Faculty of Medicine, Fayoum University, Fayoum, Egypt; Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, USA.
Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Biomed Pharmacother. 2023 Oct;166:115305. doi: 10.1016/j.biopha.2023.115305. Epub 2023 Aug 22.
Septic cardiomyopathy (SCM) is a common complication of sepsis contributing to high mortality rates. Its pathophysiology involves complex factors, including inflammatory cytokines, mitochondrial dysfunction, oxidative stress, and immune dysregulation. Despite extensive research, no effective pharmacological agent has been established for sepsis-induced cardiomyopathy. Melatonin, a hormone with diverse functions in the body, has emerged as a potential agent for SCM through its anti-oxidant, anti-inflammatory, anti-apoptotic, and cardioprotective roles. Through various molecular levels of its mechanism of action, it counterattacks the adverse event of sepsis. Experimental studies have mentioned that melatonin protects against many cardiovascular diseases and exerts preventive effects on SCM. Moreover, melatonin has been investigated in combination with other drugs such as antibiotics, resveratrol, and anti-oxidants showing synergistic effects in reducing inflammation, anti-oxidant, and improving cardiac function. While preclinical studies have demonstrated positive results, clinical trials are required to establish the optimal dosage, route of administration, and treatment duration for melatonin in SCM. Its safety profile, low toxicity, and natural occurrence in the human body provide a favorable basis for its clinical use. This review aims to provide an overview of the current evidence of the use of melatonin in sepsis-induced cardiomyopathy (SICM). Melatonin appears to be promising as a possible treatment for sepsis-induced cardiomyopathy and demands further investigation.
脓毒症性心肌病（SCM）是脓毒症的常见并发症，导致高死亡率。其病理生理学涉及复杂的因素，包括炎症细胞因子、线粒体功能障碍、氧化应激和免疫失调。尽管进行了广泛的研究，但尚未确定针对脓毒症性心肌病的有效药物治疗。褪黑素作为一种在体内具有多种功能的激素，通过其抗氧化、抗炎、抗凋亡和心脏保护作用，成为 SCM 的潜在治疗药物。通过其作用机制的各种分子水平，它对抗脓毒症的不良事件。实验研究表明，褪黑素可预防多种心血管疾病，并对 SCM 发挥预防作用。此外，褪黑素已与抗生素、白藜芦醇和抗氧化剂等其他药物联合进行了研究，在减轻炎症、抗氧化和改善心功能方面显示出协同作用。虽然临床前研究已经取得了积极的结果，但仍需要进行临床试验来确定褪黑素在 SCM 中的最佳剂量、给药途径和治疗持续时间。其安全性好、毒性低、在人体内自然存在，为其临床应用提供了有利基础。本综述旨在概述褪黑素在脓毒症性心肌病（SICM）中的应用的现有证据。褪黑素似乎是治疗脓毒症性心肌病的一种有希望的方法，需要进一步研究。
