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Saturday, 14 December 2013

The Effects of Hormone Melatonin (N-acetyl-5-methoxytryptamine) (2)

Melatonin, also known as N-acetyl-5-methoxytryptamine, a hormone secreted by the pineal gland in the brain with functions of regulating sleep cycles, other hormones, timing in secretion of female hormones that affect the menstrual cycle, etc. The levels of the circulating hormone vary in a daily cycle, depending to the circadian rhythm is an internal 24-hour “clock”.
11.Melatonin and circadian rhythms and sleep
melatonin is an internal sleep "facilitator" in humans, and therefore useful in the treatment of insomnia and the readjustment of circadian rhythms. In the study of Role of melatonin in the regulation of human circadian rhythms and sleep, researchers found that administration of melatonin is able: (i) to induce sleep when the homeostatic drive to sleep is insufficient; (ii) to inhibit the drive for wakefulness emanating from the circadian pacemaker; and (iii) induce phase shifts in the circadian clock such that the circadian phase of increased sleep propensity occurs at a new, desired time(11).

12. Melatonin in the treatment of cancer
In a systematic review of randomized controlled trials between 1992 and 2003 and included 643 patients. All trials included solid tumor cancers. All trials were conducted at the same hospital network, and were unblinded. Melatonin reduced the risk of death at 1 yr (relative risk: 0.66, 95% confidence interval: 0.59-0.73, I2=0%, heterogeneity P<or=0.56). Effects were consistent across melatonin dose, and type of cancer. No severe adverse events were reported, according to the report of the Department of Clinical Epidemiology, McMaster University(12). Others suggested that Melatonin is effective in suppressing neoplastic growth in a variety of tumors like melanoma, breast and prostate cancer, and ovarian and colorectal cancer. As an adjuvant therapy, melatonin can be beneficial in treating patients suffering from breast cancer, hepatocellular carcinoma or melanoma(12a).

13. Melatonin in oral health and disease
According to the study of Faculty of Dentistry, Zonguldak Karaelmas University, melatonin has immunomodulatory and antioxidant activities, stimulates the proliferation of collagen and osseous tissue, and acts as a protector against cellular degeneration associated with aging and toxin exposure. Arising out of its antioxidant actions, melatonin protects against inflammatory processes and cellular damage caused by the toxic derivates of oxygen. As a result of these actions, melatonin may be useful as a coadjuvant in the treatment of certain conditions of the oral cavity. However, the most important effect of melatonin seems to result from its potent antioxidant, immunomodulatory, protective, and anticancer properties. Thus, melatonin could be used therapeutically for instance, locally, in the oral cavity damage of mechanical, bacterial, fungal, or viral origin, in postsurgical wounds caused by tooth extractions and other oral surgeries. Additionally, it can help bone formation in various autoimmunological disorders such as Sjorgen syndrome, in periodontal diseases, in toxic effects of dental materials, in dental implants, and in oral cancers(13). Other researchers suggested that strong reductions of circulating melatonin are also observed in numerous disorders and diseases, including Alzheimer's disease, various other neurological and stressful conditions, pain, cardiovascular diseases, cases of cancer, endocrine and metabolic disorders, in particular diabetes type 2(14). Clinical trials have shown that melatonin is efficient in preventing cell damage under acute (sepsis, asphyxia in newborns) and chronic states (metabolic and neurodegenerative diseases, cancer, inflammation, aging). The beneficial effects of melatonin can be explained by its properties as a potent antioxidant and antioxidant enzyme inducer, a regulator of apoptosis and a stimulator of immune functions(15).

16. Melatonin and cancer theapies
In the searched 7 databases: MEDLINE (1966-February 2010), AMED (1985-February 2010), Alt HealthWatch (1995-February 2010), CINAHL (1982-February 2010), Nursing and Allied Health Collection: Basic (1985-February 2010), the Cochrane Database (2009), and the Chinese database CNKI (1979-February 2010). They included all trials that randomized patients to treatment, including MLT or a similar control group without MLT, researchers found that MLT may benefit cancer patients who are also receiving chemotherapy, radiotherapy, supportive therapy, or palliative therapy by improving survival and ameliorating the side effects of chemotherapy(16). Others found that the administration of melatonin alone or in combination with interleukin-2 in conjunction with chemoradiotherapy and/or supportive care in cancer patients with advanced solid tumors, has been associated with improved outcomes of tumor regression and survival. Moreover, chemotherapy has been shown to be better tolerated in patients treated with melatonin(17).

18.  Melatonin and breast cancer prevention
In the reviews the usefulness of this indoleamine for specific aspects of breast cancer management, particularly in reference to melatonin's antiestrogenic and antioxidant properties, found that the clinical utility of melatonin depends on the appropriate identification of its actions. Because of its SERM (selective estrogen receptor modulators) and SEEM (selective estrogen enzyme modulators) properties, and its virtual absence of contraindications, melatonin could be an excellent adjuvant with the drugs currently used for breast cancer prevention (antiestrogens and antiaromatases)(18).

19. Melatonin in Children
In children and neonates, melatonin has been used widely, including for respiratory distress syndrome, bronchopulmonary dysplasia, periventricular leukomalacia (PVL), hypoxia-ischemia encephalopathy and sepsis. In addition, melatonin can be used in childhood sleep and seizure disorders, and in neonates and children receiving surgery, according to the study by Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine(19).

20. Shift work and cancer risk
About 15-20% of the employees in Europe and in the USA are engaged in shift work that involves night work. In the review of disruption in the melatonin synthesis and its effects on shift workers found that in six out of ten studies, a statistically significant association between night shift work and risk of breast cancer has been shown (OR = 2.2; 95% CI: 1.1-4.5 in nurses in Norway with > 30 years of night shift work). The increased cancer risk has been reported in nurses, radio-telephone operators, flight attendants, and women employed in the enterprises, in which 60% of employees work at night. Most of the analyses have been based on the data from the registries, with limited potential for the exposure assessment and confounders adjustment(20).
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Sources
(11) http://www.ncbi.nlm.nih.gov/pubmed/12622846
(12) http://www.ncbi.nlm.nih.gov/pubmed/16207291 
(12a) http://www.ncbi.nlm.nih.gov/pubmed/22074586
(13) http://www.ncbi.nlm.nih.gov/pubmed/22792106
(14) http://www.ncbi.nlm.nih.gov/pubmed/22724080
(15) http://www.ncbi.nlm.nih.gov/pubmed/22511571
(16) http://www.ncbi.nlm.nih.gov/pubmed/22019490
(17) http://www.ncbi.nlm.nih.gov/pubmed/22753734
(18) http://www.ncbi.nlm.nih.gov/pubmed/22500582
(19) http://www.ncbi.nlm.nih.gov/pubmed/22370283
(20) http://www.ncbi.nlm.nih.gov/pubmed/21870422