Cardinali Daniel P, Brown Gregory M, Pandi-Perumal Seithikurippu R
Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires 1007, Argentina.
Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
Diseases. 2020 Nov 26;8(4):44. doi: 10.3390/diseases8040044.
The therapeutic potential of melatonin as a chronobiotic cytoprotective agent to counteract the consequences of COVID-19 infections has been advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, and immunomodulatory compound, melatonin could be unique in impairing the consequences of SARS-CoV-2 infection. Moreover, indirect evidence points out to a possible antiviral action of melatonin by interfering with SARS-CoV-2/angiotensin-converting enzyme 2 association. Melatonin is also an effective chronobiotic agent to reverse the circadian disruption of social isolation and to control delirium in severely affected patients. As a cytoprotector, melatonin serves to combat several comorbidities such as diabetes, metabolic syndrome, and ischemic and non-ischemic cardiovascular diseases, which aggravate COVID-19 disease. In view of evidence on the occurrence of neurological sequels in COVID-19-infected patients, another putative application of melatonin emerges based on its neuroprotective properties. Since melatonin is an effective means to control cognitive decay in minimal cognitive impairment, its therapeutic significance for the neurological sequels of SARS-CoV-2 infection should be considered. Finally, yet importantly, exogenous melatonin can be an adjuvant capable of augmenting the efficacy of anti-SARS-CoV-2 vaccines. We discuss in this review the experimental evidence suggesting that melatonin is a potential "silver bullet" in the COVID 19 pandemic.
褪黑素作为一种时间生物学细胞保护剂来对抗新冠病毒感染后果的治疗潜力已得到提倡。由于褪黑素作为一种抗氧化、抗炎和免疫调节化合物具有广泛的作用，它在减轻新冠病毒感染后果方面可能具有独特性。此外，间接证据表明褪黑素可能通过干扰新冠病毒与血管紧张素转换酶2的结合而具有抗病毒作用。褪黑素也是一种有效的时间生物学剂，可逆转社交隔离导致的昼夜节律紊乱，并控制重症患者的谵妄。作为一种细胞保护剂，褪黑素有助于对抗几种合并症，如糖尿病、代谢综合征以及缺血性和非缺血性心血管疾病，这些疾病会加重新冠病情。鉴于有证据表明新冠病毒感染患者会出现神经后遗症，基于褪黑素的神经保护特性，它又有了另一种假定的应用。由于褪黑素是控制轻度认知障碍中认知衰退的有效手段，应考虑其对新冠病毒感染神经后遗症的治疗意义。最后，同样重要的是，外源性褪黑素可以作为一种佐剂，增强抗新冠病毒疫苗的效力。我们在本综述中讨论了实验证据，表明褪黑素是新冠疫情中的一种潜在“万灵药”。
