The Janus face of statins in viral infections: integrating findings from preclinical and clinical studies

Information from the abstract

The clinical utility of statins, while fundamentally anchored in lipid management, demonstrates significant reach into virology due to their diverse secondary mechanisms. These pleiotropic actions exhibit a dualistic nature, capable of mediating both beneficial and detrimental effects in the context of viral disease. Modern investigative work has moved beyond viewing statins as a uniform therapeutic class, now establishing that their antiviral potential is governed by a critical interplay of three elements: the distinct pharmacologic profile of the individual statin, the specific pathogenic strategy of the virus, and the host’s genetic background. A notable and persistent gap remains, however, between conclusive in vitro observations and inconsistent results from human clinical studies. Systematic reviews and meta-analyses examining statin use in viral infections report contradictory outcomes, highlighting an imperative for more comprehensive evidence aggregation, such as umbrella meta-analyses. This review synthesizes current understanding of the underlying mechanisms, paying particular attention to statin-specific off-target pathways and their relevance to virus-linked cancers, while providing a critical evaluation of the available clinical data. We conducted a comprehensive literature search across PubMed, Scopus, and Web of Science from database inception to March 2025. By clarifying these research priorities and existing knowledge gaps, this analysis provides a strategic roadmap for the deliberate repurposing of statins as adjunctive therapies against viral infections and their oncogenic consequences.TWEETABLE ABSTRACTStatins show dual roles in viral infections, sometimes helping, sometimes harming. Success depends on the specific statin, virus, and patient genetics. Future trials must embrace precision medicine.

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Related topics: Lipoproteins and Cardiovascular Health · Cancer, Lipids, and Metabolism · interferon and immune responses