スタチンによるCovid-19感染へのベネフィット報告多く出現中

 スタチンによるCovid-19感染へのベネフィット報告多く出現中

25-ヒドロキシコレステロールが関連しているらしい。

 

https://health.ucsd.edu/news/releases/Pages/2020-09-23-statins-reduce-covid-19-severity-likely-by-removing-cholesterol-virus-uses-to-infect.aspx

 

At first, his team was simply curious to see which genes are switched “on” in human lung cells in response to SARS-CoV-2 infection.

A gene called CH25H was “blazing hot,” Rana said. CH25H encodes an enzyme that modifies cholesterol. “I got excited because with HIV, Zika, and a few others, we know that CH25H blocks the virus’ ability to enter human cells.”

Here’s what’s happening inside our cells: CH25H’s enzymatic activity produces a modified form of cholesterol called 25-hydroxycholesterol (25HC). In turn, 25HC activates another enzyme called ACAT, found inside cells in the endoplasmic reticulum. ACAT then depletes accessible cholesterol on the cell’s membrane. It’s a normally occurring process that gets kicked into high gear during some viral infections.

The team quickly got to work examining 25HC in the context of SARS-CoV-2 from several angles. They explored what happens to human lung cells in the lab with and without 25HC treatment when they are exposed to first a noninfectious virus that carries the SARS-CoV-2 spike protein (its key to cell entry) or to live SARS-CoV-2 virus itself.

No matter which way they came at it, added 25HC inhibited the ability of the virus to enter cells — blocking infection almost completely.

“The difference between untreated cells and those treated with 25HC was like day and night,” Rana said.

While SARS-CoV-2 uses the ACE2 receptor to initially dock on a cell, Rana’s study suggests that the virus also needs cholesterol (normally found in cell membranes) in order to fuse with and enter the cell. 25HC takes away a lot of that membrane cholesterol, preventing viral entry.

In a similar way, statins are likely beneficial in preventing or reducing the severity of SARS-CoV-2 infection because, while intended to remove cholesterol from blood vessels, they are also removing cholesterol from cell membranes. As a result, the coronavirus can’t get in.

“This is already happening in our bodies on a regular basis, so perhaps we just need to give it a boost, with statins or by other means, to better resist some viruses,” Rana said. “It’s not unlike cancer immunotherapy — the idea that sometimes instead of attacking a tumor directly, it’s better to arm a patient’s immune system to do a better job of clearing away tumors on its own.”

 

 

 

Beneficial Effect of Statins in COVID-19–Related Outcomes
A National Population-Based Cohort Study
Hae-Young Lee ,et al. Korean Society of Hypertension, National Committee for Clinical Management of Emerging Infectious Diseases
Originally published4 Feb 2021
https://doi.org/10.1161/ATVBAHA.120.315551
Arteriosclerosis, Thrombosis, and Vascular Biology.

https://www.ahajournals.org/doi/abs/10.1161/ATVBAHA.120.315551?af=R

韓国で,実験室でCOVID-19が確認された入院患者全員を,2020年1月19日から4月16日までの期間に本研究に登録した.スタチンの使用と COVID-19 関連死亡率との関連を、全体と入れ子にした 1:2 の傾向スコアマッチ試験で評価した。さらに、韓国で2019年1月~6月に肺炎で入院したCOVID-19患者とレトロスペクティブコホートとの間で、死亡のハザード比の比較を行った。COVID-19患者10,448人の年齢中央値は45歳であった。

533 例(5.1%)の患者にスタチンが処方された。

年齢、性別、併存疾患を調整した後、Cox回帰でスタチンの使用に関連したハザード比の有意な減少を示した(ハザード比、0.637[95%CI、0.425~0.953]、P=0.0283)。

さらに、COVID-19患者と入院肺炎患者のレトロスペクティブコホートとのハザード比を比較したところ、スタチンの使用は同様の有益性を示した。

www.DeepL.com/Translator(無料版)で翻訳しました。

In-Hospital Use of Statins Is Associated with a Reduced Risk of Mortality among Individuals with COVID-19
Xiao-Jing Zhang, et al.]
Cell Metab. 2020 Aug 4; 32(2): 176–187.e4.
Published online 2020 Jun 24. doi: 10.1016/j.cmet.2020.06.015
PMCID: PMC7311917
PMID: 32592657
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311917/