Mevolonate Pathway:role of bisphosphonates and statins

Cardiovascular diseases, i.e. high blood pressure, coronary heart disease, and stroke, and osteoporosis are public health problems, with several epidemiological links, and they might be related to each other in terms of pathogenesis and therapeutic agents. Bisphosphonates inhibit bone resorption and are used in the treatment of osteoporosis, whereas statins inhibit cholesterol biosynthesis and are used for the treatment of atherosclerosis and lipid metabolic disorders. Some late clinical studies suggested bisphosphonates may have beneficial effect in vivo on atherosclerotic progression, lipid profiles, and cardiovascular morbidity and mortality, whereas statins might increase bone density, and reduce fracture risk, even if properly designed prospective studies are needed to clearly define clinical effects and potential new roles for these old agents. Moreover mechanism by which these two classes of drugs act, at cellular level, may not be mutually exclusive, and the common target of action might be the mevalonate pathway. In this review, we focused on in vitro and in vivo interactions between mevolanate pathway, bisphosphonates, and statins, examining the possible therapeutic consequences of these links