Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Molecules. 2021 Feb 4;26(4):811. doi: 10.3390/molecules26040811.
Carotid artery stenosis (CAS) is an atherosclerotic disease characterized by a narrowing of the artery lumen and a high risk of ischemic stroke. Risk factors of atherosclerosis, including smoking, hypertension, hyperglycemia, hyperlipidemia, aging, and disrupted circadian rhythm, may potentiate atherosclerosis in the carotid artery and further reduce the arterial lumen. Ischemic stroke due to severe CAS and cerebral ischemic/reperfusion (I/R) injury after the revascularization of CAS also adversely affect clinical outcomes. Melatonin is a pluripotent agent with potent anti-inflammatory, anti-oxidative, and neuroprotective properties. Although there is a shortage of direct clinical evidence demonstrating the benefits of melatonin in CAS patients, previous studies have shown that melatonin may be beneficial for patients with CAS in terms of reducing endothelial damage, stabilizing arterial plaque, mitigating the harm from CAS-related ischemic stroke and cerebral I/R injury, and alleviating the adverse effects of the related risk factors. Additional pre-clinical and clinical are required to confirm this speculation.
颈动脉狭窄（CAS）是一种动脉粥样硬化性疾病，其特征为动脉管腔狭窄和发生缺血性脑卒中的风险较高。动脉粥样硬化的危险因素，包括吸烟、高血压、高血糖、高血脂、衰老和昼夜节律紊乱等，可能会使颈动脉中的动脉粥样硬化恶化，并进一步使动脉管腔变窄。严重的 CAS 导致的缺血性脑卒中以及 CAS 血管再通后的脑缺血/再灌注（I/R）损伤也会对临床结局产生不利影响。褪黑素是一种具有多种功能的药物，具有强大的抗炎、抗氧化和神经保护作用。尽管目前直接的临床证据表明褪黑素对 CAS 患者有益，但先前的研究表明，褪黑素可能对 CAS 患者有益，可减轻内皮损伤、稳定动脉斑块、减轻 CAS 相关缺血性脑卒中及脑 I/R 损伤的危害，并缓解相关危险因素的不良影响。需要更多的临床前和临床研究来证实这一推测。
