Respiratory Medicine
Volume 104, Issue 8 , Pages 1081-1091, August 2010

Statins in community acquired pneumonia: Evidence from experimental and clinical studies

  • James D. Chalmers

      Affiliations

    • University of Edinburgh, Edinburgh, UK
    • Corresponding Author InformationCorresponding author at: Centre for Inflammation Research, Queens Medical Research Institute, 51 Old Dalkeith Road, Edinburgh EH16 4TJ, UK. Tel./fax: +44 1312421908.
  • ,
  • Philip M. Short

      Affiliations

    • Ninewells Hospital, Dundee, UK
  • ,
  • Pallavi Mandal

      Affiliations

    • Royal Infirmary of Edinburgh, Edinburgh, UK
  • ,
  • Ahsan R. Akram

      Affiliations

    • Royal Infirmary of Edinburgh, Edinburgh, UK
  • ,
  • Adam T. Hill

      Affiliations

    • Royal Infirmary of Edinburgh, Edinburgh, UK

Received 13 December 2009; accepted 7 April 2010. published online 06 May 2010.

Summary 

Statins are widely used to lower cholesterol and prevent complications of cardiovascular disease. The non-lipid lowering (pleiotropic) effects of statins may also have applications to the management of infections. These include effects on endothelial function, inflammation and coagulation pathways. Several observational studies have shown a significant reduction in 30-day mortality associated with prior statin therapy in hospitalised patients with sepsis and community acquired pneumonia.

This article explores the evidence for statins as novel therapy in community acquired pneumonia. Experimental and animal studies suggest statins attenuate acute lung injury by modulating neutrophil function, reducing pro-inflammatory cytokine release and reducing vascular leak. Statins reduce endothelial dysfunction and have anti-thrombotic effects that improve outcome from pneumonia and sepsis in animal models. Clinical studies have provided conflicting results, but many suggest that statins may have a role in preventing pneumonia, or improving prognosis in hospitalised patients with community-acquired pneumonia.

Keywords: Statins, Sepsis, Pneumonia, Acute lung injury, Thrombosis, Inflammation

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PII: S0954-6111(10)00158-7

doi:10.1016/j.rmed.2010.04.005

Respiratory Medicine
Volume 104, Issue 8 , Pages 1081-1091, August 2010