Ulinastatin as a Potential Alternative Therapy for Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Abstract

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is an emergency skin disease with high mortality rates despite the incidence rate is not great. Patients with SJS/TEN will experience reduced quality of life due to the pain experienced when eating, drinking or urinating. There is not a specific treatment for patient with SJS/TEN so far. Corticosteroids and intravenous immunoglobulin (IVIG) are the most commonly used therapies yet there are still controversies due to their positive and negative effects. Ulinastatin, a trypsin inhibitor and an anti-inflammatory compound that is made from human urine is a therapeutic option for SJS/TEN. Ulinastatin may provide anti-inflammatory effect by inhibiting TNF-α production, thereby reducing the risk of septic complications and lowering mortality. Until now, the known side effects are nausea, vomiting and allergic to gelatin. Although it has a promising potential, the effectiveness of ulinastatin is still poorly studied. Further research is needed regarding the usage of ulinastatin on patients with SJS/TEN.