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Cholesterinsenker—eine neue Therapieoption bei Multipler Sklerose?

Statine als Immunmodulatoren

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Zusammenfassung

Statine sind Inhibitoren des bei der Bildung von Cholesterin notwendigen Enzyms 3-Hydroxy-3-methylglutaryl-Koenzym-A (HMG-CoA)-Reduktase und werden weit verbreitet als Cholesterinsenker verwendet. Sie vermindern Arteriosklerose und damit das kardiovaskuläre Risiko, was in der Vergangenheit hauptsächlich auf ihre Cholesterin senkenden Eigenschaften zurückgeführt wurde. Neuere Forschungsergebnisse zeigen, dass Statine zusätzlich potente immunmodulatorische Effekte haben, die Ausprägung klinischer und pathologischer Veränderungen im Tiermodell der Experimentellen Autoimmunen Enzephalomyelitis vermindern und damit als therapeutische Option für die Multiple Sklerose grundsätzlich infrage kommen. Der genaue Wirkmechanismus ist noch unklar, diskutiert werden HMG-CoA-Reduktase-abhängige Effekte oder auch direkte Einflüsse auf Immunrezeptoren.

Summary

Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, which is crucial for cholesterol biosynthesis, and are widely used as lipid-lowering agents. These drugs greatly reduce atherosclerosis and cardiovascular morbidity, which in the past was mainly attributed to their cholesterol-lowering properties. However, recent evidence suggests that statins are also potent immunomodulators. They exerted beneficial effects on animal models of experimental autoimmune encephalomyelitis and thus have therapeutic potential for multiple sclerosis. Their exact mechanism of action is still unclear. HMG-CoA-dependent effects and a direct effect on immune receptors are conceivable and are reviewed here.

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Authors and Affiliations

  1. Neurologische Universitätsklinik, Heinrich-Heine-Universität Düsseldorf

    O. Neuhaus, B. C. Kieseier & H.-P. Hartung

  2. Neurologische Universitätsklinik, Eberhart-Karls-Universität Tübingen

    H. Wiendl

  3. Neurologische Universitätsklinik, Karl-Franzens-Universität Graz

    J. J. Archelos

  4. Neurologische Universitätsklinik, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf

    O. Neuhaus

Authors
  1. O. Neuhaus
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  2. H. Wiendl
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  3. B. C. Kieseier
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  4. J. J. Archelos
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  5. H.-P. Hartung
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Correspondence to O. Neuhaus.

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Neuhaus, O., Wiendl, H., Kieseier, B.C. et al. Cholesterinsenker—eine neue Therapieoption bei Multipler Sklerose?. Nervenarzt 74, 704–707 (2003). https://doi.org/10.1007/s00115-003-1562-x

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  • DOI: https://doi.org/10.1007/s00115-003-1562-x

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