WILDERNESS MEDICAL SOCIETY
ABSTRACT INSTRUCTIONS
2006 Wilderness Medicine Conference and Annual Meeting
July 22 26, 2006
Instructions for Abstract Preparation
The abstract should be word processed, using MS Word, in 12-point Times New Roman font. The title should be in bold.
List authors full names with middle initials and degrees. List author affiliations with a limit of one affiliation per author.
The body of the abstract should be no more than 300 words and must be limited to one page. Do not include
references, illustrations, tables, or figures. Abstracts should be structured to include a brief introduction describing the
background for the research, the objectives, methods, results, and conclusion. An example abstract is shown below.
Headings for Introduction, Objectives, Methods, Results, and Conclusion should be included as shown in the sample
abstract below. Funding sources may be indicated at the end of the abstract.
The Effects of a 5-Lipoxygenase Inhibitor on Acute Mountain Sickness and Urinary
Leukotriene E4 After Ascent to High Altitude
Colin K. Grissom, M.D.
1
,
Lori D. Richer, M.D.
2
, and Mark R. Elstad, M.D.
3
1
LDS Hospital and the University of Utah, Salt Lake City, Utah
2
Dartmouth Family Practice Residency, Concord Hospital, Concord, New Hampshire
3
University of Utah and the Department of Veteran's Affairs Medical Center, Salt Lake
City, Utah
Introduction: Elevated urine and blood leukotriene levels have been reported after
ascent to high altitude in association with acute mountain sickness (AMS) and high
altitude pulmonary edema (HAPE). Zileuton is an inhibitor of the enzyme 5-lipoxygenase
that catalyzes conversion of arachidonic acid to leukotrienes.
Objectives: The objectives of this randomized double-blind placebo-controlled clinical
trial were to determine whether zileuton (600 mg orally four times a day) is effective
prophylaxis for AMS and to measure the effect of ascent to high altitude and zileuton on
urinary leukotriene E4 levels.
Methods: The study group consisted of volunteers from among climbers on the West
Buttress of Mt. McKinley (Denali), Alaska. After collecting a baseline urine sample at
sea level, subjects flew by airplane to 2300 m, and then ascended to the 4200 m camp in
5 to 10 days where a second urine sample was obtained. Symptoms of AMS were
assessed at 4200 m using the Lake Louise criteria.
Results: Using an enzyme immunoassay, urinary leukotriene E4 was found to decrease
after ascent to high altitude in both the zileuton and placebo groups. Urinary leukotriene
E4 in the zileuton group (n=9) decreased from 67 +35 pg/mg creatinine at sea level to 33
+22 pg/mg creatinine at high altitude (p=0.003). Urinary leukotriene E4 in the placebo
group (n=9) decreased from 97 +82 pg/mg creatinine at sea level to 44 +21 pg/mg
creatinine at high altitude (p=0.045). One subject in the zileuton group and 3 subjects in
the placebo group met Lake Louise criteria for AMS after arriving at 4200 m (p=0.257).
Conclusion: Elevated leukotrienes are not associated with ascent to high altitude. In
subjects with AMS urinary leukotrienes were not elevated, suggesting that leukotrienes
may not be a component of the pathophysiology of AMS. The low incidence of AMS
and the small sample size in this study prevented determination of whether zileuton is
effective prophylaxis for AMS.
Supported by a Wilderness Medical Society Research Award
