Statins are among the most widely used medicines in the world. They lower cholesterol levels and greatly reduce the risk of heart attacks and strokes, helping millions of people live longer and healthier lives.
Even though these medicines are highly effective, some people experience muscle pain, weakness, or tiredness while taking them. In rare cases, severe muscle damage can occur and may even lead to kidney failure.
A recent study has uncovered an important clue about why these side effects happen. The research was carried out by scientists at the University of British Columbia together with colleagues at the University of Wisconsin–Madison. Their findings were published in the journal Nature Communications and could help scientists develop safer statins in the future.
The researchers wanted to understand exactly how statins affect muscle cells. To do this, they used a powerful imaging method called cryo-electron microscopy. This technology allows scientists to see tiny structures inside cells in remarkable detail, helping them understand how medicines interact with proteins.
The team focused on a protein called RyR1, which plays a key role in muscle movement. This protein controls the release of calcium inside muscle cells. Calcium is essential because it tells muscles when to contract and relax, allowing people to move normally.
Under healthy conditions, the RyR1 protein opens only when calcium is needed. The researchers discovered that statins can attach to this protein and cause it to stay open for longer than it should. As a result, calcium leaks continuously from its normal storage areas inside muscle cells.
Too much calcium leaking into the cell can damage muscle tissue over time. This constant leak may explain why some people taking statins develop sore muscles, weakness, or fatigue. Lead author Dr. Steven Molinarolo said the team was able to see exactly how statins bind to the protein and trigger this harmful process.
The researchers closely studied atorvastatin, one of the world’s most commonly prescribed statins. They found that three statin molecules work together in an unusual way. The first molecule makes the protein more likely to open, while two more molecules lock it into an open position, allowing calcium to continue leaking out.
Although the study focused on atorvastatin, the scientists believe the same process may happen with several other statins. This discovery provides an important explanation for the muscle-related side effects that have puzzled researchers and doctors for many years.
Senior researcher Dr. Filip Van Petegem said the findings give scientists a detailed guide for designing better medicines. Future statins may still lower cholesterol effectively but be changed so they no longer interact with muscle proteins in this harmful way. Such medicines could reduce side effects while continuing to protect the heart.
More than 200 million people worldwide take statins, and most never develop serious muscle problems. However, mild muscle symptoms are common enough that some people stop taking their medication, increasing their risk of heart attack or stroke.
This study offers hope that future generations of statins could be both highly effective and much easier for patients to tolerate. It also highlights how advanced imaging technology is helping scientists design safer medicines by revealing exactly how drugs work inside the human body.
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