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Melatonin as pharmacologic support in burn patients: a proposed solution to thermal injury-related lymphocytopenia and oxidative damage.
Crit Care Med. 2007 Apr; 35(4):1177-85.CC

Abstract

OBJECTIVE

To review the data that support the clinical use of melatonin in the treatment of burn patients, with special emphasis on the stimulation of the oxidative defense system, the immune system, circadian rhythm of sleep/wakefulness, and the reduction in the toxicity of therapeutic agents used in the treatment of burn victims.

DATA SOURCE

A MEDLINE/PubMed search from 1975 to July 2006 was conducted.

STUDY SELECTION

The screening of the literature was examined using the key words: burn patients, lymphocytopenia, skin oxidative stress, antioxidant, melatonin, and free radicals.

DATA EXTRACTION AND SYNTHESIS

Thermal injury often causes damage to multiple organs remote from the original burn wound and may lead to multiple organ failure. Animal models and burn patients exhibit elevated free radical generation that may be causative in the local wound response and in the development of burn shock and distant organ injury. The suppression of nonspecific resistance and the disturbance in the adaptive immune system makes burn patients vulnerable to infections. Moreover, there is loss of sleep and the toxicity produced by drugs habitually used in the clinic for burn patients. Melatonin is a powerful antioxidant and is a potent protective agent against damage after experimental thermal injury. Some actions of melatonin as a potential supportive pharmacologic agent in burn patients include its: role as a scavenger of both oxygen and nitrogen-based reactants, stimulation of the activities of a variety of antioxidative enzymes, reduction in proinflammatory cytokines, inhibition of adhesion molecules, chronobiotic effects, and reduction in the toxicity of the drugs used in protocols to treat thermal injury patients.

CONCLUSIONS

These combined actions of melatonin, along with its low toxicity and its ability to penetrate all morphophysiologic membranes, could make it a ubiquitously acting and highly beneficial molecule in burn patients.

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Authors+Show Affiliations

Maldonado MD
Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Murillo-Cabezas F
No affiliation info available
Calvo JR
No affiliation info available
Lardone PJ
No affiliation info available
Tan DX
No affiliation info available
Guerrero JM
No affiliation info available
Reiter RJ
No affiliation info available

MeSH

AnimalsAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalAnti-Ulcer AgentsAntioxidantsBurnsCircadian RhythmCritical CareFree RadicalsHumansHypnotics and SedativesImmune SystemLymphopeniaMelatoninOxidative StressSkinSleep Wake Disorders

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

17312564

Citation

Maldonado, Maria-Dolores, et al. "Melatonin as Pharmacologic Support in Burn Patients: a Proposed Solution to Thermal Injury-related Lymphocytopenia and Oxidative Damage." Critical Care Medicine, vol. 35, no. 4, 2007, pp. 1177-85.
Maldonado MD, Murillo-Cabezas F, Calvo JR, et al. Melatonin as pharmacologic support in burn patients: a proposed solution to thermal injury-related lymphocytopenia and oxidative damage. Crit Care Med. 2007;35(4):1177-85.
Maldonado, M. D., Murillo-Cabezas, F., Calvo, J. R., Lardone, P. J., Tan, D. X., Guerrero, J. M., & Reiter, R. J. (2007). Melatonin as pharmacologic support in burn patients: a proposed solution to thermal injury-related lymphocytopenia and oxidative damage. Critical Care Medicine, 35(4), 1177-85.
Maldonado MD, et al. Melatonin as Pharmacologic Support in Burn Patients: a Proposed Solution to Thermal Injury-related Lymphocytopenia and Oxidative Damage. Crit Care Med. 2007;35(4):1177-85. PubMed PMID: 17312564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Melatonin as pharmacologic support in burn patients: a proposed solution to thermal injury-related lymphocytopenia and oxidative damage. AU - Maldonado,Maria-Dolores, AU - Murillo-Cabezas,Francisco, AU - Calvo,Juan-Ramón, AU - Lardone,Patricia-Judith, AU - Tan,Dun-Xian, AU - Guerrero,Juan-Miguel, AU - Reiter,Russell J, PY - 2007/2/22/pubmed PY - 2007/5/16/medline PY - 2007/2/22/entrez SP - 1177 EP - 85 JF - Critical care medicine JO - Crit Care Med VL - 35 IS - 4 N2 - OBJECTIVE: To review the data that support the clinical use of melatonin in the treatment of burn patients, with special emphasis on the stimulation of the oxidative defense system, the immune system, circadian rhythm of sleep/wakefulness, and the reduction in the toxicity of therapeutic agents used in the treatment of burn victims. DATA SOURCE: A MEDLINE/PubMed search from 1975 to July 2006 was conducted. STUDY SELECTION: The screening of the literature was examined using the key words: burn patients, lymphocytopenia, skin oxidative stress, antioxidant, melatonin, and free radicals. DATA EXTRACTION AND SYNTHESIS: Thermal injury often causes damage to multiple organs remote from the original burn wound and may lead to multiple organ failure. Animal models and burn patients exhibit elevated free radical generation that may be causative in the local wound response and in the development of burn shock and distant organ injury. The suppression of nonspecific resistance and the disturbance in the adaptive immune system makes burn patients vulnerable to infections. Moreover, there is loss of sleep and the toxicity produced by drugs habitually used in the clinic for burn patients. Melatonin is a powerful antioxidant and is a potent protective agent against damage after experimental thermal injury. Some actions of melatonin as a potential supportive pharmacologic agent in burn patients include its: role as a scavenger of both oxygen and nitrogen-based reactants, stimulation of the activities of a variety of antioxidative enzymes, reduction in proinflammatory cytokines, inhibition of adhesion molecules, chronobiotic effects, and reduction in the toxicity of the drugs used in protocols to treat thermal injury patients. CONCLUSIONS: These combined actions of melatonin, along with its low toxicity and its ability to penetrate all morphophysiologic membranes, could make it a ubiquitously acting and highly beneficial molecule in burn patients. SN - 0090-3493 UR - https://www.unboundmedicine.com/medline/citation/17312564/Melatonin_as_pharmacologic_support_in_burn_patients:_a_proposed_solution_to_thermal_injury_related_lymphocytopenia_and_oxidative_damage_ L2 - https://dx.doi.org/10.1097/01.CCM.0000259380.52437.E9 DB - PRIME DP - Unbound Medicine ER -