Dolor y Melatonina

http://www.smo.edu.mx/






Melatonina en la antinocicepción: sus aplicaciones terapéuticas


Melatonin in antinociception: its therapeutic applications.
Srinivasan V, Lauterbach EC, Ho KY, Acuña-Castroviejo D, Zakaria R, Brzezinski A.
Sri Sathya Sai Medical Educational and Research Foundation, Medical Sciences Research Study Center, Prasanthi Nilayam, 40 Kovai Thirunagar, Coimbatore-641014, Tamilnadu, India.
Curr Neuropharmacol. 2012 Jun;10(2):167-78. doi: 10.2174/157015912800604489.
Abstract
The intensity of pain sensation exhibits marked day and night variations. Since the intensity of pain perception is low during dark hours of the night when melatonin levels are high, this hormone has been implicated as one of the prime antinociceptive substances. A number of studies have examined the antinociceptive role of melatonin in acute, inflammatory and neuropathic pain animal models. It has been demonstrated that melatonin exerts antinociceptive actions by acting at both spinal cord and supraspinal levels. The mechanism of antinociceptive actions of melatonin involves opioid, benzodiazepine, α(1)- and α(2)-adrenergic, serotonergic and cholinergic receptors. Most importantly however, the involvement of MT(1)/MT(2) melatonergic receptors in the spinal cord has been well documented as an antinociceptive mechanism in a number of animal models of pain perception. Exogenous melatonin has been used effectively in the management of pain in medical conditions such as fibromyalgia, irritable bowel syndrome and migraine and cluster headache. Melatonin has been tried during surgical operating conditions and has been shown to enhance both preoperative and post-operative analgesia. The present review discusses the available evidence indicating that melatonin, acting through MT(1)/MT(2) melatonin receptors, plays an important role in the pathophysiological mechanism of pain.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3386506/pdf/CN-10-167.pdf


Neurobiología, patofisiología y tratamiento de la deficiencia y disfunción de melatonina
Neurobiology, pathophysiology, and treatment of melatonin deficiency and dysfunction.
Hardeland R.
Johann Friedrich Blumenbach Institute of Zoology and Anthropology, Georg August University, 37073 Göttingen, Germany. rhardel@gwdg.de
ScientificWorldJournal. 2012;2012:640389. doi: 10.1100/2012/640389. Epub 2012 May 2.
Abstract
Melatonin is a highly pleiotropic signaling molecule, which is released as a hormone of the pineal gland predominantly during night. Melatonin secretion decreases during aging. Reduced melatonin levels are also observed in various diseases, such as types of dementia, some mood disorders, severe pain, cancer, and diabetes type 2. Melatonin dysfunction is frequently related to deviations in amplitudes, phasing, and coupling of circadian rhythms. Gene polymorphisms of melatonin receptors and circadian oscillator proteins bear risks for several of the diseases mentioned. A common symptom of insufficient melatonin signaling is sleep disturbances. It is necessary to distinguish between symptoms that are curable by short melatonergic actions and others that require extended actions during night. Melatonin immediate release is already effective, at moderate doses, for reducing difficulties of falling asleep or improving symptoms associated with poorly coupled circadian rhythms, including seasonal affective and bipolar disorders. For purposes of a replacement therapy based on longer-lasting melatonergic actions, melatonin prolonged release and synthetic agonists have been developed. Therapies with melatonin or synthetic melatonergic drugs have to consider that these agents do not only act on the SCN, but also on numerous organs and cells in which melatonin receptors are also expressed.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354573/pdf/TSWJ2012-640389.pdf

Atentamente
Anestesiología y Medicina del Dolor
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