Anti-inflammatory effects of atorvastatin treatment in chronic obstructive pulmonary disease. A controlled pilot study

Observational studies have suggested that statins may have beneficial effects on outcomes in chronic obstructive pulmonary disease (copd) patients. these effects may be mediated through an anti-inflammatory effect of statins. the purpose of this pilot-study was to determine whether statins have an anti-inflammatory effect on the lungs of copd patients. we conducted randomized,controlled,parallel group pilot-study to compare the effects of atorvastatin (n=12) or placebo (n=6) on lung inflammation in patients with mild to moderate copd. the primary endpoint was change in cd45+ cells expression measured by immunohistochemistry and changes in expression of genes measured using microarrays in lung biopsy (tbb) samples before and after 12 weeks of treatment with atorvastatin 40 mg/day. all subjects had spirometry,lung volumes,diffusing capacity of the lungsfor carbon monoxide (dlco),st george’s respiratory questionnaire (sgrq),6 minute walk distance (6mwd),serum lipids,hs-crp,induced sputum (is),bronchoscopy and tbb carried out at baseline and after treatment. tbb specimens were processed for histology,immunohistochemistry and genome-wide association studies (gwas) profiling. seventeen subjects completed the study. there was a significant improvement in sgrq with mean sgrq decreased by 12 points after treatment with atorvastatin (p=0.012). atorvastatin treatment produced a significant 34% reduction in sputum neutrophil count,and a 57% reduction in cd45+ cells in lung biopsies (expressed as integrated optical density -iod; median iod 62.51% before,27.01% after atorvastatin treatment,p=0.008). in patients’ lung tissue atorvastatin treatment produced downregulation of key genes involved in inflammatory processes,immune response,and leukocyte activation. these data demonstrate the pulmonary anti-inflammatory effects of atorvastatin in copd patients with the potential for beneficial clinical effects. trial registration: clinicaltrials.gov: nct01748279. © 2015,polish physiological society. all rights reserved.