However, the weak and transient effect observed in cultured cells may also suggest that the influence of simvastatin on HO-1 protein level in AAA tissue could have been associated with modulation of metabolism at the organismal level, for example, changes in cholesterol or LDL cholesterol level (Table 1), rather than with direct effect on Nrf2 expression or transcriptional activity. The gene discussed is NFE2L2; the disease is triple-A syndrome.