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Uremic toxins enhance statin-induced cytotoxicity in differentiated human rhabdomyosarcoma cells.

Abstract
The risk of myopathy and rhabdomyolysis is considerably increased in statin users with end-stage renal failure (ESRF). Uremic toxins, which accumulate in patients with ESRF, exert cytotoxic effects that are mediated by various mechanisms. Therefore, accumulation of uremic toxins might increase statin-induced cytotoxicity. The purpose of this study was to determine the effect of four uremic toxins-hippuric acid, 3-carboxy-4-methyl-5-propyl-2-furanpropionate, indole-3-acetic acid, and 3-indoxyl sulfate-on statin-induced myopathy. Differentiated rhabdomyosarcoma cells were pre-treated with the uremic toxins for seven days, and then the cells were treated with pravastatin or simvastatin. Cell viability and apoptosis were assessed by viability assays and flow cytometry. Pre-treatment with uremic toxins increased statin- but not cisplatin-induced cytotoxicity (p < 0.05 vs. untreated). In addition, the pre-treatment increased statin-induced apoptosis, which is one of the cytotoxic factors (p < 0.05 vs. untreated). However, mevalonate, farnesol, and geranylgeraniol reversed the effects of uremic toxins and lowered statin-induced cytotoxicity (p < 0.05 vs. untreated). These results demonstrate that uremic toxins enhance statin-induced apoptosis and cytotoxicity. The mechanism underlying this effect might be associated with small G-protein geranylgeranylation. In conclusion, the increased severity of statin-induced rhabdomyolysis in patients with ESRF is likely due to the accumulation of uremic toxins.
AuthorsHitoshi Uchiyama, Masayuki Tsujimoto, Tadakazu Shinmoto, Hitomi Ogino, Tomoko Oda, Takuya Yoshida, Taku Furukubo, Satoshi Izumi, Tomoyuki Yamakawa, Hidehisa Tachiki, Tetsuya Minegaki, Kohshi Nishiguchi
JournalToxins (Toxins (Basel)) Vol. 6 Issue 9 Pg. 2612-25 (Sep 03 2014) ISSN: 2072-6651 [Electronic] Switzerland
PMID25192420 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Furans
  • Hippurates
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Indoleacetic Acids
  • Propionates
  • Toxins, Biological
  • indoleacetic acid
  • 3-carboxy-4-methyl-5-propyl-2-furanpropionic acid
  • Simvastatin
  • Pravastatin
  • Indican
  • hippuric acid
Topics
  • Apoptosis (drug effects)
  • Cell Differentiation
  • Cell Line, Tumor
  • Cell Survival (drug effects)
  • Drug Synergism
  • Furans (pharmacology)
  • Hippurates (pharmacology)
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors (pharmacology)
  • Indican (pharmacology)
  • Indoleacetic Acids (pharmacology)
  • Pravastatin (pharmacology)
  • Propionates (pharmacology)
  • Rhabdomyosarcoma
  • Simvastatin (pharmacology)
  • Toxins, Biological (pharmacology)
  • Uremia

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