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褪黑素作为一种时间生物学剂和细胞保护剂在糖尿病中的治疗潜力。

Therapeutic potential of melatonin as a chronobiotic and cytoprotective agent in diabetes mellitus.

作者信息

Wajid Fareha, Poolacherla Raju, Mim Fatiha Kabir, Bangash Amna, Rutkofsky Ian H

机构信息

California Institute of Behavioural Neuroscience and Psychology, Fairfield, CA USA.

出版信息

J Diabetes Metab Disord. 2020 Jul 21;19(2):1797-1825. doi: 10.1007/s40200-020-00585-2. eCollection 2020 Dec.

Abstract

PURPOSE

Diabetes mellitus is a complex metabolic disorder characterized by hyperglycemia occurring as a result of dysregulation and balance of various metabolic pathways. In recent years, circadian misalignment (due to altered sleep/wake, feeding/fasting cycles), has been intimately linked with the development of diabetes mellitus. Herein, we review our knowledge of oxidative stress, circadian rhythms control of metabolism, and the effects of its disruption on homeostasis while emphasizing the importance of melatonin, a nocturnally peaking, pineal hormone, as a potential therapeutic drug for the prevention and treatment of diabetes.

METHODS

PubMed database was systematically searched for related articles and data from all types of studies, including clinical trials, review articles, and case reports were considered without limiting the study to one specific category.

RESULTS

Experimental and epidemiological evidence indicate melatonin's multifaceted effects in intermediary metabolism via resynchronization of the circadian rhythms and its deficiency is associated with metabolic derangements. As a chronobiotic, it cures insomnia and sleep disorders caused by shift work or jet lag. The antagonistic relationship between melatonin and insulin highlights its influence in regulating insulin secretion, its action, and melatonin treatment successfully improved glucose homeostasis, energy balance, and overall health in diabetes mellitus. Melatonin's cytoprotective role as an antioxidant and free radical scavenger, proved useful in combating oxidative stress, preserving beta-cell function, and influencing the development of diabetic complications.

CONCLUSION

The therapeutic application of melatonin as a chronobiotic and cytoprotective agent is of promising significance in diabetes mellitus. Future investigations are encouraged to fully explore the efficacy of this ubiquitous molecule in various metabolic disorders.

摘要

目的

糖尿病是一种复杂的代谢紊乱疾病,其特征是由于各种代谢途径的失调和失衡导致血糖升高。近年来,昼夜节律失调(由于睡眠/觉醒、进食/禁食周期改变)与糖尿病的发生密切相关。在此,我们回顾了关于氧化应激、昼夜节律对代谢的控制及其破坏对体内平衡的影响的知识,同时强调褪黑素(一种夜间分泌达到峰值的松果体激素)作为预防和治疗糖尿病的潜在治疗药物的重要性。

方法

系统检索PubMed数据库中的相关文章和各类研究数据,包括临床试验、综述文章和病例报告,不限于某一特定类别。

结果

实验和流行病学证据表明,褪黑素通过使昼夜节律重新同步化,在中间代谢中具有多方面的作用,其缺乏与代谢紊乱有关。作为一种时间生物学药物,它可治愈由轮班工作或时差反应引起的失眠和睡眠障碍。褪黑素与胰岛素之间的拮抗关系突出了其在调节胰岛素分泌方面的影响,其作用以及褪黑素治疗成功改善了糖尿病患者的血糖稳态、能量平衡和整体健康状况。褪黑素作为抗氧化剂和自由基清除剂的细胞保护作用,在对抗氧化应激、维持β细胞功能以及影响糖尿病并发症的发展方面被证明是有用的。

结论

褪黑素作为一种时间生物学药物和细胞保护剂的治疗应用在糖尿病中具有有前景的意义。鼓励未来的研究充分探索这种普遍存在的分子在各种代谢紊乱中的疗效。

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本文引用的文献

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Melatonin: Clinical Perspectives in Neurodegeneration.褪黑素:神经退行性变的临床视角
Front Endocrinol (Lausanne). 2019 Jul 16;10:480. doi: 10.3389/fendo.2019.00480. eCollection 2019.
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Pleiotropic Effects of Melatonin.褪黑素的多效性作用
Drug Res (Stuttg). 2019 Feb;69(2):65-74. doi: 10.1055/a-0656-6643. Epub 2018 Jul 30.
7
Economic Costs of Diabetes in the U.S. in 2017.2017 年美国糖尿病的经济成本。
Diabetes Care. 2018 May;41(5):917-928. doi: 10.2337/dci18-0007. Epub 2018 Mar 22.
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Protective effect of melatonin in the diabetic rat retina.褪黑素对糖尿病大鼠视网膜的保护作用。
Fundam Clin Pharmacol. 2018 Aug;32(4):414-421. doi: 10.1111/fcp.12361. Epub 2018 Apr 2.

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