Melatonin as pharmacologic support in burn patients

A proposed solution to thermal injury-related lymphocytopenia and oxidative damage

Maria Dolores Maldonado, Francisco Murillo-Cabezas, Juan Ramón Calvo, Patricia Judith Lardone, Dun Xian Tan, Juan Miguel Guerrero, Russel J Reiter

Research output: Contribution to journalArticle

43 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1177-1185
Number of pages9
JournalCritical Care Medicine
Volume35
Issue number4
DOIs
StatePublished - Apr 2007

Fingerprint

Lymphopenia
Melatonin
Hot Temperature
Wounds and Injuries
Drug-Related Side Effects and Adverse Reactions
Free Radicals
Immune System
Sleep
Antioxidants
Protective Agents
Aptitude
Multiple Organ Failure
Wakefulness
Circadian Rhythm
PubMed
MEDLINE
Shock
Oxidative Stress
Nitrogen
Therapeutics

Keywords

  • Antioxidant
  • Burn patients
  • Free radicals
  • Lymphocytopenia
  • Melatonin
  • Skin oxidative stress

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Melatonin as pharmacologic support in burn patients : A proposed solution to thermal injury-related lymphocytopenia and oxidative damage. / Maldonado, Maria Dolores; Murillo-Cabezas, Francisco; Calvo, Juan Ramón; Lardone, Patricia Judith; Tan, Dun Xian; Guerrero, Juan Miguel; Reiter, Russel J.

In: Critical Care Medicine, Vol. 35, No. 4, 04.2007, p. 1177-1185.

Research output: Contribution to journalArticle

Maldonado, Maria Dolores ; Murillo-Cabezas, Francisco ; Calvo, Juan Ramón ; Lardone, Patricia Judith ; Tan, Dun Xian ; Guerrero, Juan Miguel ; Reiter, Russel J. / Melatonin as pharmacologic support in burn patients : A proposed solution to thermal injury-related lymphocytopenia and oxidative damage. In: Critical Care Medicine. 2007 ; Vol. 35, No. 4. pp. 1177-1185.
@article{156f232fbc4447998aa1d7f5df9aedb2,
title = "Melatonin as pharmacologic support in burn patients: A proposed solution to thermal injury-related lymphocytopenia and oxidative damage",
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.",
keywords = "Antioxidant, Burn patients, Free radicals, Lymphocytopenia, Melatonin, Skin oxidative stress",
author = "Maldonado, {Maria Dolores} and Francisco Murillo-Cabezas and Calvo, {Juan Ram{\'o}n} and Lardone, {Patricia Judith} and Tan, {Dun Xian} and Guerrero, {Juan Miguel} and Reiter, {Russel J}",
year = "2007",
month = "4",
doi = "10.1097/01.CCM.0000259380.52437.E9",
language = "English (US)",
volume = "35",
pages = "1177--1185",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Melatonin as pharmacologic support in burn patients

T2 - 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, Russel J

PY - 2007/4

Y1 - 2007/4

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.

AB - 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.

KW - Antioxidant

KW - Burn patients

KW - Free radicals

KW - Lymphocytopenia

KW - Melatonin

KW - Skin oxidative stress

UR - http://www.scopus.com/inward/record.url?scp=34247121502&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34247121502&partnerID=8YFLogxK

U2 - 10.1097/01.CCM.0000259380.52437.E9

DO - 10.1097/01.CCM.0000259380.52437.E9

M3 - Article

VL - 35

SP - 1177

EP - 1185

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 4

ER -