de la Fuente Alicia, Zagolín Mónica, Parra Víctor, Paz Adolfo A, González-Candia Alejandro, Cabrera Osvaldo, Olave Cristian, Bahamondes Constanza, Gaete María José, Gudenschwager Lodz, Rivas Javiera, Herrera Emilio A
Institute of Biomedical Sciences (ICBM), Faculty of Medicine Universidad de Chile Santiago Chile.
Instituto Nacional del Tórax (INT) Santiago Chile.
Pulm Circ. 2025 Jun 19;15(2):e70109. doi: 10.1002/pul2.70109. eCollection 2025 Apr.
Pulmonary arterial hypertension (PAH) Group 1 from the World Health Organization (WHO) is a rare, severe chronic, and progressive condition. Patients with PAH have increased oxidative stress (OS) and diminished antioxidant capacity. Melatonin is a potent antioxidant hormone with reported benefits in PAH animal models. We aimed to evaluate the functional, hemodynamic, and antioxidant response to a 6-month melatonin therapy in PAH Group 1 patients. Clinical evaluation was done at baseline (BT), as well as at 3 (T3) and 6 (T6) months of melatonin treatment in stable PAH Group 1 (WHO) patients. The principal endpoint was change in walking distance (WD) in the 6-min walking test (6MWT). Secondary endpoints were functional class (FC), quality of life (QoL), performance of right ventricle (RV), and plasma antioxidant capacity. This study included 19 patients. They were mainly women in WHO FC II and III. A significant improvement was noticed in perception of dyspnea, palpitations, and fatigue in concordance with the QoL improvement in the physical domain after 6 months of melatonin. This was represented by a significant fall in the total score of the PAH-SYMPACT questionnaire. In addition, the baseline heart rate was lower at the T6 follow-up. No significant changes were seen in the echocardiographic variables. However, the biochemical analysis showed significative increases in plasma total antioxidant (2.94 ± 0.13 vs. 8.41 ± 0.19) and ferric reducing (191 ± 12 vs. 256 ± 17) capacities. Overall, oral melatonin treatment improved the plasma antioxidant capacity and the QoL in this pilot study.
世界卫生组织（WHO）肺动脉高压（PAH）第1组是一种罕见、严重的慢性进行性疾病。PAH患者氧化应激（OS）增加，抗氧化能力降低。褪黑素是一种有效的抗氧化激素，在PAH动物模型中已报道具有益处。我们旨在评估PAH第1组患者接受6个月褪黑素治疗后的功能、血流动力学和抗氧化反应。对稳定的PAH第1组（WHO）患者在基线（BT）以及褪黑素治疗3个月（T3）和6个月（T6）时进行临床评估。主要终点是6分钟步行试验（6MWT）中步行距离（WD）的变化。次要终点是功能分级（FC）、生活质量（QoL）、右心室（RV）功能和血浆抗氧化能力。本研究纳入了19名患者。他们主要是WHO功能分级II级和III级的女性。褪黑素治疗6个月后，与身体领域QoL改善一致，呼吸困难、心悸和疲劳的感知有显著改善。这表现为PAH-SYMPACT问卷总分显著下降。此外，T6随访时基线心率较低。超声心动图变量未见显著变化。然而，生化分析显示血浆总抗氧化能力（2.94±0.13对8.41±0.19）和铁还原能力（191±12对256±17）显著增加。总体而言，在这项初步研究中，口服褪黑素治疗改善了血浆抗氧化能力和QoL。
