BioEd Online

Cholesterol drugs called statins could protect smokers from some of the lung damage inflicted by their habit, a team of researchers report today.

Their study of smokers and former smokers showed that patients who took statins were 35% less likely to need hospitalization or a visit to the emergency room for lung-related illness than those not taking the drugs.

Statins are a group of blockbuster drugs best known for lowering cholesterol and warding off heart disease. But over the past decade, researchers have come to appreciate that they also seem to reduce inflammation and animal tests have hinted that they can protect the lungs.

Walid Younis at the University of Oklahoma Medical Center in Oklahoma City and his colleagues examined the medical records of 485 smokers and former smokers. They compared medical tests of the patients' lung health with those done, on average, 2.7 years previously.

The lungs of those who were taking statins fared much better. Their lung volume, for example, had declined by just over 1% each year compared with a drop of 10% in the comparison group. "We were really impressed," says Younis, who presented the results at the American College of Chest Physicians meeting in Salt Lake City, Utah.

Pill popping

The connection now needs to be tested more rigorously in a randomized clinical trial. If it holds up, it suggests that smokers could avert some of the harm done by cigarettes with a pill already known to be safe. No other drug is known to protect against smoke-related lung damage.

Experts are keen to emphasize that taking statins will never be as beneficial as quitting the habit altogether. "I would never tell a patient it's OK to continue smoking because they're on statins, and certainly not from this one study," says respiratory biologist Michael Fessler at the National Institute of Environmental Health Sciences in Research Triangle Park, North Carolina. And there is no firm evidence that the drugs protect against lung cancer.

But it can take smokers diagnosed with lung disease many years to kick the habit, says Neil Thomson, professor of respiratory medicine at the University of Glasgow, UK. So statins might be prescribed during this period, alongside advice to quit.

Smoke break

Statins block an enzyme called HMG-CoA reductase, which is involved in the production of various fatty molecules. Blocking this enzyme lowers cholesterol levels. It also reduces the concentration of molecules that promote inflammation in response to irritants such as smoke.

The drugs might also be used to protect the lungs of non-smokers against such diseases as asthma and chronic obstructive pulmonary disease. A few studies are already testing this idea.

Researchers are hopeful that statins might help in other inflammatory diseases such as rheumatoid arthritis. "I do think their application will broaden over the next few years," Fessler says.

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