Effects of melatonin supplementation on serum oxidative stress markers and disease activity in systemic lupus erythematosus patients: A randomised, double‐blind, placebo‐controlled trial

Abstract

Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease identified by the presence of autoantibodies. 1 SLE is marked by phases of remission and exacerbation and has different symptoms such as arthritis, skin lesions, nephritis, serositis, and nervous system symptoms. 1 SLE mainly affects women of child-bearing age. 1 SLE has multifactorial etiology including genetic, hormonal, and environmental factors that leads to immune dysfunction. 1 Recently, it has been indicated that free radical damage and oxidative stress has a remarkable function in SLE pathogenesis. 2 Oxidative stress causes T helper 17/regulatory T (Th17/Treg) cells imbalance in SLE subjects. Under normal situation, Th17 and Treg cells are in balance, whilst oxidative stress generated in SLE can stimulate and increase proinflammatory Th17 cells and suppresses anti-inflammatory Treg cells, thereby exacerbating autoimmune injury. 3 Moreover, oxidative stress can lead to abnormal activation of apoptosis and delay in the apoptotic bodies clearance. This delay in clearance of apoptotic cells

Oxidative Stress Contributes to Inflammatory and Cellular Damage in Systemic Lupus Erythematosus: Cellular Markers and Molecular Mechanism

“… 12 Any disruption to the oxidant/antioxidant equilibrium in autoimmune diseases by either endogenous or exogenous toxic substances incites an aberrant innate and adaptative immune response with a continuing supply of autoantigens. 13 Some translational investigations 1 , 14 , 15 have associated oxidative stress with the pathogenesis of SLE. High levels of oxidative and nitrosative stress have been detected in individuals with active SLE.…”

“… 60 Melatonin supplementation was discovered to reduce cytokine production and dampen oxidative stress without downregulating disease activity in SLE patients, probably via affecting the NF-kβ signaling pathway. 14 Reputed to be effective agents against oxidative stress-induced tissular injuries, synthetic triterpenoids are able to block selected signaling pathways like STAT-3 in immune cells and promote Nrf2 pathway activation, thereby inhibiting oxidative stress and the formation of LN in mice. 75 , 92 Though the precise therapeutic mechanisms have not yet been exhaustively addressed, antioxidant drugs are well-positioned to become an auxiliary therapy for the treatment of SLE, which are shown in Table 3 .…”

Sleep Disorders in Connective Tissue Diseases—Coexisting Diseases or Disease Components?

“…For instance, Liu et al discovered an improvement in the function of salivary glands and reduced inflammation in an animal model of primary Sjögren's syndrome after melatonin administration [60]. Similarly, in SLE, melatonin was associated with decreased oxidative stress parameters, specifically serum malondialdehyde levels; however, no beneficial effect on disease activity was described [61]. Thus, further randomized control trials are required to prove the beneficial effect of melatonin on autoimmune disorders and related sleep issues.…”

Potential effects of shift work on skin autoimmune diseases

“…Stress mediators and melatonin may play a role in SLE ( 221 – 224 ), SSc ( 230 , 231 , 444 ), psoriasis ( 196 , 200 – 202 , 268 , 445 ), Sjögren’s syndrome ( 234 ), and vitiligo ( 203 , 209 ). A failure in the HPA-axis to control inflammation is discussed in autoimmune diseases ( 180 , 248 ) and glucocorticoids are widely used therapeutically as immunosuppressants.…”

“…Nabatian-Asl and colleagues were able to show that 10 mg/day melatonin supplementation for 12 weeks is reducing serum malondialdehyde, which is a marker for oxidative stress. Oxidative stress levels are known to correlate with SLE-activity ( 221 ). A recent systematic review by Carriedo-Diez and colleagues investigated melatonin supplementation in shift workers.…”