Immune Modulatory Effects of Hypercholesterolemia: Can Atorvastatin Convert the Detrimental Effect of Hypercholesterolemia on the Immune System?

Background and purpose: Many observations showed that hypercholesterolemia can disrupts immune response. Statin drugs that were used for the treatment of hypercholesterolemia patients can interfere in regulation of the immune response and cytokine secretion. The primary aim of the current study was to investigate the immune response among hypercholesterolemia patients, who were treatment-naive and healthy subjects. The secondary goal of the study was to determine whether atorvastatin can reverse the detrimental effect of hypercholesterolemia on the immune system. Methods: Peripheral blood mononuclear cells (PBMCs) were isolated from 50 patients afflicted with hypercholesterolemia who were treatment-naive along with 50 sex- and age-matched hypercholesterolemia patients receiving atorvastatin and 50 sex- and age-matched healthy subjects. Quantitative PCR and ELISA methods were used for gene and protein expression analysis of T helper 1 (Th1) and Th2 related cytokines. Additionally, the expression of the cluster of differentiation (CD) markers on T, B, and NK cells were measured by flow cytometry method. Results: The results showed that hypercholesterolemia and atorvastatin downregulated the expression of Th1- related cytokines and elevated the levels of Th2-related cytokines. The expression of cell surface markers, CD25 and CD69, was significantly decreased in the treatment-naive, and atorvastatin groups. Conclusion: It seems that atorvastatin is not able to repair the deleterious effects of hypercholesterolemia on the immune system, and elevated levels of cholesterol along with the administration of atorvastatin tilt the Th1/Th2 balance in favor of Th2 and reduce T cell activation.