Laboratorio de Desarrollo, Envejecimiento y Enfermedades Neurodegenerativas, División de Neurociencias, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México; Departamento de Bioingenierias, Instituto Tecnologico y de Estudios Superiores de Monterrey, Guadalajara, Jalisco, México.
Laboratorio de Desarrollo, Envejecimiento y Enfermedades Neurodegenerativas, División de Neurociencias, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México; Departamento de Neurología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico de Nacional de Occidente, IMSS, Guadalajara, Jalisco, México.
Arch Med Res. 2018 Aug;49(6):391-398. doi: 10.1016/j.arcmed.2018.12.004. Epub 2018 Dec 27.
Multiple sclerosis (MS) is a chronic inflammatory disease, which leads to focal plaques of demyelination and tissue injury in the central nervous system (CNS). Neuroinflammation and oxidative stress are involved in the pathogenesis of MS, promoting tissue damage and demielinization. Current research findings suggest that melatonin has antioxidant and neuroprotective effects. The aim of this study was to evaluate the efficacy of melatonin on serum pro-inflammatory cytokines and oxidative stress markers in relapsing-remitting multiple sclerosis (RRMS). 36 patients diagnose with RRMS treated with Interferon β-1b (IFNβ-1b) were enrolled in a double bind, randomized, placebo controlled trial. The experimental group received orally 25 mg/d of melatonin for 6 months. After melatonin administration, we observed a significant decrease in serum concentration of pro-inflammatory cytokines and oxidative stress markers; 18% for TNF-α (p <0.05), 34.8% for IL-1β (p <0.05), 34.7% for IL-6 (p <0.05), 39.9% for lipoperoxides (LPO) (p <0.05) and 24% for nitric oxide catabolites (NOC) levels (p <0.05), compared with placebo group. No significant difference in clinical efficacy outcomes were found between groups. Melatonin treatment was well tolerated and we did not observe significant differences in rates of side effects between the two groups. We concluded that melatonin administration during 6 months period is effective in reducing levels of serum pro-inflammatory cytokines and oxidative stress markers in patients with RRMS. These data support future studies evaluating the safety and effectiveness of melatonin supplementation in RRMS patients.
多发性硬化症(MS)是一种慢性炎症性疾病,导致中枢神经系统(CNS)的脱髓鞘和组织损伤。神经炎症和氧化应激参与 MS 的发病机制,促进组织损伤和脱髓鞘。目前的研究结果表明褪黑素具有抗氧化和神经保护作用。本研究旨在评估褪黑素对复发缓解型多发性硬化症(RRMS)患者血清促炎细胞因子和氧化应激标志物的疗效。36 名诊断为 RRMS 的患者接受干扰素β-1b(IFNβ-1b)治疗,进行了一项双盲、随机、安慰剂对照试验。实验组每天口服 25mg 褪黑素,持续 6 个月。褪黑素给药后,我们观察到血清促炎细胞因子和氧化应激标志物的浓度显著降低;TNF-α 降低 18%(p<0.05),IL-1β 降低 34.8%(p<0.05),IL-6 降低 34.7%(p<0.05),脂质过氧化物(LPO)降低 39.9%(p<0.05),一氧化氮代谢产物(NOC)水平降低 24%(p<0.05),与安慰剂组相比。两组间临床疗效无显著差异。褪黑素治疗耐受良好,两组间不良反应发生率无显著差异。我们得出结论,在 6 个月的时间内给予褪黑素治疗可有效降低 RRMS 患者血清促炎细胞因子和氧化应激标志物的水平。这些数据支持未来评估 RRMS 患者褪黑素补充的安全性和有效性的研究。