The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.
Statins as a newly recognized type of immunomodulator.
Abstract
Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, or statins, are effective lipid-lowering agents, extensively used in medical practice. Statins have never been shown to be involved in the immune response, although a report has indicated a better outcome of cardiac transplantation in patients under Pravastatin therapy. Major histocompatibility complex class II (MHC-II) molecules are directly involved in the activation of T lymphocytes and in the control of the immune response. Whereas only a limited number of specialized cell types express MHC-II constitutively, numerous other cells become MHC-II positive upon induction by interferon gamma (IFN-gamma). This complex regulation is under the control of the transactivator CIITA (refs 6,7). Here we show that statins act as direct inhibitors of induction of MHC-II expression by IFN-gamma and thus as repressors of MHC-II-mediated T-cell activation. This effect of statins is due to inhibition of the inducible promoter IV of the transactivator CIITA and is observed in several cell types, including primary human endothelial cells (ECs) and monocyte-macrophages (Mstraight phi). It is of note that this inhibition is specific for inducible MHC-II expression and does not concern constitutive expression of CIITA and MHC-II. In repressing induction of MHC-II, and subsequent T-lymphocyte activation, statins therefore provide a new type of immunomodulation. This unexpected effect provides a scientific rationale for using statins as immunosuppressors, not only in organ transplantation but in numerous other pathologies as well.
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“It has also been shown that statins, including atorvastatin, repress the expression of MHC II molecules induced by IFN-γ, thereby impairing T-cell activation and compromising the adaptive immune response (Kwak et al., 2000).”
From Atorvastatin Reduces the Survival of Candida albicans-Infected BALB/c Mice (2015) · cites this paper as Kwak et al., 2000
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Cites
Effect of pravastatin on outcomes after cardiac transplantation
Kobashigawa, J. A., Katznelson, S., Laks, H., Johnson, J. A., Yeatman, L., Wang, X. M., Chia, D., Terasaki, P. I., Sabad, A., Cogert, G. A., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509073331003 · Cited by 1,301
Current Perspectives on Statins
Maron, D. J., Fazio, S., & Linton, M. F. (2000) · Circulation · doi:10.1161/01.cir.101.2.207 · Cited by 1,216
Regulation of MHC Class II Expression by Interferon-γ Mediated by the Transactivator Gene CIITA
Steimle, V., Siegrist, C.-A., Mottet, A., Lisowska-Grospierre, B., & Mach, B. (1994) · Science · doi:10.1126/science.8016643 · Cited by 898
Steimle, V., Otten, L., Zufferey, M., & Mach, B. (1993) · Cell · doi:10.1016/s0092-8674(05)80090-x · Cited by 849
Hebert, P. R. (1997) · JAMA · doi:10.1001/jama.1997.03550040069040 · Cited by 740
Mach, F., Schönbeck, U., Sukhova, G. K., Bourcier, T., Bonnefoy, J., Pober, J. S., & Libby, P. (1997) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.94.5.1931 · Cited by 730
Self-citationStatins do more than just lower cholesterol
Vaughan, C. J., Murphy, M. B., & Buckley, B. M. (1996) · The Lancet · doi:10.1016/s0140-6736(96)05190-2 · Cited by 700
The evolving role of statins in the management of atherosclerosis
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Mühlethaler‐Mottet, A., Otten, L., Steimle, V., & Mach, B. (1997) · The EMBO Journal · doi:10.1093/emboj/16.10.2851 · Cited by 507
Cholesterol Lowering With Statin Drugs, Risk of Stroke, and Total Mortality
Hebert, P. R., Gaziano, J. M., Chan, K. S., & Hennekens, C. H. (1998) · Survey of Anesthesiology · doi:10.1097/00132586-199806000-00060 · Cited by 506
REGULATION OF MHC CLASS II GENES: Lessons from a Disease
Mach, B., Steimle, V., Martínez-Soria, E., & Reith, W. (1996) · Annual Review of Immunology · doi:10.1146/annurev.immunol.14.1.301 · Cited by 487
Mühlethaler‐Mottet, A., Berardino, W. D., Otten, L., & Mach, B. (1998) · Immunity · doi:10.1016/s1074-7613(00)80468-9 · Cited by 376
Masternak, K., Barras, E., Zufferey, M., Conrad, B., Corthals, G. L., Aebersold, R. H., Sanchez, J., Hochstrasser, D. F., Mach, B., & Reith, W. (1998) · Nature Genetics · doi:10.1038/3081 · Cited by 275
Lee, Y. J., & Benveniste, E. N. (1996) · The Journal of Immunology · doi:10.4049/jimmunol.157.4.1559 · Cited by 113
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Genomic analysis of the Tapasin gene, located close to the TAP loci in the MHC
Herberg, J. A., SGOUROS, J. G., Jones, T., Copeman, J. B., Humphray, S., Sheer, D., Cresswell, P., Beck, S., & Trowsdale, J. (1998) · European Journal of Immunology · doi:10.1002/(sici)1521-4141(199802)28:02 · Cited by 81
Statin trials and goals of cholesterol-lowering therapy after AMI
Pedersen, T. R. (1999) · American Heart Journal · doi:10.1016/s0002-8703(99)70340-6 · Cited by 24
Kovalik, J., Singh, N., Mendiratta, S. K., Martin, W. D., Ignatowicz, L., & Kaer, L. V. (2000) · The Journal of Immunology · doi:10.4049/jimmunol.165.3.1285 · Cited by 14
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Inflammation, Atherosclerosis, and Coronary Artery Disease
Hansson, G. K. (2005) · New England Journal of Medicine · doi:10.1056/nejmra043430 · Cited by 8,773
Cancer-related inflammation and treatment effectiveness
Diakos, C. I., Charles, K. A., McMillan, D. C., & Clarke, S. J. (2014) · The Lancet Oncology · doi:10.1016/s1470-2045(14)70263-3 · Cited by 2,193
The immune response in atherosclerosis: a double-edged sword
Hansson, G. K., & Libby, P. (2006) · Nature reviews. Immunology · doi:10.1038/nri1882 · Cited by 2,220
PLEIOTROPIC EFFECTS OF STATINS
Liao, J. K., & Laufs, U. (2005) · Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev.pharmtox.45.120403.095748 · Cited by 1,994
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Metadata
- Authors
- Kwak, B., Mulhaupt, F., Myit, S., & Mach, F.
- Affiliations
- University Hospital of Geneva (CH)
- Corresponding author
- Mach, François
- Venue
- Nature Medicine
- Published
- 2000-12
- Volume
- 6
- Issue
- 12
- Pages
- 1399-1402
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W1525331105
- Cited by
- 1,383
- References
- 18
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 26 · 2023: 27 · 2022: 25 · 2021: 33 · 2020: 33 · 2019: 35 · 2018: 29 · 2017: 39 · 2016: 37 · 2015: 53 · 2014: 55 · 2013: 44 · 2012: 56
- FWCI
- 23.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Immunotherapy and Immune Responses
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- statins, immunomodulation, MHC class II induction, interferon-gamma, CIITA, T cell activation, endothelial cells, monocytes/macrophages, immunosuppression, organ transplantation, pravastatin
- MeSH terms
- Atorvastatin, Adjuvants, Immunologic, Anticholesteremic Agents, Endothelium, Vascular, Genes, MHC Class II, Heptanoic Acids, Humans, Interferon-gamma, Lovastatin, Lymphocyte Activation, Macrophages, Monocytes, Nuclear Proteins, Pyrroles, Saphenous Vein, T-Lymphocytes, Trans-Activators, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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