Statins are among the most prescribed medications to lower cholesterol and reduce the risk of heart attacks and strokes. However, in some patients, their intake is accompanied by muscle pain, weakness or even intolerance to exercise. Symptoms which sometimes lead to reducing the dose or even stopping treatment.
A new study, published in Science Advances and conducted by researchers at McMaster University, now sheds new light on the origin of these side effects.
An immune reaction could be the cause of muscle pain
Led by Nazli Robin and Nicole Barra, with Jonathan Schertzer as lead author, the study highlights an immune and metabolic mechanism that could explain the muscle damage observed in some patients taking statins.
Researchers have found that these drugs can disrupt the energy production of muscle cells. This disruption would then trigger an immune response directly within the muscle cells, causing damage to the muscle tissue.
During experiments carried out on muscle cells and mouse models, the team managed to prevent a large part of these lesions by blocking this immune response.
According to Jonathan Schertzer, professor in the department of biochemistry and biomedical sciences at McMaster University and lead author of the study, statins remain “among the most effective drugs” for preventing cardiovascular disease and premature death. But their muscular side effects push some patients to reduce their treatment or to interrupt it.
A promising avenue for better tolerating statins
Muscle symptoms linked to statins affect approximately 7% to 29% of people who take these medications. Until now, the biological mechanisms responsible for these effects remained poorly understood.
One of the main findings of this study is that the mechanism responsible for muscle pain appears distinct from that which allows statins to lower cholesterol.
For Jonathan Schertzer, this discovery opens an encouraging perspective: it could become possible, in the future, to target muscular side effects without reducing the cardiovascular benefits of statins.
Researchers have also highlighted an unexpected link between metabolism and immunity. Changes in muscle cell metabolism appear to trigger an inflammatory response within these cells themselves, providing new understanding of the role of inflammation in the side effects of certain medications.
The authors emphasize, however, that additional research will be necessary before these results lead to new treatments. This study, published in Science Advances by a team from McMaster University, nevertheless identifies several potential targets which could, ultimately, help prevent intolerance to statins and improve the tolerance of these essential treatments.