Francisco Alejandro Lagunas-Rangel, Edgars Liepinsh, Robert Fredriksson, Ahmed M. Alsehli, Michael J. Williams, Maija Dambrova, Jörgen Jönsson, Helgi B. Schiöth
Statins are one of the most important classes of drugs. In this analytical review, we elucidate the intricate molecular mechanisms and toxicological rationale regarding both the on- (targeting 3-hydroxy-3-methylglutaryl-coenzyme A reductase [HMGCR]) and off-target effects of statins. Statins interact with a number of membrane kinases, such as epidermal growth factor receptor (EGFR), erb-b2 receptor tyrosine kinase 2 (HER2) and MET proto-oncogene, receptor tyrosine kinase (MET), as well as cytosolic kinases, such as SRC proto-oncogene, non-receptor tyrosine kinase (Src) and show inhibitory activity at nanomolar concentrations. In addition, they interact with calcium ATPases and peroxisome proliferator-activated receptor α (PPARα/NR1C1) at higher concentrations. Statins interact with mitochondrial complexes III and IV, and their inhibition of coenzyme Q10 synthesis also impairs the functioning of complexes I and II. Statins act as inhibitors of kinases, calcium ATPases and mitochondrial complexes, while activating PPARα. These off-target effects likely contribute to the side effects observed in patients undergoing statin therapy, including musculoskeletal symptoms and hepatic effects. Interestingly, some off-target effects of statins could also be the cause of favourable outcomes, relating to repurposing statins in conditions such as inflammatory disorders and cancer.
他汀类药物是最重要的药物类别之一。在这篇分析综述中,我们阐明了他汀类药物在靶向(针对 3-羟基-3-甲基戊二酰辅酶 A 还原酶 [HMGCR])和非靶向效应方面错综复杂的分子机制和毒理学原理。他汀类药物与许多膜激酶(如表皮生长因子受体(EGFR)、erb-b2 受体酪氨酸激酶 2(HER2)和 MET 原癌基因、受体酪氨酸激酶(MET))以及细胞膜激酶(如 SRC 原癌基因、非受体酪氨酸激酶(Src))相互作用,并在纳摩尔浓度下显示出抑制活性。此外,在浓度较高时,它们还与钙 ATP 酶和过氧化物酶体增殖激活受体 α(PPARα/NR1C1)相互作用。他汀类药物与线粒体复合物 III 和 IV 相互作用,抑制辅酶 Q10 的合成也会损害复合物 I 和 II 的功能。他汀类药物是激酶、钙离子 ATP 酶和线粒体复合物的抑制剂,同时激活 PPARα。这些脱靶效应可能是他汀类药物治疗患者出现副作用的原因,包括肌肉骨骼症状和肝脏效应。有趣的是,他汀类药物的某些脱靶效应也可能是产生良好疗效的原因,这与他汀类药物在炎症性疾病和癌症等疾病中的再利用有关。
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Hongtao Yu, Peter J. Greasley, Hiddo J. Lambers Heerspink, Philip Ambery, Christine Ahlstrom, Bengt Hamren, Anis A. Khan, David W. Boulton, K. Melissa Hallow