“Statins” are a group of drugs which lower cholesterol in the blood and reduce the risks of stroke and myocardial infarction (heart attack). They don’t work the same for everyone. An important new study shows that different patient responses to statins can be attributed to variations in the gut microbiome. This exciting discovery indicates that the choice of statin can be optimized, with precision, for individual patients.
Researchers at the Institute for Systems Biology (ISB), Seattle, found that the composition and diversity of the gut microbiome can predict the efficacy of statins and the potential for negative side effects.
“Specifically, we found that a Bacteroides-enriched microbiome with lower levels of diversity was associated with the strongest LDL-lowering response to statins, but also coincided with the greatest disruption to blood glucose levels,” says Dr. Tomasz Wilmanski, lead scientist of the study, in a statement.
Individuals with Ruminococcaceae in their microbiome were protected from the negative side effects of statins on insulin resistance. These subjects clearly responded well to the drugs’ LDL-lowering effects.
Wilmanski and his colleagues evaluated the microbiomes, metabolomes, genomes, and clinical records from an American cohort of more than 1,800 people. They first identified variable statin effects on both cholesterol and blood glucose markers. The team validated their results in a European cohort of nearly 1,000 subjects.
The genetic fingerprint of a patient, which includes known genetic markers of statin treatment response, has been used in the clinic to guide personalized statin treatment regimes. “The genome and the microbiome, together, appear to provide a more comprehensive and complementary picture of personalized drug responses,” says Wilmanski.
“It would be great to take this knowledge about the genome and the microbiome and predict personalized dosing regimens for a cohort of patients, and then follow these patients forward in time, tracking their metabolic health and their LDL-cholesterol levels. It could show that this population of patients undergoing a precision intervention do better than a control group of patients getting what is usually prescribed,” says co-author Dr. Sean Gibbons, an assistant professor at ISB.
The study is published in the journal Med.