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Serum-cholesterol-lowering effect of metronidazole and possible mechanisms of action

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Summary

In five patients with Crohn's disease long-term therapy with metronidazole (400 mg b.i.d.) was followed by a significant reduction of total serum cholesterol from 179 mg/dl to 156 mg/dl, 134 mg/dl, and 143 mg/dl, after 2–4 months, 6 months, and 9–12 months, respectively. Lipoprotein analysis before and after 3 weeks of administration of metronidazol (400 mg/day) to five normolipemic volunteers revealed that LDL-cholesterol was reduced by 21% (P<0.05), whereas HDL-cholesterol remained unchanged. Biliary secretion of cholesterol and bile acids were reduced by 13% and 20% (P<0.05), respectively, which might suggest a decreased sterol synthesis. The amount and percentage of intestinal cholesterol absorption were decreased by 33% and 22% (P<0.05). Thus, a possible decrease in sterol synthesis and a reduction of cholesterol absorption might be responsible for the serum-cholesterol-lowering effect of metronidazole. However, caution should be taken when considering metronidazole for long-term treatment of patients with hypercholesterolemia due to possible side effects.

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References

  1. Berg D, Regel E, Harenberg H-E, Plempel M (1984) Bifonazole and Clotrimazole. Their mode of action and the possible reason for the fungucidal behaviour of bifonazole. Arzneim Forsch/Drug Res 34:139–146

    Google Scholar 

  2. von Bergmann K, Gutsfeld-Epple M, Leiss O (1984) Differences in the effects of chenodeoxycholic and ursodeoxycholic acid on biliary lipid secretion and bile acid synthesis in patients with gallstones. Gastroenterology 87:136–143

    Google Scholar 

  3. Bilheimer DW, Grundy SM, Brown MS, Goldstein JL (1983) Mevinolin and colestipol stimulate receptor-mediated clearance of low density lipoprotein from plasma in familial hypercholesterolemia heterozygotes. Proc Natl Acad Sci USA 80:4124–4128

    Google Scholar 

  4. Davis JL, Schultz TA, Mosley CA (1983) Metronidazole lowers serum lipids. Ann Intern Med 99:43–44

    Google Scholar 

  5. Eggstein M, Kreutz FH (1966) Eine neue Bestimmung der Neutralfette in Blutserum und Gewebe. Klin Wochenschr 44:262–266

    Google Scholar 

  6. Einarsson K, Grundy SM (1980) Effects of feeding cholic acid and chenodeoxycholic acid on cholesterol absorption and hepatic secretion of biliary lipids in man. J Lipid Res 21:23–24

    Google Scholar 

  7. Grundy SM, Metzger AL (1972) A physiological method for estimation of hepatic secretion of biliary lipids in man. Gastroenterology 62:1200–1217

    Google Scholar 

  8. Gugler R, Schulte H, Steinhoff R, Jensen C (1983) Wirkstoffkonzentrationen von Metronidazol und klinischer Verlauf bei Morbus Crohn. Fortschr Antimikrob Antineopl Chemother 2–4:662–667

    Google Scholar 

  9. Hunninghake DB, Probstfield JL (1977) Drug treatment of hyperlipoproteinaemia. In: Rifkind BM, Levy RI (eds) Hyperlipidemia — Diagnosis and Therapy. Grune and Stratton, New York, pp 327–362

    Google Scholar 

  10. Leiss O, von Bergmann K, Streicher U, Strotkoetter H (1984) The effects of three different dihydroxy bile acids on intestinal cholesterol absorption in normal volunteers. Gastroenerology 87:144–149

    Google Scholar 

  11. Lipid Research Clinic Program Manual of Laboratory Operations Department of Health, Education of Welfare Publication. NIH 1974; 75–628

  12. Mabuchi H, Sakai T, Sakai Y, Yoshimura A, Watanabe A, Wakasugi T, Koizumi J, Takeda R (1983) Reduction of serum cholesterol in heterozygous patients with familial hypercholesterolemia. Additive effect of compactin and cholestyramine. N Engl J Med 308:609–613

    Google Scholar 

  13. Roeschlau P, Bernt E, Gruber W (1974) Enzymatische Bestimmung des Gesamt-Cholesterins im Serum. Z Klin Chem Biochem 12:226–231

    Google Scholar 

  14. Sedegath AP, Samuel P, Crouse JR, Ahrens Jr EH (1975) Effects of neomycin on absorption, synthesis, and/or flux of cholesterol in man. J Clin Invest 55:12–21

    Google Scholar 

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This project was supported by a grant from “Sandoz Stiftung für therapeutische Forschung”.

The authors thank Mrs. P. Pitters, G. Westphal, H., Ahten und Mr. S. Weiner for their technical assistance

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von Bergmann, K., Streicher, U., Leiss, O. et al. Serum-cholesterol-lowering effect of metronidazole and possible mechanisms of action. Klin Wochenschr 63, 279–281 (1985). https://doi.org/10.1007/BF01731475

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  • DOI: https://doi.org/10.1007/BF01731475

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