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Inhibitors of Cholesterol Synthesis and Cataracts FREE

Richard J. Cenedella, PhD
JAMA. 1987;257(12):1602-1602. doi:10.1001/jama.1987.03390120064020
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To the Editor.—  The results presented in the article entitled "Therapeutic Response to Lovastatin (Mevinolin) in Nonfamilial Hypercholoesterolemia"1 clearly indicate that lovastatin (a potent inhibitor of the rate-limiting step in cholesterol biosynthesis) could be a useful agent for the management of an elevated low-density lipoprotein cholesterol level. The purpose of this letter is to caution against the possible complication of cataract development that might result from long-term use of this agent. Although the authors reported no apparent increases in lens opacities in adult subjects treated for 18 weeks with lovastatin, they should be aware that serious consequences could result from long-term inhibition of cholesterol synthesis by the ocular lens, especially in children and young adults.The avascular lens grows throughout life by laying down layer upon layer of permanently retained fiber cells that are enclosed by an extremely cholesterol-rich plasma membrane. The human lens increases in size with each

REFERENCES

The Lovastatin Study Group II:  Therapeutic response to lovastatin (mevinolin) in nonfamilial hypercholesterolemia: A multicenter study . JAMA 1986;;256:2829-2834.
Cenedella RJ:  Sterol synthesis by the ocular lens of the rat during postnatal development . J Lipid Res 1982;;23: 619-626.
Cenedella RJ:  Lipoproteins and lipids in cow and human aqueous humor . Biochim Biophys Acta 1984;;793:448-454.
Cenedella RJ, Bierkamper GG:  Mechanism of cataract production by 3-beta(2-diethylaminoethoxy) androst-5-en-17-one hydrochloride, U18666A: An inhibitor of cholesterol biosynthesis . Exp Eye Res 1979;;28:673-688.
Hoffmann G, Gibson KM, Brandt IK, et al:  Mevalonic acid urea—an inborn error of cholesterol and nonsterol isoprene biosynthesis . N Engl J Med 1986;;314:1610-1614.

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The Lovastatin Study Group II:  Therapeutic response to lovastatin (mevinolin) in nonfamilial hypercholesterolemia: A multicenter study . JAMA 1986;;256:2829-2834.
Cenedella RJ:  Sterol synthesis by the ocular lens of the rat during postnatal development . J Lipid Res 1982;;23: 619-626.
Cenedella RJ:  Lipoproteins and lipids in cow and human aqueous humor . Biochim Biophys Acta 1984;;793:448-454.
Cenedella RJ, Bierkamper GG:  Mechanism of cataract production by 3-beta(2-diethylaminoethoxy) androst-5-en-17-one hydrochloride, U18666A: An inhibitor of cholesterol biosynthesis . Exp Eye Res 1979;;28:673-688.
Hoffmann G, Gibson KM, Brandt IK, et al:  Mevalonic acid urea—an inborn error of cholesterol and nonsterol isoprene biosynthesis . N Engl J Med 1986;;314:1610-1614.
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