings were: 1) gene expression of several chemokines (i.e., macrophage inflammatory protein [MIP]-1alpha, MIP-1beta, and interleukin [IL]-8) and chemokine receptors (i.e., CC chemokine receptor [CCR]1, CCR2, CCR4, and CCR5) was markedly increased among CAD patients compared with healthy control subjects-, 2) treatment with atorvastatin and simvastatin markedly reduced the mRNA levels of some of these chemokines (i.e., MIP-1alpha, MIP-1beta, IL-8) and receptors (i.e., CCR1 and CCR2), with the most pronounced effect in the atorvastatin group; -and 3) statin therapy reduced the spontaneous release of IL-8 and MIP-1alpha from PBMCs in CAD patients. CONCLUSIONS This study demonstrates a down-regulatory effect of statins on the chemokine network in CAD patients, possibly contributing to the beneficial effects of statins in this disorder. (C) 2003 by the American College of Cardiology Foundation.