This Article Full Text Full Text (PDF) All Versions of this Article: 200205-410OCv1 167/9/1271    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Johnson, B. A. Articles by Duncan, S. R. Search for Related Content PubMed PubMed Citation Articles by Johnson, B. A. Articles by Duncan, S. R.

Statin Use Is Associated with Improved Function and Survival of Lung Allografts

Department of Medicine and Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Correspondence and requests for reprints should be addressed to Steven R. Duncan, M.D., Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh, 628 NW MUH, 3459 Fifth Ave., Pittsburgh, PA 15213. E-mail: duncsr{at}msx.upmc.edu

3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are widely used antilipidemic agents that are also immunomodulatory. We evaluated possible effects of these agents after lung transplantation by comparing outcomes of 39 allograft recipients, who were prescribed statins for hyperlipidemia, with those of 161 contemporaneous control recipients who did not receive these drugs. Acute rejection ( Grade II) was less frequently found in the statin group (15.1 versus 25.6% of biopsies, p < 0.01). None of 15 recipients started on statins during postoperative Year 1 developed obliterative bronchiolitis, whereas the cumulative incidence of this complication among control subjects was 37% (p < 0.01). Total cellularity, as well as proportions of inflammatory neutrophils and lymphocytes, were significantly lower in bronchoalveolar lavages of statin recipients. Among double lung recipients, those taking statins had significantly better spirometry: FVC (80 ± 2 versus 70 ± 1%) and FEV₁ (87 ± 2 versus 70 ± 1%), as percentages of predicted values, and absolute FEV₁/FVC (83.4 ± 1.2 versus 78.6 ± 0.5) (all p < 0.01). The 6-year survival of recipients taking statins (91%) was much greater than that of control subjects (54%) (p < 0.01). These data suggest statin use may have substantial clinical benefits after pulmonary transplantation.

Key Words: bronchiolitis obliterans • graft rejection • hydroxymethylglutaryl CoA reductase inhibitors • transplantation

This article has been cited by other articles:

				S. Takahashi, H. Nakamura, M. Seki, Y. Shiraishi, M. Yamamoto, M. Furuuchi, T. Nakajima, S. Tsujimura, T. Shirahata, M. Nakamura, et al. Reversal of elastase-induced pulmonary emphysema and promotion of alveolar epithelial cell proliferation by simvastatin in mice Am J Physiol Lung Cell Mol Physiol, May 1, 2008; 294(5): L882 - L890. [Abstract] [Full Text] [PDF]

				W. MacNee Update in Chronic Obstructive Pulmonary Disease 2007 Am. J. Respir. Crit. Care Med., April 15, 2008; 177(8): 820 - 829. [Full Text] [PDF]

				K. I. Paraskevas Applications of statins in cardiothoracic surgery: more than just lipid-lowering Eur. J. Cardiothorac. Surg., March 1, 2008; 33(3): 377 - 390. [Abstract] [Full Text] [PDF]

				D. M. Murphy, I. A. Forrest, P. A. Corris, G. E. Johnson, T. Small, D. Jones, A. J. Fisher, J. J. Egan, T. E. Cawston, C. Ward, et al. Simvastatin attenuates release of neutrophilic and remodeling factors from primary bronchial epithelial cells derived from stable lung transplant recipients Am J Physiol Lung Cell Mol Physiol, March 1, 2008; 294(3): L592 - L599. [Abstract] [Full Text] [PDF]

				J. I. Keddissi, W. G. Younis, E. A. Chbeir, N. N. Daher, T. A. Dernaika, and G. T. Kinasewitz The Use of Statins and Lung Function in Current and Former Smokers Chest, December 1, 2007; 132(6): 1764 - 1771. [Abstract] [Full Text] [PDF]

				S. E. Alexeeff, A. A. Litonjua, D. Sparrow, P. S. Vokonas, and J. Schwartz Statin Use Reduces Decline in Lung Function: VA Normative Aging Study Am. J. Respir. Crit. Care Med., October 15, 2007; 176(8): 742 - 747. [Abstract] [Full Text] [PDF]

				A. Van Muylem, C. Knoop, and M. Estenne Early Detection of Chronic Pulmonary Allograft Dysfunction by Exhaled Biomarkers Am. J. Respir. Crit. Care Med., April 1, 2007; 175(7): 731 - 736. [Abstract] [Full Text] [PDF]

				I. Al-Githmi, N. Batawil, N. Shigemura, M. Hsin, T. W. lee, G.-W. He, and A. Yim Bronchiolitis obliterans following lung transplantation Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 846 - 851. [Abstract] [Full Text] [PDF]

				E Hothersall, C McSharry, and N C Thomson Potential therapeutic role for statins in respiratory disease. Thorax, August 1, 2006; 61(8): 729 - 734. [Abstract] [Full Text] [PDF]

				K. Morimoto, W. J. Janssen, M. B. Fessler, K. A. McPhillips, V. M. Borges, R. P. Bowler, Y.-Q. Xiao, J. A. Kench, P. M. Henson, and R. W. Vandivier Lovastatin enhances clearance of apoptotic cells (efferocytosis) with implications for chronic obstructive pulmonary disease. J. Immunol., June 15, 2006; 176(12): 7657 - 7665. [Abstract] [Full Text] [PDF]

				D. S. Wilkes, T. M. Egan, and H. Y. Reynolds Lung Transplantation: Opportunities for Research and Clinical Advancement Am. J. Respir. Crit. Care Med., October 15, 2005; 172(8): 944 - 955. [Abstract] [Full Text] [PDF]

				S. Gullu, R. Emral, M. Bastemir, A. B Parkes, and J. H Lazarus In vivo and in vitro effects of statins on lymphocytes in patients with Hashimoto's thyroiditis Eur. J. Endocrinol., July 1, 2005; 153(1): 41 - 48. [Abstract] [Full Text] [PDF]

				K. L. Watts, E. M. Sampson, G. S. Schultz, and M. A. Spiteri Simvastatin Inhibits Growth Factor Expression and Modulates Profibrogenic Markers in Lung Fibroblasts Am. J. Respir. Cell Mol. Biol., April 1, 2005; 32(4): 290 - 300. [Abstract] [Full Text] [PDF]

				K. L. Lentine and D. C. Brennan Statin use after renal transplantation: a systematic quality review of trial-based evidence Nephrol. Dial. Transplant., September 1, 2004; 19(9): 2378 - 2386. [Abstract] [Full Text] [PDF]

				H. F. Nadrous, J. H. Ryu, W. W. Douglas, P. A. Decker, and E. J. Olson Impact of Angiotensin-Converting Enzyme Inhibitors and Statins on Survival in Idiopathic Pulmonary Fibrosis Chest, August 1, 2004; 126(2): 438 - 446. [Abstract] [Full Text] [PDF]

				R. M. Kotloff, V. N. Ahya, and S. W. Crawford Pulmonary Complications of Solid Organ and Hematopoietic Stem Cell Transplantation Am. J. Respir. Crit. Care Med., July 1, 2004; 170(1): 22 - 48. [Abstract] [Full Text] [PDF]

				R. ten Cate, P. H. Nibbering, and R. G. M. Bredius Therapy-refractory systemic juvenile idiopathic arthritis successfully treated with statins Rheumatology, July 1, 2004; 43(7): 934 - 935. [Full Text] [PDF]

				M. J. Tobin Chronic Obstructive Pulmonary Disease, Pollution, Pulmonary Vascular Disease, Transplantation, Pleural Disease, and Lung Cancer in AJRCCM 2003 Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 301 - 313. [Full Text] [PDF]

				J. H. Ryu, J. L. Myers, and S. J. Swensen Bronchiolar Disorders Am. J. Respir. Crit. Care Med., December 1, 2003; 168(11): 1277 - 1292. [Abstract] [Full Text] [PDF]