Melatonin preconditioning of bone marrow-derived mesenchymal stem cells promotes their engraftment and improves renal regeneration in a rat model of chronic kidney disease

Bone marrow-derived mesenchymal stem cells (BMMSCs) transplantation has shown to be effective in treating chronic kidney disease. However, the effectiveness of this strategy is constrained by low homing and survival rate of transplanted cells in the injured organs. Therefore, developing strategies to improve homing and cell survival rate and therapeutic potential in cell-based therapies seems necessary. The purpose of this study is to evaluate the effect of pretreating BMMSCs with melatonin (MT) on the prosurvival and renoprotective of transplanted cells into the irreversible model of unilateral ureteral obstruction. Adult male Sprague-Dawley rats were randomized into four groups: Sham, UUO, UUO + BMMSCs, and UUO + BMMSCs + MT. The results of our study demonstrated that preconditioning with MT enhanced homing of BMMSCs into the injured kidney. MT reduced the number of TUNEL positive transplanted cells in the UUO + BMMSCs + MT group. The UUO + BMMSCs + MT group showed lower expressions of TGF-β1, α-SMA and TNF-α at both gene and protein levels but higher expression of E-cadherin compared with the UUO + BMMSCs group. In addition, MT preconditioned BMMSCs ameliorated basement membrane disruption and histological status of injured renal tubules and also reduced fibrosis in damaged kidneys. In conclusion, our results show that stem cells pretreated by MT may represent a feasible approach for improving the beneficial effects of stem cell therapy and significantly enhance their survival after transplantation to the injured kidney.

[Melatonin in the treatment of low back pain and predictors of its efficacy]

AIM

To assess analgesic properties of melatonin in the treatment of chronic non-specific low back pain and to study predictors of its efficacy.

MATERIAL AND METHODS

A study included 178 patients, aged from 40 to 65 years, with chronic non-specific low back pain during >3 month and the VAS score >3. Patients were stratified into 6 groups (3 pairs of comparison). In the first pair, patients of both groups received a combination of 500 mg of glucosamine hydrochloride and 500 mg of chondroitin sulfate; in the second pair - a combination of 500 mg of glucosamine hydrochloride and 500 mg of chondroitin sulfate and diclofenac, in the third pair - diclofenac. All patients received additionally melaxen. The duration of the study was 3 month in the first pair and one month in the second and third pairs. With regard to response to melatonin, patients of the main groups were divided into responders and non-responders. Baseline factors determining the efficacy of treatment with melatonin were studied.

RESULTS AND CONCLUSION

A significant reduction in pain intensity at movement and resting state was noted in all main groups compared to comparison groups. This result indicates possible analgesic properties of melatonin. Moreover, factors predicting the efficacy of such therapy were determined. Addition of melatonin to the standard scheme of low back pain treatment increases its efficacy, in particular in case of comorbidity of pain and sleep disorders and depressive symptoms.

Melatonin in Chronic Pain Syndromes

Melatonin is a neurohormone secreted by epiphysis and extrapineal structures. It performs several functions including chronobiotic, antioxidant, oncostatic, immune modulating, normothermal, and anxiolytic functions. Melatonin affects the cardiovascular system and gastrointestinal tract, participates in reproduction and metabolism, and body mass regulation. Moreover, recent studies have demonstrated melatonin efficacy in relation to pain syndromes. The present paper reviews the studies on melatonin use in fibromyalgia, headaches, irritable bowel syndrome, chronic back pain, and rheumatoid arthritis. The paper discusses the possible mechanisms of melatonin analgesic properties. On one hand, circadian rhythms normalization results in sleep improvement, which is inevitably disordered in chronic pain syndromes, and activation of melatonin adaptive capabilities. On the other hand, there is evidence of melatonin-independent analgesic effect involving melatonin receptors and several neurotransmitter systems.

[Melatonin in chronic pain syndromes]

Melatonin, a neurohormone synthesized by the epiphysis and extrapineal structures, has several functions including chronobiotic, antioxidant, oncostatic, immunomodulating, normothymic and anxiolytic ones. It impacts on the cardiovascular system and the gastrointestinal tract and is involved in reproductive functions, metabolism and body mass regulation. Moreover, recent studies have demonstrated the efficacy of melatonin in pain syndromes. The authors present a literature review on the studies of melatonin in treatment of fibromyalgia, headache, irritated bowel syndrome, chronic back pain and rheumatoid arthritis. Possible mechanisms of analgesic properties of melatonin are discussed. On one hand, there is the improvement of sleep and activation of own adaptive potential of melatonin by normalizing circadian rhythms inevitably disturbed in chronic pain syndromes. On the other hand, there are the data on the analgesic effect of melatonin realized through melatonin receptors and several neurotransmitter systems.