Roles of melatonin in endometriosis

Melatonin as candidate therapeutic for endometriosis

Key Points

Highlight:

• Melatonin can regulate the reproductive system under physiological and pathological conditions.

Importance:

• Melatonin has essential roles in obstetrical and gynecological disorders and could be a candidate therapeutic drug for the regulation of inflammation.

What's done here:

• This systematic review article discusses the pleiotropic roles of melatonin in endometriosis, recurrent spontaneous abortion, and polycystic ovary syndrome.
• It explores melatonin in the context of pathological implications and treatment potential.

Data:

• Endometriosis pathogenesis is associated with oxidative stress, inflammation, and immune dysregulation.
• Melatonin plays pleiotropic and essential roles in endometriosis, recurrent spontaneous abortion, and polycystic ovary syndrome and would be a candidate therapeutic drug to regulate inflammation and immune function in these conditions.

Lay Summary

Melatonin is a neurohormone synthesized mainly by the pineal gland of mammals. It is controlled by the endogenous circadian clock located in brain hypothalamus. Melatonin is regulated by environmental light where the concentrations are low during the daytime and high at night. The physiological functions of melatonin include regulation of a variety of central and peripheral actions related to circadian rhythms and reproduction. It has a broad spectrum of effects including antioxidant, free radical scavenger, an anti-inflammatory agent, potential immunoregulator, anticarcinogenic effector, sleep inducer, and regulator of the circadian rhythm.

In this review article published in the recent issue of American Journal of Reproductive Immunology, Yang et al., from Fudan University summarise and evaluate the pleiotropic roles of melatonin in endometriosis, recurrent spontaneous abortion, and polycystic ovary syndrome to explore the relationship between melatonin and pathological implications of these conditions and treatment potential.

The findings indicate that melatonin could be a novel therapeutic approach for these conditions based on modulation of the oxidative stress, inflammation, and immune system. Melatonin can act as an immunoregulator and antioxidant in these reproductive diseases. Melatonin can regulate endometrial morphology and embryo implantation. It is essential for progesterone production in human granulosa and luteal cells.

"Accumulating pieces of evidence showed that exogenous melatonin could suppress ectopic endometriosis lesions, relieve pelvic pain, and improve sleeping quality", said researchers.

Hence, melatonin seems to be a capable therapeutic candidate for endometriosis due to anti-inflammation and endocrine modulation ability. However, more direct evidence to measure the melatonin levels in peripheral blood and the local ectopic environment of endometriosis will be required in future studies. It is also unclear at this point whether melatonin concentrations are related to the occurrence, development, and severity of endometriosis.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29493042