title: The role of melatonin in pancreatic protection: could melatonin be used in the treatment of acute pancreatitis?
abstract: Acute pancreatitis is a disease, which could be manifested as either a mild edematous form or a more severe necrotizing pancreatitis which has a poor prognosis. The etiology and pathogenesis of this ailment is not completely clear. Melatonin is an indoleamine which is produced from L-tryptophan in the pineal gland and in the other tissue including gastrointestinal tract. Both melatonin and its precursor have been demonstrated to protect the pancreas against acute pancreatitis and to attenuate pancreatic tissue damage. In the pancreas melatonin and L-tryptophan activate complex mechanisms which involve direct scavenging of the radical oxygen and nitrogen species, activation of antioxidant enzymes (catalase, superoxide dysmutase, glutation peroxidase), reduction of pro-inflammatory cytokines and prostaglandins, activation of heat shock protein, and a decrease of necrosis and increase of regeneration in the pancreas. There are several arguments for the idea that endogenous melatonin produced in the pineal gland and in the gastrointestinal system could be the part of a native mechanisms for protecting the pancreas against acute damage: 1/ the melatonin precursor L-tryptophan exerts similar protective effect as melatonin, 2/ application of the melatonin receptor antagonist, luzindole aggravates acute pancreatitis, 3/ pinealectomy results in the exacerbation of acute pancreatitis, 4/ low melatonin plasma levels are associated with an increased risk of severe acute pancreatitis. These observations leads to the idea that perhaps melatonin could be used in clinical trials as supportive therapy in acute pancreatitis.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Jaworek
authors.forename: Anna
authors.initials: A
authors.lastname: Leja-Szpak
authors.forename: Michalina
authors.initials: M
authors.lastname: Kot
authors.forename: Andrzej
authors.initials: A
authors.lastname: Jaworek
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Nawrot-Porbka
authors.forename: Joanna
authors.initials: J
authors.lastname: Bonior
authors.affiliation: Department of Medical Physiology, Faculty of Health Care, Jagiellonian University Medical College, 16 Michalowskiego Street, 31- 126 Cracow, Poland. mpjawore@cyf-kr.edu.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Szklarczyk
mesh_terms: D000208:Acute Disease; D006801:Humans; D008550:Melatonin / Q000378:metabolism / Q000502:physiology* / Q000627:therapeutic use; D010179:Pancreas / Q000502:physiology*; D010195:Pancreatitis / Q000188:drug therapy*; D044094:Receptors, Melatonin / Q000378:metabolism
chemical_list: D044094:Receptors, Melatonin; D008550:Melatonin