Open AccessMelatonin for the treatment of sepsis: the scientific rationale
Author(s) -
Ruben Manuel Luciano Colunga Biancatelli,
Max Berrill,
Yassen H. Mohammed,
Paul E. Marik
Publication year - 2020
Publication title -
journal of thoracic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2019.12.85
Subject(s) - melatonin , sepsis , medicine , septic shock , intensive care medicine , adjunctive treatment , organ dysfunction , shock (circulatory) , bioinformatics , nitric oxide , pharmacology , immunology , biology
Sepsis affects 30 million people worldwide, leading to 6 million deaths every year (WHO), and despite decades of research, novel initiatives are drastically needed. According to the current literature, oxidative imbalance and mitochondrial dysfunction are common features of septic patients that can cause multiorgan failure and death. Melatonin, alongside its traditionally accepted role as the master hormonal regulator of the circadian rhythm, is a promising adjunctive drug for sepsis through its anti-inflammatory, antiapoptotic and powerful antioxidant properties. Several animal models of sepsis have demonstrated that melatonin can prevent multiorgan dysfunction and improve survival through restoring mitochondrial electron transport chain (ETC) function, inhibiting nitric oxide synthesis and reducing cytokine production. The purpose of this article is to review the current evidence for the role of melatonin in sepsis, review its pharmacokinetic profile and virtual absence of side effects. While clinical data is limited, we propose the adjunctive use of melatonin is patients with severe sepsis and septic shock.