Melatonin, a natural antioxidant therapy in spinal cord injury

Frontiers in Cell and Developmental Biology, 2023 · DOI: 10.3389/fcell.2023.1218553 · Published: August 25, 2023

Spinal Cord Injury Endocrinology Neurology

Simple Explanation

Spinal cord injury (SCI) disrupts neural tissue, leading to loss of motor control and sensory function. Oxidative stress is a hallmark of SCI, followed by inflammation and apoptosis. Melatonin, an antioxidant, has shown promise in mitigating these effects. Melatonin, a hormone produced by the pineal gland, exhibits specific on-site protection against mitochondrial reactive oxygen species (ROS), working as an antioxidant. Researchers are exploring its potential as a natural antioxidant therapy for SCI rehabilitation. This review outlines the application of melatonin in SCI, focusing on its neuroprotective role, effects on gut microbiota and peripheral organs, synergistic potential with other therapies, and potential side effects. It aims to provide new insights on melatonin as a natural antioxidant therapy in SCI rehabilitation.

Study Duration

Not specified

Participants

Animal models (mouse, rat, and rabbit)

Evidence Level

Review

Key Findings

1
Melatonin maintains the integrity of the blood–spinal cord barrier (BSCB), reducing edema and neutrophil infiltration after traumatic SCI.
2
Melatonin inhibits neuronal death, promotes neuroplasticity, and prevents axonal degeneration and demyelination, contributing to functional restoration after SCI.
3
Melatonin attenuates oxidative stress by correcting the levels of MDA, GSH, SOD, NO, XO, TBARS, iNOS, and MPO, which benefits rehabilitation.

Research Summary

This review discusses the potential of melatonin as a natural antioxidant therapy for spinal cord injury (SCI). It highlights the relationship between melatonin rhythm and SCI, the neuroprotective role of melatonin in experimental SCI, its effects on gut microbiota and peripheral organs, and its synergistic potential with other therapies. Melatonin exhibits neuroprotective effects by maintaining the integrity of the blood-spinal cord barrier, preventing neural death, facilitating neuroplasticity, decreasing scar formation, and promoting axon regeneration. Melatonin, administered independently or synergistically with other treatments, aids in SCI by mitigating oxidative stress, neuroinflammation, and cellular apoptosis, ultimately leading to improved functional recovery and systemic recovery.

Practical Implications

Therapeutic Potential

Melatonin could be a valuable adjunct therapy for SCI, particularly in mitigating secondary injuries.

Combination Therapies

Exploring synergistic effects of melatonin with existing SCI treatments (e.g., methylprednisolone, exercise) may enhance outcomes.

Drug Development

The review highlights the need for further research into melatonin analogs and selective compounds for effective melatonergic therapy in SCI.

Study Limitations

1
The receptor-dependent mechanism is rarely mentioned, e.g., MT1 or MT2.
2
Potential rise of long-term melatonin exposure and the high dose of melatonin used in SCI
3
Bioavailability of exogenous melatonin is highly variable

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