This study investigates the causal relationships between antihypertensive and lipid-lowering drugs and inflammatory cytokines using a drug-targeted Mendelian randomization approach. By leveraging genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) data, the study evaluates the effects of angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), HMG-CoA reductase inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors on key inflammatory cytokines such as IL-1β, TNF-α, CRP, and MCP-1. The findings aim to provide insights into the prevention and control of excessive inflammatory responses, particularly in patients with hypertension and dyslipidemia, by assessing the causal effects of these therapies.
This observational study focuses on elucidating the causal relationships between commonly prescribed antihypertensive drugs (ACEIs and ARBs) and lipid-lowering drugs (HMG-CoA reductase inhibitors, PCSK9 inhibitors, and NPC1L1 inhibitors) with various inflammatory cytokines, including IL-1β, TNF-α, CRP, MCP-1, and IFN-γ, using a drug-targeted Mendelian randomization (MR) framework. The study employs large-scale genetic data from European populations, drawing from genome-wide association studies (GWAS) and expression quantitative trait loci (eQTL) datasets, to construct instrumental variables that mimic the effects of drug exposure. The primary aim is to explore how these pharmaceutical interventions influence inflammatory pathways at the molecular level. The use of MR methods enables causal inference by utilizing genetic variants within or near drug-target genes, allowing for the estimation of downstream effects similar to those produced by actual drug interventions. Key statistical methods, including inverse variance weighting and sensitivity analyses, are applied to ensure robustness and validity of the results. This research provides critical evidence for the selection of antihypertensive and lipid-lowering therapies that not only manage cardiovascular risk factors but also modulate inflammation, contributing to personalized medicine strategies for patients with chronic inflammatory conditions. Furthermore, the findings have broader implications for drug repurposing and the development of new therapeutic targets aimed at mitigating inflammatory processes that underlie various chronic diseases.
Study Type
OBSERVATIONAL
Enrollment
250,736
Guangzhou Institute of Respiratory Diseases, the First Affiliated Hospital of Guangzhou Medical University
Guangzhou, Guangdong, China
Reduction in IL-1β Levels Due to ACE Inhibitors
The primary outcome is the reduction in plasma levels of IL-1β due to exposure to ACE inhibitors (ACEIs). The study evaluates the causal relationship between ACEIs and IL-1β levels using Mendelian randomization.(Unit: pg/mL)
Time frame: Baseline to 12 months
Reduction in TNF-α Levels Due to ACE Inhibitors
The primary outcome is the reduction in plasma levels of TNF-α due to exposure to ACE inhibitors (ACEIs). The study evaluates the causal relationship between ACEIs and TNF-α levels using Mendelian randomization.(Unit: pg/mL)
Time frame: Baseline to 12 months
Reduction in CRP Levels Due to ACE Inhibitors
The primary outcome is the reduction in plasma levels of CRP due to exposure to ACE inhibitors (ACEIs). The study evaluates the causal relationship between ACEIs and CRP levels using Mendelian randomization.(Unit: mg/L)
Time frame: Baseline to 12 months
Modulation of MCP-1 Levels Due to Statin Therapy
The primary outcome is the modulation of plasma levels of MCP-1 in patients treated with statins (HMG-CoA reductase inhibitors). The study investigates the effect of statins on MCP-1 levels.(Unit: pg/mL)
Time frame: Baseline to 12 months
Modulation of MIP-1α Levels Due to Statin Therapy
The primary outcome is the modulation of plasma levels of MIP-1α in patients treated with statins (HMG-CoA reductase inhibitors).(Unit: pg/mL)
Time frame: Baseline to 12 months
Modulation of MIP-1β Levels Due to Statin Therapy
The primary outcome is the modulation of plasma levels of MIP-1β in patients treated with statins (HMG-CoA reductase inhibitors).(Unit: pg/mL)
Time frame: Baseline to 12 months
Reduction in IL-1β Levels Due to PCSK9 Inhibitors
The primary outcome is the reduction in plasma levels of IL-1β in individuals exposed to PCSK9 inhibitors.(Unit: pg/mL)
Time frame: Baseline to 12 months
Reduction in IL-6 Levels Due to PCSK9 Inhibitors
The primary outcome is the reduction in plasma levels of IL-6 in individuals exposed to PCSK9 inhibitors.(Unit: pg/m)
Time frame: Baseline to 12 months
Reduction in Cardiovascular Events Due to Antihypertensive Therapy
The secondary outcome evaluates the reduction in cardiovascular events (e.g., myocardial infarction, stroke) linked to antihypertensive therapies such as ACEIs and ARBs.
Time frame: Baseline to 24 months
Changes in LDL-C Levels Due to Statin Therapy
This outcome examines changes in LDL cholesterol (LDL-C) levels due to statin therapy.
Time frame: Baseline to 24 months
Changes in HDL-C Levels Due to Statin Therapy
This outcome examines changes in HDL cholesterol (HDL-C) levels due to statin therapy.
Time frame: Baseline to 24 months
Reduction in IL-1β Levels Due to PCSK9 Inhibitors
The secondary outcome measures the reduction in IL-1β levels linked to PCSK9 inhibitors.
Time frame: Baseline to 24 months
Changes in Cardiometabolic Outcomes Due to PCSK9 Inhibitors
This secondary outcome measures changes in cardiometabolic outcomes, including changes in lipid levels and inflammatory cytokine profiles.
Time frame: Baseline to 24 months
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