THE LANCET • Vol 363 • June 12, 2004 • www.thelancet.com
Epidemiological study and clinical
trial findings suggest that selenoprotein
inhibition might heighten the risk of
Moosmann and Behl’s hypothesis is
confirmed, statins could not only trigger
autoimmune diseases but also contribute
to the development of some types of
cancer. Further studies are, therefore,
warranted to determine the long-term
safety of these lipid-lowering agents.
Department of Dermatology, Centre Hospitalier
Universitaire Vaudois, 1011 Lausanne,
1 Moosmann B, Behl C. Selenoprotein
synthesis and side-effects of statins. Lancet
2004; 363: 892–94.
2 Noel B. Risks and benefits of statins in lupus
erythematosus. Arch Intern Med 2004; 164:
3 Sridhar MK, Abdulla A. Fatal lupus-like
syndrome and ARDS induced by fluvastatin.
Lancet 1998; 352: 114.
4 Youssef S, Stuve O, Patarroyo JC, et al. The
HMG-CoA reductase inhibitor, atorvastatin,
promotes a Th2 bias and reverses paralysis in
central nervous system autoimmune disease.
Nature 2002; 420: 78–84.
5 Sinha R, El-Bayoumy K. Apoptosis is a
critical cellular event in cancer
chemoprevention and chemotherapy by
selenium compounds. Curr Cancer Drug
Targets 2004; 4: 13–28.
Chechnya is currently witnessing a
health and humanitarian crisis. Years
of war have left medical services in
chaos. Unable to cope, they are
propped up by donations from the
international aid community so that
local medical staff can continue to
treat patients. Available drugs and
services are insufficient to treat key
causes of morbidity and mortality:
cardiovascular disease, cancer, and
tuberculosis. Many medical staff have
fled the country. Those who remain
are frustrated at the lack of equipment
and poor access to new and improved
Because of the repeated kidnapping
of expatriate workers, Chechnya
remains closed off to international
scrutiny. Our colleague, Arjan Erkel,
Médecins Sans Frontières’ Head