Statins Show Benefits, Limitations in Asthma

Researchers try to determine the future of statins in treating asthma. The drugs show promise but pills might not be the best way to get them into the respiratory tract.

A group of researchers reviewed the existing studies and clinical trials of statins used as a treatment for asthma to generate a list of recommendations for future studies. Dipanjan Bhattacharjee, of the Department of Pharmacology, at Kasturba Medical College, Manipal University in Manipal, India, and colleagues, investigated how statins “exert their anti-inflammatory effects” and whether or not they may be used to treat asthma in the future, as well as why evidence from clinical studies has been inconsistent.

Asthma has been a recognized problem as far back as ancient civilizations, however, it wasn’t until the 1960s that corticosteroids were identified as a treatment. According to the researchers, “Thenceforth, many drugs, bearing different target sites in the asthma pathophysiology have been introduced.”

While the anti-inflammatory effects of statins are well-documented in cardiology studies, “the actions of statins on the respiratory tract are still unclear.” Studies have examined how statins can limit changes in the airways due to asthma, as well as reduce airway inflammation.

Changes in the airway, or “airway remodeling” has been a topic of scientific studies for about twenty years. Some preclinical and animal studies have shown that statins may “exert beneficial influences against a few of the phenotypic changes seen in asthmatics’ airways during the course of airway restructuring.” Goblet cell hyperplasia, thickening of the basement membrane, and inhibiting the “contractile regulatory proteins in the airway smooth muscles” are just a few of the ways that statins may be beneficial for asthmatics.

Some studies seem to have shown that statins impact the production of nitrous oxide and “may potentially stand to negate the inflammatory phenomena in asthma.” Two other possibilities, that statins can “induce endothelial cell repair and regeneration” and that they may “may cause a reduction in the expression of the major proinflammatory cytokines” have been investigated.

The preclinical studies that seemed to indicate that statins would be useful for treating asthma “fuelled a flurry of clinical studies over the past decade.” However, the results of those trials were inconsistent. Several future studies could resolve the issue.

The researchers question whether or not oral administration of statins, “which is the only approved route of administration in humans” is best suited for treating the respiratory tract. The dosage and type of statin are two other areas that could lead to inconsistent results, as well as whether statins work better alone or in combination with other therapies.