To: Casaubon who wrote (14617 ) 12/10/2004 8:40:18 AM From: Biomaven Respond to of 52153 reducing LDL vs. reducing LDL via statin use I'm suggesting that it's possible (even likely from my own perspective) that the dramatic benefits of statins come not from their effects on LDL but from a concomitant effect they are having as an anti-inflammatory. For example: Nat Med. 2001 Jun;7(6):687-92. Related Articles, Links Click here to read Click here to read Statins selectively inhibit leukocyte function antigen-1 by binding to a novel regulatory integrin site. Weitz-Schmidt G, Welzenbach K, Brinkmann V, Kamata T, Kallen J, Bruns C, Cottens S, Takada Y, Hommel U. Novartis Pharma AG, Preclinical Research, Basel, Switzerland. gabrielle.weitz@pharma.novartis.com The beta2 integrin leukocyte function antigen-1 (LFA-1) has an important role in the pathophysiology of inflammatory and autoimmune diseases. Here we report that statin compounds commonly used for the treatment of hypercholesterolemia selectively blocked LFA-1-mediated adhesion and costimulation of lymphocytes. This effect was unrelated to the statins' inhibition of 3-hydroxy-3-methylglutaryl coenzyme-A reductase; instead it occurred via binding to a novel allosteric site within LFA-1. Subsequent optimization of the statins for LFA-1 binding resulted in potent, selective and orally active LFA-1 inhibitors that suppress the inflammatory response in a murine model of peritonitis. Targeting of the statin-binding site of LFA-1 could be used to treat diseases such as psoriasis, rheumatoid arthritis, ischemia/reperfusion injury and transplant rejection. My skepticism comes mostly from studies "in the wild" where low overall cholesterol levels (particularly in the elderly) are universally associated with higher mortality. Peter