Melatonin for the treatment of sepsis: the scientific rationale

Journal of Thoracic Disease
Ruben Manuel Luciano Colunga BiancatelliPaul E Marik

Abstract

Sepsis affects 30 million people worldwide, leading to 6 million deaths every year (WHO), and despite decades of research, novel initiatives are drastically needed. According to the current literature, oxidative imbalance and mitochondrial dysfunction are common features of septic patients that can cause multiorgan failure and death. Melatonin, alongside its traditionally accepted role as the master hormonal regulator of the circadian rhythm, is a promising adjunctive drug for sepsis through its anti-inflammatory, antiapoptotic and powerful antioxidant properties. Several animal models of sepsis have demonstrated that melatonin can prevent multiorgan dysfunction and improve survival through restoring mitochondrial electron transport chain (ETC) function, inhibiting nitric oxide synthesis and reducing cytokine production. The purpose of this article is to review the current evidence for the role of melatonin in sepsis, review its pharmacokinetic profile and virtual absence of side effects. While clinical data is limited, we propose the adjunctive use of melatonin is patients with severe sepsis and septic shock.

Citations

Jul 1, 2020·Journal of Pineal Research·Somanathapura K NaveenKumarKesturu S Girish
Jun 24, 2020·Frontiers in Medicine·Russel J ReiterAlberto Dominguez-Rodriguez
Dec 16, 2020·Journal of Intensive Care Medicine·Pierre KoryPaul E Marik
Jan 23, 2021·Healthcare·Alina DimaMariana Jinga
Nov 11, 2020·Antioxidants·Nadia FerlazzoDaniela Caccamo
Dec 19, 2020·Comprehensive Reviews in Food Science and Food Safety·Karina Juhnevica-RadenkovaVitalijs Radenkovs
Jan 21, 2021·International Journal of Molecular Sciences·Russel J ReiterSergio Rosales-Corral
Jul 10, 2021·Journal of Clinical Laboratory Analysis·Hai-Yuan LuHai-Tao Jiang
Aug 28, 2021·International Journal of Molecular Sciences·Adam WichniakWiesław Jerzy Cubała
Aug 24, 2021·Advanced Therapeutics·Stephanie M KronstadtSteven M Jay

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