Akira Endo, Pioneer of Cholesterol-Lowering Statins, Passes Away at 90

Akira Endo, a pioneering Japanese biochemist whose groundbreaking research led to the development of statins—medications that have transformed the treatment of high cholesterol and significantly reduced the risk of heart disease—has passed away at the age of 90. His death on June 5, 2024, was confirmed by colleagues and has prompted tributes highlighting his monumental contributions to medicine.

Endo's work in the early 1970s is often compared to the discovery of penicillin, a breakthrough that revolutionized antibiotics and saved countless lives. Statins, which lower levels of "bad" cholesterol in the blood, are now among the most widely prescribed medications globally, with over 200 million people relying on them to prevent heart attacks and strokes. The global market for these drugs was valued at approximately $15 billion in 2023 and is expected to grow further as awareness of their benefits continues to spread.

Born in rural Japan in 1933, Endo developed an early fascination with fungi, inspired by stories from his grandfather about their medicinal properties. This interest would later guide his research as he sought to find a natural solution to combat high cholesterol, a major health issue that was becoming increasingly prevalent in the 20th century. At the time, the only methods available to lower cholesterol involved strict diets and medications that often caused unpleasant side effects.

While working for a pharmaceutical company, Endo embarked on an ambitious project to explore the potential of fungi in producing cholesterol-lowering compounds. He meticulously tested thousands of microbial strains, ultimately isolating a substance from a specific type of mold known as Penicillium citrinum. This compound, later named mevastatin, was the first statin and demonstrated the ability to inhibit a crucial enzyme involved in cholesterol production.

Despite the promise of his discovery, Endo faced significant challenges in gaining support for clinical trials. Initially, his employer was hesitant to pursue the development of mevastatin, preferring to refine existing treatments. Undeterred, Endo conducted secret experiments with patients suffering from genetic cholesterol disorders, which ultimately demonstrated the drug's efficacy. However, it was another company that would capitalize on his work, leading to the approval of lovastatin, the first statin to receive regulatory approval in the United States.

Endo's contributions to medicine have been recognized with numerous awards, including the Japan Prize and the Lasker Award, often referred to as America's Nobel Prize. However, despite the profound impact of his work, he never received a Nobel Prize, a fact lamented by many in the scientific community. "The millions of people whose lives will be extended through statin therapy owe it all to Akira Endo," remarked two Nobel laureates in 2004, underscoring the significance of his legacy.

In recent years, the safety and efficacy of statins have been the subject of debate, with some patients questioning their use due to conflicting reports about potential side effects. Nevertheless, major studies have consistently shown that for most individuals, the benefits of statins far outweigh the risks, reinforcing their status as a cornerstone of cardiovascular disease prevention.

Endo's journey from a curious child in rural Japan to a leading figure in biochemistry serves as a testament to the power of perseverance and innovation in science. His work not only paved the way for a new class of drugs but also exemplified the potential of natural products in medicine, echoing the historical significance of discoveries like penicillin. As the world reflects on his contributions, Endo's legacy will undoubtedly continue to influence the field of medicine for generations to come.