Melatonin: Diagnostic evidence and therapeutic roles in systemic lupus erythematosus

Melatonin, a molecule synthesized by the pineal gland and possibly all other organs, demonstrates promise as a therapeutic agent for systemic lupus erythematosus (SLE) and its severe complication, lupus nephritis. The etiology of SLE involves a complex interplay of genetic predisposition, hormonal imbalance, and environmental factors contributing to immune dysregulation and oxidative stress. Melatonin's antioxidant and anti-inflammatory properties make it a potential treatment option for SLE. Studies indicate lower serum melatonin levels in SLE patients, suggesting diagnostic relevance. Preclinical studies demonstrate melatonin's ability to reduce renal damage by suppressing inflammation and oxidative stress. Clinical trials support these findings, revealing decreased oxidative stress markers and disease activity in SLE patients receiving melatonin supplementation. Melatonin also exhibits antifibrotic effects, ameliorating kidney damage in lupus nephritis. Further research is needed to fully elucidate melatonin's mechanisms in SLE and lupus nephritis. In consideration of its multifaceted therapeutic effects and established safety profile, melatonin's efficacy as an adjunctive therapy for managing SLE and lupus nephritis warrants comprehensive investigation, and it offers potential to alleviate symptoms and mitigate disease progression.