Decreased Daily Melatonin Levels in Women with Systemic Lupus Erythematosus - A Short Report

Year 2013, Volume: 2013 Issue: 3, 273 - 276, 01.03.2013

Ralitsa Robeva Dobromir Tanev Georgi Kirilov Milena Stoycheva Analia Tomova Philip Kumanov Rasho Rashkov Zlatimir Kolarov

Abstract

Background: The neuroendocrine system is known to influence immunity, but the precise interactions between different hormones and autoimmune disorders remain obscure. Aims: The present study aimed to investigate the role of daily serum melatonin concentrations in the development of systemic lupus erythematosus (SLE) in women. Study Design: Case-control study Methods: One-hundred and eleven SLE female patients and 46 healthy women were included in the study. Daily serum melatonin levels were investigated in all participants. Results: SLE patients showed significantly lower daily melatonin levels in comparison to healthy women during the short photoperiod (17.75±7.13 pg/mL [16.05] vs. 21.63±6.60 pg/mL [20.10], p=0.012). Hormone concentrations were inversely related to the SLE activity index (SLEDAI) (r= -0.268, p=0.004), but they did not correlate to any particular American College Rheumatology (ACR) criterion (p>0.05 for all). Conclusion: Daily melatonin levels were decreased in women with systemic lupus erythematosus and correlated inversely to the activity of the autoimmune disease. Further studies are needed to clarify the importance of the pineal and extrapineal melatonin secretion in patients with systemic lupus erythematosus as well as the interrelations between hormones and autoimmunity. Turkish Başlık: Sistemik Lupus Eritematozuslu Kadınlarda Azalmış Günlük Melatonin Düzeyleri - Kısa Bir Rapor Anahtar Kelimeler: Melatonin, sistemik lupus eritematozus, kadın, SLEDAI Arkaplan: Nöroendokrin sistemin bağışıklığı etkilediği bilinmektedir, ancak farklı hormonlar ve otoimmün hastalıklar arasındaki kesin etkileşim karanlıkta kalmaya devam etmektedir. Amaç: Bu çalışmada kadınlarda sistemik lupus eritematozus (SLE) gelişiminde günlük serum melatonin konsantrasyonlarının rolünü araştırmak amaçlandı. Çalışma tasarımı: Vaka-kontrol çalışma Yöntemler: 111 SLE kadın hasta ve 46 sağlıklı kadın çalışmaya dahil edildi. Günlük serum melatonin düzeyleri tüm katılımcılarda araştırıldı. Bulgular: Kısa fotoperiyod sırasında SLE hastaları sağlıklı kadınlara kıyasla anlamlı olarak daha düşük günlük melatonin seviyeleri gösterdi (17.75±7.13 pg/mL [16.05] vs. 21.63±6.60 pg/mL [20.10], p=0.012). Hormon konsantrasyonları SLE aktivite indeksi (SLEDAI) ile ters olarak ilişkiliydi (r=-0,268, p=0.004), ancak herhangi özel bir Amerikan Romatoloji Derneği (ACR) kriteri ile korele değildi (tümü için p> 0.05). Sonuç: Günlük melatonin düzeyleri sistemik lupus eritematozuslu kadınlarda azalmıştı ve otoimmün hastalığın aktivitesi ile ters olarak korele idi. Sistemik lupus eritematozuslu hastalarda pineal ve ekstrapineal melatonin salgılanmasının önemini ve ayrıca hormonlar ve otoimmünite arasındaki ilişkileri açıklığa kavuşturmak için daha ileri çalışmalara ihtiyaç vardır.

Keywords

Melatonin, systemic lupus erythematosus, women, SLEDAI

Decreased Daily Melatonin Levels in Women with Systemic Lupus Erythematosus - A Short Report

Abstract

References

• Cervera R, Espinosa G, D’Cruz D. Systemic lupus erythematosus: pathogenesis, clinical manifestations and diagnosis. In: Bijlsma JW, editor. EULAR Compendium on Rheumatic Diseases. BMJ Publishing Group and European League Against Rheumatism; 2009,p.257-68.
• Cutolo M, Capellino S, Straub R. Sex hormones, the immune system and autoimmune diseases. In: Asherson R, editor. Handbook of Systemic Autoimmune Diseases vol. 9. Walker S, Jara L, editors. Endocrine manifestations of systemic autoimmune diseases, Oxford, Elsevier; 2008, p. 13-19.
• Cutolo M, Straub RH. Insights into endocrine-immunological disturbances in autoimmunity and their impact on treatment. Arthritis Res Ther 2009;2:218. [CrossRef]
• Szczepanik M. Melatonin and its influence on immune system. J Physiol Pharmacol 2007;58:115-24.
• Sulli A, Maestroni GJ, Villaggio B, Hertens E, Craviotto C, Pizzorni C, et al. Melatonin serum levels in rheumatoid arthritis. Ann N Y Acad Sci 2002;966:276-83. [CrossRef]
• Fei GH, Liu RY, Zhang ZH, Zhou JN. Alterations in circadian rhythms of melatonin and cortisol in patients with bronchial asthma. Acta Pharmacol Sin 2004;25:651-56.
• Carrillo-Vico A, Lardone PJ, Naji L, Fernández-Santos JM, MartínLacave I, Guerrero JM, et al. Beneficial pleiotropic actions of melatonin in an experimental model of septic shock in mice: regulation of pro-/anti-inflammatory cytokine network, protection against oxidative damage and anti-apoptotic effects. J Pineal Res 2005;39:400-08. [CrossRef]
• Hochberg MC. Updating the American College of Rheumatology revised criteria for classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725. [CrossRef]
• Stoll T, Seifert B, Isenberg DA. SLICC/ACR Damage Index is valid, and renal and pulmonary organ scores are predictors of severe outcome in patients with systemic lupus erythematosus. Br J Rheumatol 1996;35:248-54. [CrossRef]
• Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 1996;39:363-9. [CrossRef]
• Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 1992;35:630-40. [CrossRef]
• Wehr TA. The durations of human melatonin secretion and sleep respond to changes in daylength (photoperiod). J Clin Endocrinol Metab 1991;73:1276-80. [CrossRef]
• Luboshitzky R, Yanai D, Shen-Orr Z, Israeli E, Herer P, Lavie P. Daily and seasonal variations in the concentration of melatonin in the human pineal gland. Brain Res Bull 1998;47:271-6. [CrossRef] Lechner O, Dietrich H, Oliveira dos Santos A, Wiegers GJ, Schwarz S, Harbutz M, et al. Altered circadian rhythms of the stress hormone and melatonin response in lupus-prone MRL/MPfas(Ipr) mice. J Autoimmun 2000;14:325-33. [CrossRef]
• Bullough JD, Rea MS, Figueiro MG. Of mice and women: light as a circadian stimulus in breast cancer research. Cancer Causes Control 2006;17:375-83. [CrossRef]
• Shah A, Sadasivan B, Leng BM, Ho J. A teratocarcinoma developing after gross total excision of a pineal teratoma in a patient with systemic lupus erythematosus. Neurol Res 1995;17:229-32.
• Peress NS, Perillo E, Fenstermacher JD. Circumventricular organs in chronic serum sickness: a model for cerebral lupus. Biol Psychiatry 1989;26:397-07. [CrossRef]
• Reiter RJ, Tan DX, Allegra M. Melatonin: reducing molecular pathology and dysfunction due to free radicals and associated reactants. Neuro Endocrinol Lett 2002;23:3-8.
• Lang U, Theintz G, Rivest RW, Sizonenko PC. Nocturnal urinary melatonin excretion and plasma cortisol levels in children and adolescents after a single oral dose of dexamethasone. Clin Endocrinol (Oxf) 1986;25:165-72. [CrossRef]
• Demisch L, Demisch K, Nickelsen T. Influence of dexamethasone on nocturnal melatonin production in healthy adult subjects. J Pineal Res 1988;5:317-22. [CrossRef]
• Tomova A, Kumanov P, Robeva R, Manchev S, Konakchieva R. Melatonin secretion and non-specific immune responses are differentially expressed in corticotropin-dependent and corticotropin-independent Cushing‘s syndrome. Med Sci Monit 2008;14:327-32.
• Jimenez-Caliani AJ, Jimenez-Jorge S, Molinero P, Fernandez-Santos JM, Martin-Lacave I, Rubio A, et al. Sex-dependent effect of melatonin on systemic erythematosus lupus developed in Mrl/Mpj-Faslpr mice: it ameliorates the disease course in females, whereas it exacerbates it in males. Endocrinology 2006;147:1717-24. [CrossRef]
• Lenz SP, Izui S, Benediktsson H, Hart DA. Lithium chloride enhances survival of NZB/W lupus mice: influence of melatonin and timing of treatment. Int J Immunopharmacol 1995;17:581-92. [CrossRef]
• Haga HJ, Brun JG, Rekvig OP, Wetterberg L. Seasonal variations in activity of systemic lupus erythematosus in a subarctic region. Lupus 1999;8:269-73. [CrossRef]
• World weather and climate information. http://www.weatherand-climate.com, data access 17.01.2013.
• Huether G. The contribution of extrapineal sites of melatonin synthesis to circulating melatonin levels in higher vertebrates. Experientia 1993;49:665-70. [CrossRef]
• Bubenik GA. Gastrointestinal melatonin: localization, function, and clinical relevance. Dig Dis Sci 2002;47:2336-48. [CrossRef]
• Gómez-Corvera A, Cerrillo I, Molinero P, Naranjo MC, Lardone PJ, Sanchez-Hidalgo M, et al. Evidence of immune system melatonin production by two pineal melatonin deficient mice, C57BL/6 and Swiss strains. J Pineal Res 2009;47:15-2. [CrossRef] Caglayan S, Ozata M, Ozisik G, Turan M, Bolu E, Oktenli C, et al. Plasma melatonin concentration before and during testosterone replacement in Klinefelter‘s syndrome: relation to hepatic indolamine metabolism and sympathoadrenal activity. J Clin Endocrinol Metab 2001;86:738-43. [CrossRef]