Influence of Statins and Fibrates Drugs on Bone Health and Regeneration

Abstract

In the medical and dental field, the importance and need for the study of materials and drugs for use as bone grafts or regeneration in injured areas due tothe presence of fractures, infections or tumors that cause extensive loss ofbone tissue is observed. Bone is a specialized, vascularized and dynamic connective tissue that changes throughout the life of the organism. When injured, it has a unique ability to regenerate and repair without the presence ofscars, but in some situations, due to the size of the defect, the bone tissue doesnot regenerate completely. Thus, due to its importance, there is a great development in therapeutic approaches for the treatment of bone defectsthrough studies that include autografts, allografts and artificial materials usedalone or in association with bone grafts. Pharmaceuticals composed of biomaterials and osteogenic active substances have been extensively studied because they provide potential for tissue regeneration and new strategies for thetreatment of bone defects. Statins work as specific inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (HMG-CoAreductase). They representefficient drugs in lowering cholesterol, as they reduce platelet aggregation andthrombus deposition; in addition, they promote angiogenesis, reduce theβ-amyloid peptide related to Alzheimer’s disease and suppress the activation of T lymphocytes. Furthermore, these substances have been used in thetreatment of hypercholesterolemia and coronary artery disease. By inhibitingHMG-CoAreductase, statins not only inhibit cholesterol synthesis, but alsoexhibit several other beneficial pleiotropic effects. Therefore, there has beenincreasing interest in researching the effects of statins, including Simvastatin, on bone and osteometabolic diseases. However, statins in high doses causeinflammation in bone defects and inhibit osteoblastic differentiation, negatively contributing to bone repair. Thus, different types of studies with different concentrations of statins have been studied to positively or negativelycorrelate this drug with bone regeneration. In this review we will address thepositive, negative or neutral effects of statins in relation to bone defectsproviding a comprehensive understanding of their application. Finally, wewill discuss a variety of statin-based drugs and the ideal dose through a theoretical basis with preclinical, clinical and laboratory work in order to promotethe repair of bone defects.