Melatonin for the treatment of spinal cord injury

Neural Regeneration Research, 2018 · DOI: 10.4103/1673-5374.238603 · Published: October 1, 2018

Spinal Cord Injury Endocrinology Neurology

Simple Explanation

Spinal cord injury (SCI) can severely impair sensory and motor function, often leading to paralysis. Melatonin, a hormone primarily secreted by the pineal gland, has shown promise in preclinical studies for treating SCI due to its antioxidative, antiapoptotic, neuroprotective, and anti-inflammatory properties. The review explores how melatonin's neuroprotective qualities and potential mechanisms might benefit SCI treatment. It also discusses combining melatonin with exercise, oxytetracycline, and dexamethasone to lessen secondary damage after SCI and limit possible adverse effects. Finally, the review considers how the level of spinal injury could impact melatonin secretion. It suggests melatonin replacement therapy may improve sleep in patients with tetraplegia.

Study Duration

Not specified

Participants

Animal models (rats, mice, rabbits)

Evidence Level

Review of preclinical studies

Key Findings

1
Melatonin has antioxidative properties, which help reduce oxidative stress and damage to neurons during the progress of SCI by regulating levels of MDA, GSH and SOD.
2
Melatonin reduces inflammation by decreasing the expression and release of proinflammatory mediators, preventing secondary inflammatory response and tissue damage after SCI.
3
Melatonin promotes BSCB repair and neurologic recovery and reverses the decrease of neuroplasticity-associated proteins after SCI.

Research Summary

This review discusses the therapeutic potential and underlying mechanisms of melatonin for the treatment of SCI, including its antioxidative, anti-inflammatory, and antiapoptotic effects. Melatonin's beneficial effects have been demonstrated in multiple animal models of SCI. It regulates iNOS, inhibits pro-inflammatory cytokines, repairs injured blood vessels, improves edema, and inhibits cell autophagy. Future clinical studies are needed to validate the major findings in animal studies related to the therapeutic effects of melatonin and to clarify the cellular and molecular mechanisms that underlie these effects.

Practical Implications

Therapeutic Potential

Melatonin shows promise as a therapeutic agent for SCI due to its neuroprotective properties.

Combination Therapies

Combining melatonin with other treatments (e.g., exercise, dexamethasone) may enhance its therapeutic effects.

Personalized Treatment

The level of spinal injury may influence melatonin secretion, suggesting the need for personalized treatment approaches.

Study Limitations

1
The clinical relevance of previous findings in animal SCI models remains obscure.
2
Additional studies are needed to determine whether sex differences exist in the efficacy, therapeutic features, and mechanisms of action of melatonin.
3
Future studies are also needed to clarify the cellular and molecular mechanisms that underlie the therapeutic effects of melatonin.

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