Statins and Asthma


dr_duane_graveline_m.d._134By Duane Graveline, MD, MPH

During my 23 years of medical practice, asthma was one of the most common conditions I treated. Common symptoms include coughing, shortness of breath, tightness of the chest and the very characteristic wheezing. The underlying condition is spasm of the airways, known as bronchospasm.

Ordinarily an asthmatic will have attacks of asthma and be relatively normal in between these attacks, although lung studies will usually reveal some degree of impaired lung function. The attacks of wheezing will be brought on by exposure to dust, chemicals  or various seasonal allergens in the air such as certain fall flowers or new spring foliage. Ragweed may be a common trigger.

In addition to this environmental factor there is a genetic factor to asthma and the asthmatic tendency often is present in mother or father. Some cases are purely seasonal and can best be treated by a single injection of a long acting steroid supplemented with use of a bronchodilator of which several different kinds are available. 

The chronic cases are very challenging in that some have been found due to dander of pets and body parts of common insects such as mites.

Because of their wide ranging anti-inflammatory effects and immunomodulatory properties, statin drugs have been found to have a very negative effect on patients with asthma.  67% of statin users reported increased maintenance medication. 75% reported more frequent use of albuterol.  33% had more nocturnal awakenings. 38% were seen more frequently at office visits for acute asthma attacks. (Ref: http://www.ncbi.nlm.nih.gov/pubmed/20084838).

The mechanisms involved are a combination of decreased synthesis of CoQ10 and dolichols contributing to increased mitochondrial DNA damage. In concert with the other members of its anti-oxidant team CoQ10 suffices to keep oxidative damage to a minimum. 
 

That tens of thousands of DNA lesions occur daily, despite all that our anti-oxidant system can do, is a sobering reality.  Fortunately most of these errors never make it beyond the next cell division at which point they are replaced naturally by normal configurations. 

Most of the serious damage is to our bases, those four amino acids:  adenine, cytosine, thymine and guanine, comprising our DNA strands.  Of extreme importance to us is the base excision repair process, in which faulty bases must be excised and replaced by correct ones.

This is where dolichols come in. Each one of these base repairs requires a specific glycohydrolase.  Since glycohydrolase is one of our ubiquitous glycoproteins, the joining together of sugar and peptides, dolichols are required for glycohydrolase synthesis. 

CoQ10 helps to minimize the DNA damage. Dolichols helps to repair the ones that got through. Statins inhibit both of these critical biochemicals. There is reason to believe that the mitochondrial loss sustained by respiratory tract cells is permanent and recovery from statin use may be incomplete.   

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor

Updated February 2016
 

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