The study and usage of melatonin in various fields of medicine has become relevant in recent years. Many studies show high efficacy of melatonin treatment in different diseases that are accompanied by immunodeficiency in humans: oncology, viral and infectious diseases, neuro-degenerative diseases, heart disease, kidney disease, and liver disease. However, the separately immunomodulatory effects of melatonin in diseases accompanied by such conditions has not been studied. We conducted a qualitative systematic review of randomized controlled trials (RCTs) using the recommended guidelines of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA regarding the disclosure of status and changes in the immune system during melatonin treatment in adult patients in order to investigate immunomodulatory effect in diseases accompanied by immunodeficiency. We searched in 6 electronic databases from the moment they were created until May 2020.
All trials investigated diseases accompanied by immunodeficiency conditions using melatonin as monotherapy and as adjunctive treatment and included analysis of specific indicators: TNF-α, IL-1β, IL-1Ra, IL-2, IL-6, IL-12, IL-8, IL- 4, IL-10, CD44, CD133, YKL-40. These criteria were used to guide our test quality assessment. We included 9 RCTs published between 1964 and 2020, and included 365 patients. The ten authors of the review independently checked the search results, extracted data and evaluated the quality of the research. We estimated statistical heterogeneity using IBM SPSS Statistics. The risk of bias of each included study was assessed using the web ‚riskofbias.info‘ tool. The quality of the evidence was assessed using GLMM methods. We found that melatonin substantially improved the status of the immune system (heterogeneity
p < 0.05). The effects were consistent between melatonin dose, duration of treatment and baseline immune status. No serious adverse events were reported. Significant immunomodulatory effect, low side effects and low costs associated with this intervention indicate the great potential of melatonin in the treatment of diseases accompanied by immunodeficiency. Confirmation of immunomodulatory effect and safety of melatonin in diseases associated with such conditions should require blind, independent RCT.
Key words: Immunity, cytokines, immunodeficiency, immunostimulatory therapy, melatonin.
Lek Obz, 2021, 70 (1): 25-32
Tetiana I. Liadova 1, Mykola M. Popov 1, Diana M. Dorosh1, Alexander V. Martynenko 2, Olga V. Volobueva 1, Iryna V. Kadyhrob3, Olga G. Sorokina 1, Alla P. Gamilovskaya 1, Olesya V. Gololobova 1, Natalia V. Shepylieva 1
1 V. N. Karazin Kharkiv National University, School of Medicine, Department of General and Clinical Immunology and Allergology, head: Tetiana I. Liadova Doctor of Medicine, Professor
2 V. N. Karazin Kharkiv National University, School of Medicine, Department of Hygiene and Social Medicine, head: Zhanna V. Sotnikova-Meleshkina, Ph.D., Assistant Professor
3 Municipal non-profit enterprise «State Dermatovenerology Dispansary No1» of Kharkiv municipal council, head: Iryna V. Kadyhrob, Ph.D., Assistant Professor
CITE:
Liadova T.I., Popov M.M., Dorosh D.M., Martynenko A.V., Volobueva O.V, Kadyhrob I.V., Sorokina O.G., Gamilovskaya A.P., Gololobova O.V., Shepylieva N.V.: Assessment of immunological effects of melatonin in immunodeficient population: A systematic review of 180190 randomized controlled trials. Lek Obz, 2021, 70 (1): 25-32
