Xie Lei, Wu Hang, Huang Xiaohong, Yu Tengbo
Institute of Sports Medicine and Health, Qingdao University, Qingdao, China.
Department of Orthopedic Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China.
Front Cell Dev Biol. 2023 Aug 25;11:1218553. doi: 10.3389/fcell.2023.1218553. eCollection 2023.
Spinal cord injury (SCI) is a sudden onset of disruption to the spinal neural tissue, leading to loss of motor control and sensory function of the body. Oxidative stress is considered a hallmark in SCI followed by a series of events, including inflammation and cellular apoptosis. Melatonin was originally discovered as a hormone produced by the pineal gland. The subcellular localization of melatonin has been identified in mitochondria, exhibiting specific onsite protection to excess mitochondrial reactive oxygen species and working as an antioxidant in diseases. The recent discovery regarding the molecular basis of ligand selectivity for melatonin receptors and the constant efforts on finding synthetic melatonin alternatives have drawn researchers' attention back to melatonin. This review outlines the application of melatonin in SCI, including 1) the relationship between the melatonin rhythm and SCI in clinic; 2) the neuroprotective role of melatonin in experimental traumatic and ischemia/reperfusion SCI, i.e., exhibiting anti-oxidative, anti-inflammatory, and anti-apoptosis effects, facilitating the integrity of the blood-spinal cord barrier, ameliorating edema, preventing neural death, reducing scar formation, and promoting axon regeneration and neuroplasticity; 3) protecting gut microbiota and peripheral organs; 4) synergizing with drugs, rehabilitation training, stem cell therapy, and biomedical material engineering; and 5) the potential side effects. This comprehensive review provides new insights on melatonin as a natural antioxidant therapy in facilitating rehabilitation in SCI.
脊髓损伤（SCI）是脊髓神经组织突然受到破坏，导致身体运动控制和感觉功能丧失。氧化应激被认为是脊髓损伤的一个标志，随后会引发一系列事件，包括炎症和细胞凋亡。褪黑素最初被发现是由松果体产生的一种激素。褪黑素的亚细胞定位已在线粒体中得到确认，它对过量的线粒体活性氧具有特定的原位保护作用，并在疾病中发挥抗氧化剂的作用。最近关于褪黑素受体配体选择性分子基础的发现以及寻找合成褪黑素替代品的持续努力，使研究人员的注意力重新回到褪黑素上。这篇综述概述了褪黑素在脊髓损伤中的应用，包括：1）临床中褪黑素节律与脊髓损伤的关系；2）褪黑素在实验性创伤性和缺血/再灌注性脊髓损伤中的神经保护作用，即表现出抗氧化、抗炎和抗凋亡作用，促进血脊髓屏障的完整性，减轻水肿，防止神经死亡，减少瘢痕形成，促进轴突再生和神经可塑性；3）保护肠道微生物群和外周器官；4）与药物、康复训练、干细胞治疗和生物医学材料工程协同作用；5）潜在的副作用。这篇全面的综述为褪黑素作为一种天然抗氧化疗法促进脊髓损伤康复提供了新的见解。
