褪黑素失调、多发性硬化症中的睡眠障碍和疲劳。
Melatonin dysregulation, sleep disturbances and fatigue in multiple sclerosis.
机构信息
Division of Neuroimmunology & Multiple Sclerosis Center, Carmel Medical Center, Haifa, Israel.
出版信息
J Neurol Sci. 2012 Mar 15;314(1-2):37-40. doi: 10.1016/j.jns.2011.11.003. Epub 2011 Dec 1.
BACKGROUND
Sleep disruption and fatigue are common in Multiple Sclerosis (MS). Melatonin is one of the major regulators of sleep-wake cycle. The role of melatonin in MS-related sleep disturbances and fatigue as well as the interaction between melatonin and Interferon beta (IFN-β) treatment were the subject of this study.
OBJECTIVE
To assess the influence of IFN-β treatment on melatonin secretion, fatigue and sleep characteristics in patients with MS.
METHODS
13 MS patients and 12 healthy controls participated. Fatigue was evaluated using the Fatigue Impact Scale (FIS), sleep was assessed by actigraphy and day/night levels of 6-sulphatoxy-melatonin (6-SMT) in urine were determined using a highly specific ELISA assay.
RESULTS
Naïve MS patients demonstrated significantly decreased levels of 6-SMT and disrupted circadian regulation of its secretion, which were increased with IFN-β treatment, in association with improved fatigue. Sleep Efficiency was significantly lower in the MS group compared to controls.
CONCLUSION
Our findings suggest dysregulation of Melatonin secretion in MS, which may be influenced by IFN-β treatment. The results call for further characterization of the role of neuro-hormones such as melatonin in MS, and their cross-regulation with immune-mediators.
背景
睡眠障碍和疲劳在多发性硬化症（MS）中很常见。褪黑素是调节睡眠-觉醒周期的主要激素之一。本研究旨在探讨褪黑素在 MS 相关睡眠障碍和疲劳中的作用，以及褪黑素与干扰素-β（IFN-β）治疗之间的相互作用。
目的
评估 IFN-β 治疗对 MS 患者褪黑素分泌、疲劳和睡眠特征的影响。
方法
13 名 MS 患者和 12 名健康对照者参与了本研究。采用疲劳影响量表（FIS）评估疲劳，通过活动记录仪评估睡眠，采用高度特异性 ELISA 测定尿液中 6-硫酸褪黑素（6-SMT）的日/夜水平。
结果
未经治疗的 MS 患者表现出明显降低的 6-SMT 水平和褪黑素分泌的昼夜节律紊乱，这些改变在接受 IFN-β 治疗后得到改善，同时疲劳也得到了改善。与对照组相比，MS 组的睡眠效率明显降低。
结论
我们的研究结果表明，MS 患者存在褪黑素分泌失调，这可能受到 IFN-β 治疗的影响。这些结果呼吁进一步研究神经激素（如褪黑素）在 MS 中的作用及其与免疫调节剂的交叉调节。
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