Antioxidant Effect of Melatonin in Preterm Newborns

Abstract

Introduction. Preterm infants are at risk of free radical-mediated diseases from oxidative stress (OS) injury. Increased free radical generation has been demonstrated in preterm infants during the first seven days of life. Melatonin (MEL) is a powerful antioxidant and scavenger of free radicals. In preterm neonates, melatonin deficiency has been reported. Exogenous melatonin administration appears a promising strategy in the treatment of neonatal morbidities in which OS has a leading role. Objective. The aim was to evaluate plasma MEL concentrations and OS biomarkers in preterm newborns after early administration of melatonin. Methods. A prospective, randomized double-blind placebo-controlled pilot study was conducted from January 2019 to September 2020. Thirty-six preterm newborns were enrolled. Starting from the first day of life, 21 received a single dose of oral melatonin 0.5 mg/kg once a day, in the morning (MEL group); 15 newborns received an equivalent dose of placebo (placebo group). Samples of 0.2 mL of plasma were collected at 24 and 48 hours after MEL administration. Plasma concentrations of melatonin, non-protein-bound iron (NPBI), advanced oxidation protein products (AOPP), and F2-isoprostanes (F2-Isopr) were measured. Babies were clinically followed until discharge. Results. At 24 and 48 hours after MEL administration, the MEL concentrations were significantly higher in the MEL group than in the placebo group ( 52759.30 ± 63529.09 vs. 28.57 ± 46.24 pg/mL and 279397.6 ± 516344.2 vs. 38.50 ± 44.01 pg/mL, respectively). NPBI and AOPP did not show any statistically significant differences between the groups both at 24 and 48 hours. At 48 hours, the mean blood concentrations of F2-Isopr were significantly lower in the MEL group than in the placebo group ( 36.48 ± 33.85 pg/mL vs. 89.97 ± 52.01 pg/mL). Conclusions. Early melatonin administration in preterm newborns reduces lipid peroxidation in the first days of life showing a potential role to protect high-risk newborns. Trial Registration. This trial is registered with NCT04785183, Early Supplementation of Melatonin in Preterm Newborns: the Effects on Oxidative Stress.

Urinary Melatonin Metabolite in Premature Infants with Extremely and Very Low Birth Weight

“…However, the design of this study used the radioimmunoassay method and not randomized premature infants based on birth weight. Deficiency of the powerful antioxidant melatonin was the basis for studying the effect of increasing in blood levels in premature infants by oral supplementation [17]. The study included 36 premature weighing more than 1700 g. However, outcomes have not been studied.…”

Melatonin and REGN-CoV2 combination as a vaccine adjuvant for Omicron variant of SARS-CoV-2

“…Complementary adjunctive and immunomodulatory therapies are required to reverse immune system dysfunction and cytokine dysregulation. Melatonin is also known to have anti-inflammatory [ 15 ], antioxidant [ 16 ], immunomodulatory [ 17 ] and antiviral [ 18 ] infectious activities. It may be useful to use melatonin together with REGN-COV2 in elderly and other high-risk patients as an adjuvant to vaccines against the Omicron variant of SARS-CoV-2infection.…”

The relationship of melatonin concentration in preterm infants and adverse outcomes in the late neonatal period

“…Thus, they often suffer from respiratory distress syndrome (RDS), necrotizing enterocolitis (NEC), intraventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), early- and late-onset infections ( 2 ). Free radical-mediated tissue damage due to oxidative stress is a common factor in the pathogenesis of these diseases ( 3 , 4 ). Oxidative stress is defined as an imbalance between the production of pro-oxidant substances and the protective antioxidant system, with the predominance of pro-oxidants, which can lead to damage ( 5 ).…”