Crestor, grapefruits and Italian towns have what in common?

In the current issue of the journal Circulation, there is a study supporting concerns that Crestor (known to chemists as rosuvastatin) is riskier than other statins. When you take most statins you can't drink grapefruit juice, which sounds like an odd prohibition, but for which there is a biochemical basis. Crestor is unusual, in that grapefruit juice does not affect the metabolism of the drug. So what is it in grapefruit juice that mucks up the behaviors of the statins?

Imbibing grapefruit juice (but not orange juice) raises the blood levels of the statins, making them more potent in terms of lowering cholesterol, but also more toxic. A component of the grapefruit juice apparently inhibits an enzyme responsible for the breakdown of the statins in the liver. One possible culprit is bergamottin.

If you drink Earl Grey tea, scented with oil of bergamot, this name may seem familiar to you. Etymologically, bergamottin is derived from the same source as bergamot, both stem from a citrus tree Citrus Bergamia , named for a town in Italy, Bergamo, where such trees presumably grow.

---

The cholesterol-lowering statins were first isolated from molds. The first (Lovastatin aka Mevacor) was isolated in the 70s from Aspergillus terreus .