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Wednesday 15 May 2013

By Jupiter! - Satins Part 3

Makes more sense if you have read:-
Statins Part 1
Statins Part 2


 
For most of you Jupiter is the fifth planet from the Sun, or maybe the largest planet in the Solar System.  To a young boy like Monty, Jupiter is a red fire engine, normally driven by Fireman Sam.

If you are a cardiologist you will have heard of the JUPITER trial. (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin trial)

It was a huge study looking into the possible benefits of giving statins to older people with low cholesterol.  All the 17,802 subjects had elevated levels of high-sensitivity C-reactive protein (CRP) levels, which is a marker for cardiac (and neuro) inflammation.  Half were given 20mg of a statin and the other half had a placebo.  The study measured their cholesterol, CRP levels and whether they later had a cardiac incident.  The group with the statin lowered their already okay LDL and triglycerides level and also lowered their CRP level by a thumping 37%.

At the time of study termination (median follow up, 1.9 years; maximal follow-up, 5.0 years), 142 first major cardiovascular events had occurred in the statin group, as compared with 251 in the placebo group.

This was interpreted by the authors as evidence that even older people without elevated cholesterol could benefit from statins to reduce their risk of cardiovascular events.

 


 
JUPITER and autism

What JUPITER tells me is that statins were highly effective at reducing inflammation as measured by CRP.

 
Autism and CRP

Now we just need some data on the level of CRP in Autism.  Thanks to those nice people in Iran we have a study called: - The complementary role of high sensitivity C-reactive protein in the diagnosis and severity assessment of autism.

 They concluded:-

► Inflammatory process can play key role in the pathophysiology of autism.
► Higher levels of hs-CRP are detected in autistic children.
► A correlation exists between hs-CRP level and autism severity.
► Hs-CRP can be considered a complementary diagnostic test for autism.
►These findings affirm the role of inflammation in autism.

I guess because Iran is public enemy number two, nobody took much note of this study, except Paul Whiteley of course.
 
 
Autism & Statins

So it looks pretty likely that statins will reduce CRP in autistic subjects and if statins can do this, they will reduce both the neuroinflammation and, by inference, the severity of autistic behaviours.

 
Peter Research

While in the Astra Zeneca-funded JUPITER study there were 17,802 subjects and five years of research; here in the Peter Research Institute we have one subject and one week of research.

As with my Bumetanide research, I am shocked by the almost immediate effect of the drug.  In terms of lowering cholesterol, statins are supposed to take two weeks to reach full effect.  In terms of reducing neuroinflammation the effect appears to be much faster – very encouraging but, to be honest, quite unexpected.  


Back to Cholesterol & Autism

The important thing is that statins appear to reduce autistic behaviours, at least in my subject; it would however also be nice to fully understand why.  The research shows the presence of dyslipidemia (abnormal amounts of lipids) in boys with autism.
 

The findings were: - LDL normal, HDL low, Triglycerides high, Total cholesterol normal.  The current benchmark used is that Total Cholesterol divided by HDL should be less than 4.5.  With low HDL and high triglycerides, this could put many autistic subjects in the zone of elevated risk.

Also, be aware of the very rare condition called Smith-Lemli-Opitz Syndrome (SLOS), caused by low levels of cholesterol;  it is explained in this open-access paper:-


In one of the studies I read that CRP always drops before the fall in cholesterol.  This would imply that in the case of ASD, the cholesterol issue is just a consequence; it is the precursors that actually matter.  At least to me, that makes a lot of sense.



In case you missed the prequels:

Statins Part 1
Statins Part 2


and now there is Part 4  http://epiphanyasd.blogspot.com/2013/05/tapas-time-statins-part-4.html



 

4 comments:

  1. Hi Peter, As you know my son seems to have abnormal cholesterol metabolism, low means LDL.
    Although verapamil helps him in many aspects, there are some days/nights that start with considerable unexplained fatigue and end up with severe inattensiveness and lack of his abitity to focus on his studying. This causes him a lot of distress and fells depressed. Some people call this state a "burnout".
    I'd like to trial atorvastatin but don't know how to combine it with Verapamil and Nac. Could you guide me?
    Last night we had this with throat inflammation,but some other times no inflammation is visible.
    When my son was a kid he used to respond to Ponstan, but he doesn't seem to respond to it so well anymore. It seems that he responds to Ibuprofen better.
    By the way, if you need to trial Ponstan to Monty, it's really easy and cheap for me to send.

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  2. I have Ponstan, thanks. Greece is a good place to buy it.

    We use atorvastatin with verapamil and NAC. We had no problems. If your son responds to Atorvastatin he will notice with a day or two, so I think it is safe to try.

    If it works well you can recheck his cholesterol in case it gets too low, but this would take a week or more.

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  3. Peter,
    Calvin's cholesterol and free t4 have come back high... you think I should start a statin?

    ReplyDelete
    Replies
    1. Audrey, you could take the opportunity to see if a statin (atorvastatin or simvastatin) gives a cognitive boost. This happens very quickly if he is a responder, so you will know within a couple of days. I use 10mg of Atorvastatin, you might want to try half of that.

      Delete

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