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X-linked adrenoleukodystrophy (X-ALD) is a fatal, axonal demyelinating, neurometabolic disease. It results from the functional loss of a member of the peroxisomal ATP-binding cassette transporter subfamily D (ABCD1), which is involved in the metabolism of very long-chain fatty acids (VLCFA). Oxidative damage of proteins caused by excess of the hexacosanoic acid, the most prevalent VLCFA accumulating in X-ALD, is an early event in the neurodegenerative cascade. We demonstrate here that valproic acid (VPA), a widely used anti-epileptic drug with histone deacetylase inhibitor properties, induced the expression of the functionally overlapping ABCD2 peroxisomal transporter. VPA corrected the oxidative damage and decreased the levels of monounsaturated VLCFA (C26:1 n-9), but not saturated VLCFA. Overexpression of ABCD2 alone prevented oxidative lesions to proteins in a mouse model of X-ALD. A 6-month pilot trial of VPA in X-ALD patients resulted in reversion of the oxidative damage of proteins in peripheral blood mononuclear cells. Thus, we propose VPA as a promising novel therapeutic approach that warrants further clinical investigation in X-ALD. This work was supported by grants from the European Commission (LSHM-CT2004-502987 and FP7-241622), the European Leukodystrophy Association (ELA 2006-043I4), the Spanish Institute for Health Carlos III (FIS PI080991 and FIS PI051118) and the Autonomous Government of Catalonia (2009SGR85) to A.P. S.F. was a fellow of the European Leukodystrophy Association (ELA 2007-018F4). S.K. also received a grant from the European Leukodystrophy Association (ELA 2006-031I4). The work was developed under the COST action BM0604 (to A.P.). The CIBER de Enfermedades Raras is an initiative of the ISCIII. Work carried out at the Department of Experimental Medicine was supported in part by I + D grants from the Spanish Ministry of Science and Innovation (AGL2006-12433 and BFU2009-11879/BFI), the Spanish Ministry of Health (RD06/0013/0012 and PI081843), the Autonomous Government of Catalonia (2009SGR735), ‘La Caixa’ Foundation and COST B35 Action from the European Union. A.N. received a predoctoral fellowship from ‘La Caixa’ Foundation.

We have studied the substrate specificity of the inducible (acyl-CoA oxidase I) and non-inducible (acyl-CoA oxidase II) oxidases in peroxisome-enriched fractions from rat kidney. The two oxidases were separated by means of ion-exchange chromatography and shown to accept a variety of acyl-CoA esters as substrates, including lignoceroyl-CoA, palmitoyl-CoA, lauroyl-CoA, caproyl-CoA, and trimethyltridecanoyl-CoA. Glutaryl-CoA was found to react exclusively with the inducible enzyme, and pristanoyl-CoA exclusively with the non-inducible enzyme. We conclude that under normal non-induced conditions both acyl-CoA oxidase I and II contribute to the oxidation of the various acyl-CoA esters with the exception of pristanoyl-CoA and glutaryl-CoA, although the extent to which each enzyme contributes to the oxidation was found to differ between the various acyl-CoA esters.