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, Russell J.
N1 - Funding Information:
Supported, in part, by the Mapfre Foundation 2005– 2006 and the Seville University (Spain), program number 2006/534, code 1808030101 (Dr. Maldonado).
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
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U2 - 10.1097/01.CCM.0000259380.52437.E9
DO - 10.1097/01.CCM.0000259380.52437.E9
M3 - Review article
C2 - 17312564
AN - SCOPUS:34247121502
VL - 35
SP - 1177
EP - 1185
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 4
ER -