The Immunomodulatory Effects of Statins on Macrophages
Open accessAbstract
Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors used worldwide to manage dyslipidaemia and thus limit the development of atherosclerotic disease and its complications. These atheroprotective drugs are now known to exert pleiotropic actions outside of their cholesterol-lowering activity, including altering immune cell function. Macrophages are phagocytic leukocytes that play critical functional roles in the pathogenesis of atherosclerosis and are directly targeted by statins. Early studies documented the anti-inflammatory effects of statins on macrophages, but emerging evidence suggests that these drugs can also enhance pro-inflammatory macrophage responses, creating an unresolved paradox. This review comprehensively examines the in vitro, in vivo, and clinical literature to document the statin-induced changes in macrophage polarization and immunomodulatory functions, explore the underlying mechanisms involved, and offer potential explanations for this paradox. A better understanding of the immunomodulatory actions of statins on macrophages should pave the way for the development of novel therapeutic approaches to manage atherosclerosis and other chronic diseases and conditions characterised by unresolved inflammation.
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Statins have demonstrated potential in off-label applications, such as anti-inflammatory and immunomodulatory effects.
“In addition to their primary role in lowering LDL cholesterol, statins have demonstrated potential in various off‐label applications, such as anti‐inflammatory and immunomodulatory effects, which continue to drive research into their expanded therapeutic uses [108, 109].”
From Statins as Antifungal Agents: A Review on Drug Repurposing and Nanotechnology-Driven Delivery Strategies (2025) · cites this paper as [109]
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- Authors
- Sheridan, A., Wheeler-Jones, C. P. D., & Gage, M. C.
- Affiliations
- Royal Veterinary College (GB)
- Corresponding author
- Gage, Matthew C.
- Venue
- Immuno
- Publisher
- MDPI AG
- Published
- 2022-04-08
- Volume
- 2
- Issue
- 2
- Pages
- 317-343
- ISSN
- 2673-5601 (ISSN-L)
- OpenAlex
- W4224247700
- Cited by
- 48
- References
- 183
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 12 · 2023: 9 · 2022: 1
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Immuno (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- British Heart Foundation (PG/16/87/32492)
- Diabetes UK (17/0005682)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- statins, macrophages, immunomodulation, macrophage polarization, atherosclerosis, pleiotropy, anti-inflammatory activity, pro-inflammatory effects, unresolved inflammation, chronic inflammation
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