51. Clinical and biochemical effects of zileuton in patients with the Sjogren-Larsson syndrome
- Author
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Peter M. Steijlen, Jaco W. Pasman, Johannes R.M. Cruysberg, Marinette van der Graaf, Monique A. J. Lutt, Jan J. Rotteveel, Michèl A.A.P. Willemsen, Ertan Mayatepek, and Maria W.G. Nijhuis-van der Sanden
- Subjects
Adult ,Male ,medicine.medical_specialty ,Magnetic Resonance Spectroscopy ,Adolescent ,Leukotriene B4 ,Urinary system ,Disturbances of cerebral development in the young child ,Pathofysiologie van Hersenen en Gedrag ,Neuropsychological Tests ,Pathophysiology of Brain and Behaviour ,Gastroenterology ,chemistry.chemical_compound ,Internal medicine ,Biomedische Magnetische Resonantie ,Congenital ichthyosis ,medicine ,Humans ,Hydroxyurea ,Spasticity ,Lipoxygenase Inhibitors ,experimenteel en klinisch onderzoek en behandeling. [Erfelijke en verworven vitreo-retinale aandoeningen] ,Leukotriene ,Sjögren–Larsson syndrome ,integumentary system ,Ichthyosis ,business.industry ,Neuromusculaire en neurometabole aandoeningen ,Epidermal differentiation and cutaneous inflammation ,Brain ,Electroencephalography ,Zileuton ,medicine.disease ,Magnetic Resonance Imaging ,Biomedical Magnetic Resonance ,Sjogren-Larsson Syndrome ,Endocrinology ,chemistry ,Neuromuscular and neurometabolic disorders ,Pediatrics, Perinatology and Child Health ,Cerebrale ontwikkelingsstoornissen bij het jonge kind ,Epidermale differentiatie en cutane ontstekingsprocessen ,Female ,experimental and clinical research and treatment. [Hereditary and acquired vitreo-retinal disorders] ,medicine.symptom ,business ,medicine.drug - Abstract
The Sjogren-Larsson syndrome (SLS) is an inborn error of lipid metabolism, characterised clinically by congenital ichthyosis, mental retardation and spasticity. Patients also suffer from severe pruritus. The degradation of leukotriene (LT) B4 is one of the defective metabolic routes in SLS. Zileuton inhibits the synthesis of LTB4 and the cysteinyl leukotrienes. Five SLS patients were treated with zileuton for 3 months. Favourable effects were found on pruritus score (P=0.006), general well-being, and background activity of electroencephalographic studies. Neuropsychological test results did not change significantly. There was, however, a clinically important trend towards improvement in the speed of information processing. Results of cerebral MRI and proton magnetic resonance spectroscopy did not change during therapy. Urinary concentrations of LTB4 and ω-OH-LTB4 decreased significantly (P=0.02 and P=0.003 respectively), while their concentrations in CSF were normal at baseline and remained so after therapy. Conclusion: patients with Sjogren-Larsson syndrome might benefit from treatment with zileuton, especially with respect to the agonising pruritus. The findings reported here, point to a crucial role for leukotriene B4 in the pathogenesis of pruritus.
- Published
- 2001