Statins: the lifesavers that help defeat cholesterol
We might be familiar with statins – the medication commonly taken after a big meal of barbecued, fatty meats, though some are best taken at night before sleep – usually by middle-aged or elderly people with high levels of cholesterol.
While your body needs cholesterol to build new tissue and produce bile in the liver, a high concentration of the substance could develop fatty deposits in the blood vessels. An increase in these deposits could restrict ideal blood flow through the body and form clots. Under worse conditions, the clots could cause a heart attack or stroke. That is the whole point of consuming statins, to manage and treat hypercholesterolemia, a condition where an individual has high cholesterol concentration in their blood.
Statins are also known as an inhibitor of an enzyme called hydroxymethylglutaryl-CoA (HMG-CoA) reductase, which exhibit its effects through increasing the concentration of high-density lipoprotein (HDL) and decreasing the concentrations of total cholesterol, low-density lipoprotein (LDL) and triglyceride concentrations.
HDL is the “good cholesterol”, which absorbs cholesterol in the bloodstream and transports it back to the liver, where it will be eliminated from the body. Meanwhile LDL is the “bad cholesterol”, where high levels of it can increase the risk of stroke and heart diseases.
How do statins work?
Once statin is consumed, it gets transported into the liver cells where it will competitively block the active site of HMG-CoA reductase. Normally, the enzyme helps with the conversion of mevalonic acid to cholesterol. However, since it is blocked under the presence of statins, cholesterol production is decreased. Additionally, statins can enable the liver to remove any LDL that is already in the bloodstream.
Statin is not “one-size-fits-all”!
One patient consuming statin may not experience the same effects as another patient consuming the exact same medication with the same dosage. This leads to the patient not achieving a reduction in their cholesterol levels and, under worse circumstances, experiencing adverse effects. The response of the patient to statin itself is known to be difficult to predict, as factors such as genetic predisposition come into play.
The most common adverse effects of statins include statin myositis and statin-associated muscle symptoms. Statin myositis is associated with muscle pain or weakness due to the inflammation of muscle tissue. Other adverse effects like liver toxicity and central nervous system (CNS) toxicity could also happen, though usually with low probability.
Genetics: the key to understanding your medications
In recent years, a lot of advancements have been made towards a field called pharmacogenomics. As a commonly used drug, understanding the pharmacogenomics of statins offered tremendous help on the reasoning behind why some patients could experience the aforementioned adverse effects, despite consuming the same medication at the same dosage.
The adverse effects have direct correlations with everyone’s genetic makeup, which varies from one to another. There have been more than 40 genes studied and implicated to affect the performance of statins. Some individuals could have variants in these genes, which may result in either beneficial or harmful effects. Additionally, some genetic variants are associated with more severe side effects.
One of the genes is the SLCO1B1 gene, variants in this gene impact the statin transportation into the liver. This could be the main reason why some patients could be experiencing adverse effects – the statin itself had trouble accessing the HMG-CoA enzyme in the liver!
The SLCO1B1 gene is one out of many genes that could affect statin distribution. There is a tremendously huge number of genes that are involved in how your body processes medications. Focusing on the genetic aspect of the body could greatly help with avoiding inaccurate prescriptions – which could be done through pharmacogenomics testing.
Why pharmacogenomics testing?
Recently, the Official Journal of The Royal Pharmaceutical Society released an article regarding a pilot study conducted in Northwest England that involves the implementation of pharmacogenomic testing by general practitioners. If successful, there are plans to make this program nation-wide.
The study, funded by the National Health Services (NHS), will start in early 2023. Medications including statins, antidepressants and proton pump inhibitors (PPIs) will be tested for feasibility to be incorporated into the pharmacogenomics testing.
Pharmacogenomics testing has an undeniably promising impact on the healthcare industry and Is on its way to be the standard. By having access to personalized care, the risks of experiencing adverse effects through inaccurate prescription will significantly decrease, leading to a better quality of life.
At Nalagenetics, we strive to make personalization the standard of future healthcare through our products. Our pharmacogenomic test will offer a concise report consisting of an overview, a detailed medication report, continuous support, and scientific evidence. We have also engaged with multiple hospitals, clinics, and laboratories in Southeast Asia to encourage healthcare professionals to implement personalized care into their practice. To find out more about our pharmacogenomics test, click this link!
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