Why the study?
Statins during radiation therapy associate with reduced long-term cardiovascular risk, but the mechanisms protecting the vasculature from irradiation injury remain poorly understood.
Does pretreatment with pravastatin or atorvastatin prevent radiation-induced injury in cultured human endothelial cells and mice?
Does pretreatment with pravastatin or atorvastatin prevent radiation-induced injury in cultured human endothelial cells and mice?
Pravastatin, a hydrophilic statin, may offer superior protection against radiation-induced mitochondrial injury and inflammation in endothelial cells compared to lipophilic atorvastatin.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for endothelial protection; leaves open clinical translation to reduced ASCVD after radiation.
Background: The incidental use of statins during radiation therapy has been associated with a reduced long-term risk of developing atherosclerotic cardiovascular disease. However, the mechanisms by which statins protect the vasculature from irradiation injury remain poorly understood. Objectives: Identify the mechanisms by which the hydrophilic and lipophilic statins pravastatin and atorvastatin preserve endothelial function after irradiation. Methods: Cultured human coronary and umbilical vein endothelial cells irradiated with 4 Gy and mice subjected to 12 Gy head-and-neck irradiation were pretreated with statins and tested for endothelial dysfunction, nitric oxide production, oxidative stress, and various mitochondrial phenotypes at 24 and 240 h after irradiation. Results: Both pravastatin (hydrophilic) and atorvastatin (lipophilic) were sufficient to prevent the loss of endothelium-dependent relaxation of arteries after head-and-neck irradiation, preserve the production of nitric oxide by endothelial cells, and suppress the cytosolic reactive oxidative stress associated with irradiation. However, only pravastatin inhibited irradiation-induced production of mitochondrial superoxide; damage to the mitochondrial DNA; loss of electron transport chain activity; and expression of inflammatory markers. Conclusions: Our findings reveal some mechanistic underpinnings of the vasoprotective effects of statins after irradiation. Whereas both pravastatin and atorvastatin can shield from endothelial dysfunction after irradiation, pravastatin additionally suppresses mitochondrial injury and inflammatory responses involving mitochondria. Clinical follow-up studies will be necessary to determine whether hydrophilic statins are more effective than their lipophilic counterparts in reducing the risk of cardiovascular disease in patients undergoing radiation therapy.
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Ait‐Aissa et al. (2023) studied this question.
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