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Trilostane: Beyond Cushing's Syndrome.

Ali R Olaimat1,2, Parastoo Jafarzadehbalagafsheh1, Mohammad Gol3

  • 1Laboratory of Experimental Epilepsy, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.

Animals : an Open Access Journal From MDPI
|February 13, 2025
PubMed
Summary
This summary is machine-generated.

Trilostane blocks progesterone synthesis, treating Cushing's syndrome in dogs. Its effects on the brain suggest potential for neurological and psychiatric disorders due to increased neurosteroids like allopregnanolone.

Keywords:
Cushing’s syndromeallopregnanolonebrainepilepsyneurosteroidstrilostane

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Area of Science:

  • Veterinary Medicine
  • Neuroscience
  • Endocrinology

Background:

  • Trilostane inhibits 3β-hydroxysteroid dehydrogenase/Δ5-4 isomerase, blocking progesterone synthesis.
  • This mechanism is utilized to treat endocrinological diseases, notably Cushing's syndrome in canines.
  • Trilostane modulates the hypothalamic-pituitary-adrenal axis, impacting brain neurosteroid levels.

Purpose of the Study:

  • To review the historical development, current applications, mechanisms, and future potential of trilostane.
  • To explore trilostane's efficacy in treating hyperadrenocorticism and its emerging roles in neurological and psychiatric conditions.
  • To analyze literature on trilostane's effects, particularly concerning neurosteroids and their implications.

Main Methods:

  • Comprehensive literature search from 1978 to 2025.
  • Analysis of 101 identified papers focusing on trilostane's use in various animal species and humans.
  • Categorization of studies based on animal model, disease treated, and research focus (clinical vs. preclinical).

Main Results:

  • Trilostane is extensively studied for treating hyperadrenocorticism, particularly in dogs (55 papers).
  • Studies also explored its use in cats (3 papers) and other animals (23 papers), with 15 studies involving human patients.
  • Emerging research indicates potential applications in psychiatric (2 papers) and neurological disorders (3 papers) due to neurosteroid modulation.

Conclusions:

  • Trilostane is a well-established treatment for hyperadrenocorticism, with significant veterinary applications.
  • Its influence on neurosteroids like allopregnanolone opens new therapeutic avenues for neurological and psychiatric conditions.
  • Further research into trilostane's neuroactive properties could lead to novel treatment strategies for brain disorders.