June 23, 2014
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Preliminary data indicate Singulair as potential diabetic retinopathy therapy

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SAN FRANCISCO — Leukotriene B4 receptor 1 levels, leukotriene B4 generation and superoxide production may be potential pathogenic markers for diabetic retinopathy in young patients with type 1 diabetes, according to study data presented here.

The preliminary data also suggested that Singulair (montelukast sodium, Merck), a selective and orally active leukotriene receptor antagonist that inhibits the cysteinyl leukotriene CysLT1 receptor, may be a potential therapy for diabetic retinopathy.

“If we could use this already U.S. Food and Drug Administration-approved drug to block our leukotriene pathway, it would be a great way to intervene and actually help prevent diabetic retinopathy,” Marcella Luercio, MD, of Case Western University, said during a presentation at the American Diabetes Association’s 74th Scientific Sessions. “Our preliminary studies here show that when we treat leukocytes isolated from diabetic patients with montelukast sodium, we can inhibit LTB4 production in almost all of these patients. It actually goes down significantly. If we can block this, we would hope that we could prevent some diabetic retinopathy in our young diabetes patients.”

The study presented included 28 patients with type 1 diabetes (mean HbA1c > 6.5%; diabetes duration of at least 5 years) and 16 age-matched healthy controls.

Luercio and colleagues assessed leukotriene B4 receptor 1 (BLT1) levels, leukotriene B4 generation (LTB4), and superoxide production and effects on endothelial cells.

Data indicated that patients with diabetes demonstrated a 1.4-fold increase in BLT1 levels (P = .002), with levels increasing among patients with worsened glycemia and longer diabetes duration, compared with patients without diabetes.

Leukocyte levels in patients with a diabetes duration of more than 10 years also appeared to generate a 1.3-fold increase in LTB4 (P = .007), and produced a twofold increase of superoxide (P = .028), according to the researchers.

“Perhaps these markers could be used … to identify young patients we see each day in the clinic who could be at high risk for diabetic retinopathy to be treated with montelukast or other therapeutic agents that are yet to be discovered,” Luercio said. – by Samantha Costa

Disclosure: Luercio has no relevant financial disclosures.

For more information:

Luercio MF. Abstract #352-OR. Presented at: American Diabetes Association’s 74th Scientific Sessions; June 13-17, 2014; San Francisco.