1
|
Pérez-Lloret S, Cardinali DP. Melatonin as a Chronobiotic and Cytoprotective Agent in Parkinson's Disease. Front Pharmacol 2021; 12:650597. [PMID: 33935759 PMCID: PMC8082390 DOI: 10.3389/fphar.2021.650597] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/10/2021] [Indexed: 12/16/2022] Open
Abstract
This article discusses the role that melatonin may have in the prevention and treatment of Parkinson’s disease (PD). In parkinsonian patients circulating melatonin levels are consistently disrupted and the potential therapeutic value of melatonin on sleep disorders in PD was examined in a limited number of clinical studies using 2–5 mg/day melatonin at bedtime. The low levels of melatonin MT1 and MT2 receptor density in substantia nigra and amygdala found in PD patients supported the hypothesis that the altered sleep/wake cycle seen in PD could be due to a disrupted melatonergic system. Motor symptomatology is seen in PD patients when about 75% of the dopaminergic cells in the substantia nigra pars compacta region degenerate. Nevertheless, symptoms like rapid eye movement (REM) sleep behavior disorder (RBD), hyposmia or depression may precede the onset of motor symptoms in PD for years and are index of worse prognosis. Indeed, RBD patients may evolve to an α-synucleinopathy within 10 years of RBD onset. Daily bedtime administration of 3–12 mg of melatonin has been demonstrated effective in RDB treatment and may halt neurodegeneration to PD. In studies on animal models of PD melatonin was effective to curtail symptomatology in doses that allometrically projected to humans were in the 40–100 mg/day range, rarely employed clinically. Therefore, double-blind, placebo-controlled clinical studies are urgently needed in this respect.
Collapse
Affiliation(s)
- Santiago Pérez-Lloret
- Universidad Abierta Interamericana-Centro de Altos Estudios en Ciencias Humanas y de La Salud, Consejo Nacional de Investigaciones Científicas y Técnicas, UAI-CAECIHS. CONICET, Buenos Aires, Argentina.,Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Daniel P Cardinali
- Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| |
Collapse
|
2
|
Song J, Chu S, Fang X, Xu F, Zhang P, Zhao X, Ma Z, Xia T, Gu X. Time-restricted feeding alters isoflurane-induced memory deficits. Transl Neurosci 2020; 11:341-355. [PMID: 33335774 PMCID: PMC7718622 DOI: 10.1515/tnsci-2020-0130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 11/19/2022] Open
Abstract
Food consumption during the rest phase promotes circadian desynchrony, which is corrected with harmful physiological and mental disorders. Previously, we found that circadian desynchrony was involved in isoflurane-induced cognitive impairment. Here, we scheduled food access to modulate daily rhythm to examine its impact on isoflurane-induced cognitive impairments. Mice were randomly transferred to restricted feeding (RF) time groups: Control group (Zeitgeber time (ZT) 0–ZT24, ad libitum feeding), Day-Feeding group (ZT0–ZT12, misaligned feeding), and Night-Feeding group (ZT12–ZT24, aligned feeding). Then, some of them were subjected to 5 h of 1.3% isoflurane anaesthesia from ZT14 to ZT19 and were divided into the Control + Anes group, the Day-Feeding + Anes group, and the Night-Feeding + Anes group. Mini-Mitter was used to monitor the daily rhythm. Fear conditioning system was conducted to assess cognition of mice. We observed that the Night-Feeding group adapted to RF gradually, whereas the Day-Feeding group exhibited a disturbed daily rhythm. The Night-Feeding + Anes group exhibited a partially enhanced daily rhythm, whereas the Day-Feeding + Anes group exhibited sustained phase advances and diurnality score increase 7 days after isoflurane anaesthesia. Notably, in tests of hippocampus-dependent contextual memory, the Night-Feeding + Anes group demonstrated decreased deficits; the Day-Feeding + Anes group showed prolonged post-anaesthetic deficits 14 days after isoflurane anaesthesia. However, amygdala-dependent cued-fear conditioning post-anaesthesia was not altered by the RF schedule. In conclusion, we demonstrated that misaligned feeding disturbed the daily rhythm and led to persistent post-anaesthetic cognitive dysfunction. Aligned feeding enhanced the daily rhythm partially and improved post-anaesthetic cognitive dysfunction.
Collapse
Affiliation(s)
- Jia Song
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Shuaishuai Chu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Xin Fang
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Fangxia Xu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Peng Zhang
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Xin Zhao
- Department of Anesthesiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, No 30 Zhongyang Road, Nanjing, 210008, China
| | - Zhengliang Ma
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| | - Tianjiao Xia
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China.,Jiangsu Key Laboratory of Molecular Medicine, Nanjing University, Nanjing 210093, China
| | - Xiaoping Gu
- Department of Anesthesiology, Affiliated Drum Tower Hospital of Medical Department of Nanjing University, 321 Zhong Shan Road, Nanjing, Jiangsu 210008, P. R. China
| |
Collapse
|
3
|
Cardinali DP. Melatonin: Clinical Perspectives in Neurodegeneration. Front Endocrinol (Lausanne) 2019; 10:480. [PMID: 31379746 PMCID: PMC6646522 DOI: 10.3389/fendo.2019.00480] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 07/03/2019] [Indexed: 12/20/2022] Open
Abstract
Prevention of neurodegenerative diseases is presently a major goal for our Society and melatonin, an unusual phylogenetically conserved molecule present in all aerobic organisms, merits consideration in this respect. Melatonin combines both chronobiotic and cytoprotective properties. As a chronobiotic, melatonin can modify phase and amplitude of biological rhythms. As a cytoprotective molecule, melatonin reverses the low degree inflammatory damage seen in neurodegenerative disorders and aging. Low levels of melatonin in blood characterizes advancing age. In experimental models of Alzheimer's disease (AD) and Parkinson's disease (PD) the neurodegeneration observed is prevented by melatonin. Melatonin also increased removal of toxic proteins by the brain glymphatic system. A limited number of clinical trials endorse melatonin's potentiality in AD and PD, particularly at an early stage of disease. Calculations derived from animal studies indicate cytoprotective melatonin doses in the 40-100 mg/day range. Hence, controlled studies employing melatonin doses in this range are urgently needed. The off-label use of melatonin is discussed.
Collapse
|
4
|
Ruppert E, Kilic-Huck U. [Diagnosis and comorbidities of Circadian Rhythm Sleep Disorders]. Presse Med 2018; 47:969-976. [PMID: 30391268 DOI: 10.1016/j.lpm.2018.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 10/08/2018] [Indexed: 10/28/2022] Open
Abstract
Circadian rhythm sleep disorders (CRSD) result from a disturbed endogenous clock (intrinsic CRSD) or from a misalignment between the biological clock and an imposed environment (extrinsic CRSD). Among intrinsic CRSD, one distinguishes the delayed sleep-wake phase disorder, the advanced sleep-wake phase disorder, the irregular sleep-wake rhythm disorder and the non-24-hour sleep-wake rhythm disorder. Shift work disorder, jet lag disorder and circadian sleep-wake disorder not otherwise specified are extrinsic CRSD. Prevalences of the different CRSD remain largely unknown. Some CRSD are particularly frequent such as sleep delayed phase syndrome in adolescents. Overall, CRSD are probably under-diagnosed. CRSD generate insomnia and excessive daytime somnolence. A biological clock dysfunction has to be evoked in case of insomnia or sleepiness. Furthermore, as CRSD can overlap with other sleep disorders, their diagnosis and treatment are essential. CRSD cause significant mental, physical or socio-professional sufferings. They are frequently associated with comorbidities, mainly neurodevelopmental, psychiatric and neurodegenerative disorders. Regarding neurodevelopmental comorbidities, therapy using a chronobiological approach is complementary to the usual clinical care. It helps to limit the significant impact of CRSD on quality of live, daytime functioning, social interactions and neurocognitive difficulties in the children. In psychiatry, sleep disorders and circadian rhythms sleep-wake disorders are a factor of vulnerability, of suicidal risk, of relapse and pharmacoresistance. Thus, diagnosis of CRSD associated with a psychiatric disorder is of major importance. Treatment using a chronobiological approach reinforcing the entrainment of the sleep-wake cycle is complementary to usual treatments. Sleep disorders and circadian sleep-wake rhythm disorders can be a preclinical sign of Alzheimer's and Parkinson's disease. In the elderly, a beginning neurodegenerative disorder can be associated with a CRSD and complaints of sleepiness, nocturnal awakenings and/or irregular sleep-wake cycles. Patients affected by neurogenerative disorders are particularly vulnerable for having CRSD. Data from different studies suggest that CRSD participate in pathophysiology of Alzheimer's disease. Even though treatment of CRSD associated with neurodegenerative disorders is entirely part of the treatment strategy, it remains uncertain to which extend this treatment may impact disease progression.
Collapse
Affiliation(s)
- Elisabeth Ruppert
- Hôpital Civil, centre des troubles du sommeil-CIRCSom, département neurologique, 1, place de l'Hôpital, 67091 Strasbourg, France; Université de Strasbourg, institut des neurosciences cellulaires et intégratives, CNRS - UPR 3212, 5, rue Blaise-Pascal, 67000 Strasbourg, France.
| | - Ulker Kilic-Huck
- Hôpital Civil, centre des troubles du sommeil-CIRCSom, département neurologique, 1, place de l'Hôpital, 67091 Strasbourg, France; Université de Strasbourg, institut des neurosciences cellulaires et intégratives, CNRS - UPR 3212, 5, rue Blaise-Pascal, 67000 Strasbourg, France
| | | |
Collapse
|
5
|
Willis GL, Boda J, Freelance CB. Polychromatic Light Exposure as a Therapeutic in the Treatment and Management of Parkinson's Disease: A Controlled Exploratory Trial. Front Neurol 2018; 9:741. [PMID: 30778331 PMCID: PMC6156259 DOI: 10.3389/fneur.2018.00741] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 08/14/2018] [Indexed: 12/11/2022] Open
Abstract
Parkinson's disease (PD) is a disorder characterized by loss of dopamine (DA) in the nigro-striatal dopamine (NSD) system with the primary symptoms of bradykinaesia, rigidity, tremor, and altered gate. Secondary symptoms including depression, insomnia, involuntary movement, and psychiatric side effects are also commonly observed. While the treatment focus for the past 50 years has been aimed at replacing deficient DA, to relieve the primary symptoms, more recent studies have suggested that the circadian system plays a critical role in the etiology and treatment of this disorder. Several case studies and open label trials have implemented bright light therapy (BT) in an attempt to repair sleep, depression and even the primary motor symptoms of this disorder, however controlled studies are yet to be fully implemented. In this controlled trial, patients that had been maintained on BT daily for 4 months to 5 years previously were assigned to one of three groups: continued polychromatic light, continued with red light or discontinued polychromatic light for a 2 week period. The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDSUPDRS), The Parkinson's Disease Questionnaire (PDQ-39), The Beck Depression Inventory II, The Beck Anxiety Inventory, The Epworth Sleep Scale (ESS) and a global rating scale were used to assess patients prior to and at 1 and 2 weeks after commencing the trial. Patients continuing polychromatic BT showed significant improvement on the MDSUPDRS Rating Scale (12 points; p = 0.028), the PDQ-39 (10 points; p = 0.011), ESS (4 points; p = 0.013), and numerous motor and secondary symptoms on a global rating scale. Performance on standardized motor tests also incrementally improved in this group while those exposed to red light and those that discontinued BT treatment deteriorated. These results demonstrate that strategically applied polychromatic light was beneficial in reducing many primary motor and secondary symptoms of PD. Further work investigating the role of light in mitigating PD symptoms and involvement of the circadian system will provide further advances in the treatment of PD. Clinical Trial Registration: http://www.anzctr.org.au, identifier ACTRN12617001309370.
Collapse
Affiliation(s)
- Gregory L Willis
- The Bronowski Institute of Behavioural Neuroscience, The Bronowski Clinic, Coliban Medical Centre, Kyneton, VIC, Australia
| | - Jamilee Boda
- The Bronowski Institute of Behavioural Neuroscience, The Bronowski Clinic, Coliban Medical Centre, Kyneton, VIC, Australia
| | - Christopher B Freelance
- The Bronowski Institute of Behavioural Neuroscience, The Bronowski Clinic, Coliban Medical Centre, Kyneton, VIC, Australia
| |
Collapse
|
6
|
Zhu C, Huang Q, Zhu H. Melatonin Inhibits the Proliferation of Gastric Cancer Cells Through Regulating the miR-16-5p-Smad3 Pathway. DNA Cell Biol 2018; 37:244-252. [PMID: 29359963 DOI: 10.1089/dna.2017.4040] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The incidence and mortality of gastric cancer is steadily increasing annually around the world, which required further investigation about alternative therapy strategies. Melatonin, an indoleamine synthesized in the pineal gland, has shown dramatic anticancer effect in several cancers, however, the function of melatonin in gastric cancer needs to be characterized. In this study, we found that melatonin inhibited the growth and induced apoptosis of gastric cancer cells. microRNAs (miRNAs) have been attractive targets for many anticancer drugs. To explore the underlying molecular mechanism by which melatonin attenuated the growth of cancer cells, miRNA microarray analysis was performed to screen the miRNAs, which significantly altered after melatonin treatment. The result showed that melatonin administration enhanced the expression of miR-16-5p. Further molecular mechanism research revealed that miR-16-5p targeted Smad3 and consequently negatively regulated the abundance of Smad3. Consistently, melatonin exposure decreased the level of Smad3 and overexpression of Smad3 attenuated the inhibitory effect of melatonin in gastric cancer cells. These results uncovered the anticancer effect of melatonin and highlighted the critical roles of miR-16-5p-Smad3 pathway in melatonin-induced growth defects of gastric cancers.
Collapse
Affiliation(s)
- Chenyu Zhu
- 1 Gastrointestinal Surgery, The First College of Clinical Medical Science, China Three Gorges University , Yi Chang, China
| | - Qun Huang
- 2 Operating Room, The First College of Clinical Medical Science, China Three Gorges University , Yi Chang, China
| | - Hongyu Zhu
- 3 Gynecology Department, The First College of Clinical Medical Science, China Three Gorges University , Yi Chang, China
| |
Collapse
|