Melatonin as an Antioxidant and Immunomodulator in Atopic Dermatitis–A New Look on an Old Story–A Review

Abstract

Atopic dermatitis (AD) is common inflammatory dermatosis, typically with chronic and recurrent course, which significantly reduces the quality of life. Sleep disturbances are considered to be remarkably burdensome ailments in the patients with AD, and are routinely included during assessment of disease severity. Therefore, endogenous substances engaged in the control of circadian rhythms might be important in pathogenesis of AD and, possibly, be used as biomarkers of disease severity or even in development of novel therapies. Melatonin (MT), the indoleamine produced by pineal gland (but also by multiple other tissues, including skin), plays a pivotal role in maintaining the sleep/wake homeostasis. Additionally, it possess strong antioxidant and anti-inflammatory properties, which might directly link chronic skin inflammation and sleep abnormalities characteristic of AD. The objective of this work is to systematically present and summarize the results of studies (both experimental and clinical) that investigated the role of MT in the AD, with focus on the antioxidant and immunomodulatory effects of MT.

Melatonin and Sleep Disturbances in Children With Atopic Dermatitis

“…The correlation between SCORAD and melatonin levels has not been widely studied. 8 A Turkish study by Uysal et al in 2016 reported a significant negative correlation between SCORAD in severe AD and melatonin levels, while in mild-moderate cases, a non-significant correlation was found. 31 In this study, all participants in the case group had moderate AD, thus data on the correlation between melatonin levels and SCORAD in severe AD were not obtained.…”

“…7 Sleep loss is an undisputed feature of AD, which must be taken into account when in assessing disease severity using the Scoring Atopic Dermatitis (SCORAD) scale. 8 Sleep disturbances among AD patients is prevalent and frequently reported, especially in children with moderate-severe AD. 8 Although the main symptoms of AD, such as excessive itch and the consequent scratching, seem to sufficiently explain the abnormal sleep pattern seen among patients, previous studies have reported that children with AD in remission experience significant sleep disturbances not related to scratching.…”

“…8 Sleep disturbances among AD patients is prevalent and frequently reported, especially in children with moderate-severe AD. 8 Although the main symptoms of AD, such as excessive itch and the consequent scratching, seem to sufficiently explain the abnormal sleep pattern seen among patients, previous studies have reported that children with AD in remission experience significant sleep disturbances not related to scratching. 9 This raises the suspicion that more complex underlying mechanisms are involved.…”

“…5,10 A vast variety of interleukins, chemokines, neuropeptides, and even hormones are linked to abnormal sleep in AD. 8 Another molecule which provisionally plays a crucial role in sleep disturbance in AD is melatonin. 6 The circadian rhythm regulates variations in the physiological and biological rhythms in order to adapt to the changes that occur every day, including changes in the physiological functions of the skin.…”

“…12 To date, research on melatonin levels in children with AD remains limited. 8 Therefore, this study aims to analyze the correlation between melatonin levels and sleep quality, as assessed using the Indonesian version of the Children's Sleep Habits Questionnaire (CSHQ), in children with AD.…”