Revista de Odontologia da UNESP
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Revista de Odontologia da UNESP
Review Article

As estatinas e o tecido ósseo: revisão da literatura

Statins and bone tissue: a literature review

Anbinder, A.L.; Quirino, M.R.S.; Rocha, R.F.

Rev. odontol. UNESP, vol.35, n4, p.239-246, 2006
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Resumo

As estatinas são medicamentos muito utilizados nas duas últimas décadas para a redução de níveis elevados de colesterol plasmático. São inibidores competitivos da 3‑hidróxi‑3‑metilglutaril coenzima A (HMG-CoA) redutase, enzima que catalisa a conversão do HMG-CoA a mevalonato, um intermediário importante no metabolismo do colesterol. Como o metabolismo do mevalonato dá origem a uma série de compostos isoprenóides vitais para diversas funções celulares, a ação das estatinas pode levar a outros efeitos benéficos, além da redução da hipercolesterolemia, como redução da inflamação, inibição da proliferação celular com propriedades anticarcinogênicas, estabilização de placas ateroscleróticas e ação no tecido ósseo. Desde 1999, vários estudos foram realizados relatando a ação das estatinas na formação óssea pela estimulação da expressão da proteína morfogenética óssea-2. Visto isso, passou-se a acreditar que as estatinas, se seletivamente direcionadas ao osso, poderiam apresentar efeitos benéficos no tratamento da osteoporose e de fraturas. O objetivo deste trabalho foi revisar a literatura pertinente à ação das estatinas no osso, uma vez que a estimulação da formação óssea é um evento bastante desejado em várias especialidades odontológicas. Não existe ainda um consenso na literatura, tendo numerosos trabalhos demonstrado a ação desses medicamentos na melhoria da qualidade óssea e na redução do risco de fraturas, enquanto outros negaram sua ação no esqueleto. Somente novas pesquisas prospectivas poderão esclarecer a polêmica atual sobre a ação dos inibidores da HMG-CoA redutase no tecido ósseo.

Palavras-chave

Estatinas, osso, regeneração óssea, osteoporose.

Abstract

Statins are drugs which have been widely used for the treatment of hypercholesterolemia for the last two decades. They inhibit 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, an enzyme that catalyzes the conversion of HMG-CoA to mevalonate, an early step in cholesterol biosynthesis. Because mevalonate pathway yields a series of isoprenoids that are vital for diverse cellular functions, statins can lead to some great events other than cholesterol reduction, such as reduction of inflammation, inhibition of cell proliferation with anticarcinogenic action, stabilization of atherosclerotic plaques and action on bone metabolism. Since 1999, many studies have been conducted suggesting that statins can stimulate bone formation by increasing the expression of bone morphogenetic protein-2. Thus, some researchers began to believe that if statins are selectively targeted to bone, they could have great potential for the treatment of osteoporosis and fractures. The aim of this study was to review the literature that associates statins and bone, since bone stimulation is an event desired in many dental specialties. There is no consensus until now, many studies concluded that statins do improve bone quality and reduce fracture risk, while others refute statins skeletal benefits. Just new prospective studies can clarify the current controversy over the bone action of HMG-CoA reductase inhibitors.

Keywords

Statins, bone, bone regeneration, osteoporosis

References

 


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