"New Research on Statins may Give Answers for Polios"

Written by Tessa Jupp RN from writings by Edward Bollenbach, for the Post Polio Network of WA

 

Edward Bollenbach

BA, MA, Professor Emeritus in Microbiology and Chemistry, a retired professor of micro-biology and chemistry from Connecticut USA is a polio survivor himself.  Articles he has written on post polio can be found at his website www.angelfire.com/mi/nccc

 

Quotes below from some of his most recent writings on statins may help us to understand this new research.

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“As polio survivors, the question is how can we utilize these statin medications, to lower cholesterol, without worrying about adverse muscle effects?

If one reads current medical literature addressing statin drugs to try to find out what it is about statins that causes the adverse muscle effects one will invariably find "It is not known". The probable answer to the question of cause has been worked out simultaneously in Japan, Harvard, and at Beth Israel Hospital in Boston, Massachusetts. The biological roots of statin muscle damage are similar, coincidentally, to the atrophy we experience with polio.

Researcher's have performed a series of elegant experiments which reveal how statins produce this muscle damage or myopathy in some patients.

Because of the new knowledge countermeasures are already being planned to develop agents which will eliminate these troublesome muscle problems due to statin therapy.  However, Dr. Lecker of Harvard, a leader in this group of researchers, couldn't provide an answer regarding a medicine or substance one can take to eliminate the possibility of myopathy resulting from statin drug therapy.

Instead he recommended a trial of Co-enzyme Q10, since this important compound has multiple functions in energy production and is decreased significantly by statins, as is cholesterol.  Co-Q10 is not only used extensively by the processes leading to myopathy, but it is reduced in amount during the same process that lowers cholesterol concentration.  Statins themselves lower Co-Q10 blood concentration.

The biochemistry of muscle damage is complex.  The aforementioned researcher's leading explanation of this damage is that a gene within our DNA called atrogen-1 is turned on by statins.  Age also turns it on.  Diseases like cancer, infection and polio can turn it on. Once it is on it provides the information for the muscle fibre to produce an enzyme called Ubiquitin ligase (Co-enzyme Q10 ligase).

This molecule binds with several Co-enzyme Q10 molecules until the entire structure has a shape that allows it to snatch up small repair proteins in the muscle. Once these proteins are bound they are deposited into a tiny body called a proteosome, which breaks up these repair proteins into smaller pieces.

This effectively removes the ability of the muscle to repair itself, and atrophy (breakdown) of the muscle fibre occurs. Exercise inhibits this entire process and more repairs can be made but if the exercise is too intense, too frequent, or too long, the process is stimulated again.

Such intense exercise in the presence of a statin turns on atrogen-1 much more readily in most people.  So polios particularly, should be careful with extreme vigorous exercise while on a statin.

When drugs like Lipitor, Zocor, Crestor, Mevacor among others, are used, they slow the speed of cholesterol formation, and the amount of cholesterol in the blood and muscles decreases.  Geranylgeranyl pyrophosphate, the chemical responsible for preventing muscle problems, also decreases, and it does not function as it normally does.  This decrease is very likely the cause of muscle-related problems.

I think physicians should probably, if they do not already, take into account other medications that a patient is using when prescribing a statin drug.

Because Lipitor, for example, is broken down in the liver by a different chemical than Crestor or some of the other statins. Other medications are also broken down in the liver by other chemicals. If medications, like the heart drug amiodarone or the hypertension drugs called calcium channel blockers, are taken together with a particular statin like Lipitor, the chemical that breaks down both drugs is the same, so the statin will not be broken down as quickly and will increase in the blood. This may cause muscle soreness.

Some medication interactions are stronger than others. One particularly powerful interaction is with anti-fungal drugs called azoles. Using them while using statins can increase the amount of statin in the blood significantly and increase the probability of muscle problems.

Since there are several different statins that use different liver decomposition chemicals, patients should use a statin that is processed by a chemical in the liver that is not being used by another medication they are taking.”

 



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