Statins are among the most commonly prescribed medicines in the world because they lower cholesterol and greatly reduce the risk of heart attacks and strokes.
For millions of people, these medicines are an important part of staying healthy after heart disease or preventing future cardiovascular problems.
Even so, some people find it difficult to continue taking statins because they develop muscle pain, weakness, or tiredness after starting treatment.
Doctors have known about these side effects for many years, but the exact reason they happen has remained uncertain. Some people stop taking their medicine because of the discomfort, while others reduce the dose without medical advice. This can reduce the protection that statins provide against serious heart problems.
A new study from McMaster University has uncovered an important clue that may explain why muscle symptoms develop in some people.
The findings, published in Science Advances, suggest that the problem may come from an unexpected interaction between muscle cells and the immune system rather than from cholesterol lowering itself.
The researchers wanted to understand what happens inside muscle cells after statin treatment begins. Their experiments showed that statins can interfere with the way muscle cells produce energy. When the cells struggled to make energy normally, they activated an immune response inside the muscle tissue.
Instead of protecting the body, this immune response appeared to contribute to muscle damage. In laboratory experiments using muscle cells and mice, the scientists found that blocking this immune pathway greatly reduced the damage. This suggests that the immune response, rather than the cholesterol-lowering effect, may be responsible for many muscle symptoms.
One of the most encouraging findings was that the newly discovered pathway appears to be separate from the pathway that lowers cholesterol. If future research confirms these results in people, scientists may eventually develop medicines that prevent muscle side effects while allowing statins to continue protecting the heart.
The study also revealed a surprising connection between metabolism and immunity. Changes in the way muscle cells produced energy directly influenced how the immune system behaved inside those cells. This finding may improve scientists’ understanding of inflammation in many other diseases as well.
Researchers estimate that between seven and twenty-nine percent of people taking statins report muscle-related symptoms.
While many cases are mild, others are severe enough to make exercise difficult or cause patients to stop treatment. Since statins save many lives every year, improving their tolerability could have major public health benefits.
The scientists caution that this research is still at an early stage. The experiments were carried out mainly in laboratory models, so more work is needed before new treatments become available.
Clinical studies in humans will be required to confirm that targeting this immune pathway is both safe and effective.
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Source: McMaster University.
