Spielen Statine eine Rolle als adjuvante Therapie bei Entzündung? / Do statins play a role as an adjuvant therapy in inflammation?

Despite recent advances in management of patients in intensive care
units, sepsis and septic shock are the major causes of morbidity
and mortality. Prompt and adequate antibiotic therapy accompanied
by surgical removal of the infectious material are the first-line
therapy of choice. In addition, various immunomodulatory treatments
have been investigated during the past decades. However, despite
promising results in studies with animal models, studies in humans
with antibodies against lipopolysaccharide (LPS), tumor necrosis
factor and interleukin-1 have not been successful. In addition,
high doses of steroids, immunoglobulins or antibodies against LPS
and cytokines did not reduce mortality, probably owing to timing
and dosage of these drugs. Prophylactic administration of
immunomodulatory drugs cannot be recommended due to severe adverse
effects. However, owing to pleiotropic effects of statins this
class of cholesterol lowering drugs has been suggested to be
beneficial as adjuvant therapy for sepsis. The present review
summarizes the pathophysiology of sepsis as well as experimental
and clinical evidence for the use of statins in sepsis.