Reviews in Endocrine and Metabolic Disorders

, Volume 19, Issue 4, pp 363–395 | Cite as

Statins, metformin, proprotein-convertase-subtilisin-kexin type-9 (PCSK9) inhibitors and sex hormones: Immunomodulatory properties?

  • Christian A. KochEmail author
  • Siegfried Krabbe
  • Bernd HehmkeEmail author


The immune system is closely intertwined with the endocrine system. Many effects of medications used for various clinical endocrine conditions such as the metabolic syndrome, hypercholesterolemia, diabetes mellitus, hypertension, Graves’ disease and others also have an impact on the immune system. Some drugs including statins, metformin, angiotensin converting enzyme and proprotein-convertase-subtilisin-kexin type-9 (PCSK9) inhibitors and sex hormones are known to have immunomodulatory properties. We here review the literature on this topic and provide some clinical examples including the use of statins in Graves’ orbitopathy, rheumatoid arthritis, multiple sclerosis, and adult-onset Still’s disease. In that context, we introduce a special immunodiagnostics method developed at the Institute of  Diabetes “Gerhardt Katsch” in Karlsburg, Germany, to not only measure but also monitor immune disease activity.


Statin Flow cytometry Interleukin 2 Autoantigen Somatostatin Immune Thyroid Orbitopathy Autoimmune Multiple sclerosis Rheumatoid arthritis Metformin PCSK9 Testosterone Lupus 


Compliance with ethical standards

All patients have provided informed consent for the off label use of statins and for permission to conduct experiments and publish the results. One case study with Graves’s orbitopathy has been published in poster format at the Endocrine Society Meeting 2018 in Chicago: Statins As Immunomodulatory Therapy In Graves’ Orbitopathy. Poster Presentation SAT-676, 100th Endocrine Society Meeting, Chicago, IL, March 17, 2018.

Conflict of interest

Prof. Koch declares no direct conflict with this article. He has served on the Advisory Board of Novartis on the topic acromegaly and has participated in educational conferences on the topics neuroendocrine tumors and acromegaly sponsored by Novartis and Ipsen. Dr. Hehmke declares no conflict of interest. Prof. Krabbe declares no direct conflict with this article. He has served on the Advisory Board of Lilly and as speaker for Berlin-Chemie, Amgen, and MSD Sharp & Dohme / Merck & Co. Inc.

Figure and Table legends are provided within the respective text sections.

Reference [16] and parts of the table from it are available as open access article and for reproduction use as long as the source is acknowledged / cited which is the case here.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medicover GmbH BerlinBerlinGermany
  2. 2.Carl von Ossietzky UniversityOldenburgGermany
  3. 3.Technical University of DresdenDresdenGermany
  4. 4.University of LouisvilleLouisvilleUSA
  5. 5.University of Tennessee Health Science CenterMemphisUSA
  6. 6.University of GreifswaldGreifswaldGermany
  7. 7.Institute of Diabetes ‘‘Gerhardt Katsch’’KarlsburgGermany

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