Protective role of statins against ventilator-induced lung injury

experiment on the protective role of simvastatin against ventilator-induced lung injury (VILI). Th eir results are in line with those of a relevant study published recently by our research team; we also showed that pretreatment with statins (specifi cally atorvastatin) attenuates VILI [2]. By synthesizing the fi ndings of the above contributions [1,2], one could make several points. First, given that Müller and colleagues administered simvastatin [1] while we chose atorvastatin [2], it seems that the observed benefi t is a class-specifi c rather than a drug-specifi c eff ect; that is, it may apply to the whole class of statins. Second, the prevention of VILI by statins seems not to be species-specifi c; indeed, our colleagues employed mice [1], while we preferred rabbits [2]. Th ird, while the fi rst study used female animals [1] and the second study used male animals [2], there were no diff erences in the produced results; thus, statins seem to be useful for the prevention of VILI in both sexes. Th is observation is important given the ongoing interest in the possibility that drug responses may diff er by sex [3]. Fourth, by using diff erent markers, both studies noted that administration of statins reduced VILI-associated hyperpermeability [1,2]. Indeed, the German group [1] used as a marker of lung permeability the human-serumalbumin bronchoalveolar lavage/plasma ratio, while we used both lung edema and ultrafi ltration coeffi cient (Kf,c). Finally, Müller and colleagues implemented a 6-hour model of injurious mechanical ventilation to show that statins ameliorate pulmonary infl ammation [1], whereas we focused on the very acute phase of lung injury, when mechanical phenomena rather than infl ammation may best explain the injury [2]. In conclusion, we believe that the two papers [1,2] combined provide strong experimental evidence that a dose of statin as high as 20 mg/kg body weight administered before the induction of mechanical ventilation may protect against VILI and relevant clinical trials are thus fully justifi ed.