Damasceno Alfredo, Moraes Adriel Santos, Farias Alessandro, Damasceno Benito Pereira, dos Santos Leonilda Maria Barbosa, Cendes Fernando
Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil; Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas (UNICAMP), Campinas, Brazil.
Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas (UNICAMP), Campinas, Brazil.
J Neurol Sci. 2015;353(1-2):166-8. doi: 10.1016/j.jns.2015.03.040. Epub 2015 Apr 7.
Sunlight can influence the immune system independently of vitamin D, such as through melatonin production in the pineal gland. Inflammatory disorders can suppress nocturnal melatonin production, but only a few studies have investigated melatonin status in multiple sclerosis (MS). We aimed to study melatonin production in association with clinical and immunological data in MS patients. Eleven treated relapsing-remitting MS (RRMS) patients and eight controls underwent neurological examination and were assessed for fatigue severity and depressive symptoms. Inflammatory cytokines were analyzed in blood samples and concentration of 6-sulfatoxymelatonin (6-SMT) was determined in 24h urine. Patients with an abnormal proportion of overnight 6-SMT (n=8, 72.7%) had higher disability and fatigue severity (p<0.05). Overnight 6-SMT was inversely related with fatigue severity (p=0.016), number of relapses in the previous 12 months (p=0.010) and EDSS scores (p=0.049). In conclusion, disruption of melatonin circadian rhythm production is frequent among RRMS patients and seemingly related to higher disability and fatigue scores. Future studies with larger sample size are necessary to establish melatonin status as a biomarker of disease severity in MS.
阳光可独立于维生素D影响免疫系统，比如通过松果体产生褪黑素。炎症性疾病会抑制夜间褪黑素的产生，但仅有少数研究调查过多发性硬化症（MS）患者的褪黑素状态。我们旨在研究MS患者褪黑素的产生与临床及免疫学数据之间的关系。11例接受治疗的复发缓解型MS（RRMS）患者和8名对照者接受了神经学检查，并对疲劳严重程度和抑郁症状进行了评估。分析血样中的炎性细胞因子，并测定24小时尿液中6-硫酸氧褪黑素（6-SMT）的浓度。夜间6-SMT比例异常的患者（n = 8，72.7%）残疾程度和疲劳严重程度更高（p<0.05）。夜间6-SMT与疲劳严重程度（p = 0.016）、过去12个月内的复发次数（p = 0.010）和扩展残疾状态量表（EDSS）评分（p = 0.049）呈负相关。总之，RRMS患者中褪黑素昼夜节律产生紊乱很常见，且似乎与更高的残疾程度和疲劳评分有关。有必要开展更大样本量的未来研究，以确定褪黑素状态作为MS疾病严重程度生物标志物的地位。
