Low Melatonin Levels Research Articles

The validity and feasibility of saliva melatonin assessment in the elderly.

Recent work in young and middle-aged subjects suggests that melatonin levels in saliva may represent a viable alternative to serum melatonin measurement. We hypothesized that it may be a valid measure of melatonin levels in older adults as well, but features unique to the elderly may limit its utility. To study this, subjects were admitted to an academic medical center where saliva and serum specimens were collected concurrently in dim light conditions during a 14-hr overnight study period and analyzed for melatonin levels with radioimmunoassays (RIAs). Eighty-five subjects over the age of 65 with a broad range of medical conditions participated in the study. Subjects with dementia, depression and anemia were excluded. We found that saliva volume was inadequate for analysis (<200 microL) in 23.6% of specimens, with the majority of inadequate volume specimens occurring after midnight and inadequate specimens occurring more frequently in females than in males. The correlation coefficient for saliva melatonin and serum melatonin was r = 0.659 (Spearman, P < 0.001), and r = 0.466 for saliva dim light melatonin onset (DLMO) and serum DLMO. Saliva melatonin levels were 30.9% of serum melatonin levels, with a wide range of ratios noted between subjects. Overall melatonin levels influenced both the correlation and ratio of saliva melatonin to serum melatonin; higher correlations and lower ratios were noted when melatonin levels were high. Saliva specimens provide an economical and practical method for melatonin assessment, however, in older adults, issues such as hyposalivation and low melatonin levels limit the feasibility and validity, respectively, of saliva melatonin.

Melatonin deficiencies in women

The pineal hormone melatonin is the mediator of external light to physiologic adaptation to day and night rhythms, it regulates reproduction in animals but attempts to utilize melatonin in women for contraception have failed. Melatonin seems to be the natural hormone to facilitate sleep in insomniac patients and causes no hang over. When applied together with benzodiazepine it allows reduction of benzodiazepine without withdrawal effects. It should be applied 2 h before sleeping time in doses between 3 and 5 mg. Melatonin acts via the γ-aminobutyric acid- and benzodiazepine receptor explaining its success in treatment of seizures in children and in adults. Constant application of benzodiazepine reduced the production of natural melatonin in rats, supporting the evidence that long-term application of benzodiazepine in humans does not restore sleeping habits but reduces natural sleeping habits even more. Low melatonin levels were seen in bulimia or neuralgia and in women with fibromyalgia; replacement reduced pain, sleeping disorders, and depression in fibromyalgia and bulimia. Melatonin profiles are a diagnostic tool to distinguish between several forms of depression, like major depression, winter depression (SAD), unipolar depression, delayed sleep phase syndrome (DSPS). In patients with a major depression success with antidepressants correlated with an increase in their melatonin profiles but only patients suffering from DSPS can be successfully treated with melatonin. In perimenopausal women melatonin administration did produce a change in LH, FSH and thyroid hormones. Some oncostatic properties are supported by cell culture work and studies in animals. In Nordic countries indigenous people suffer less from breast and prostate cancer, winter darkness seems to protect. The supposedly increased melatonin levels created the ‘melatonin hypothesis’. Epidemiological studies did show that blind people indeed have half the rate of breast cancers, supporting the hypothesis. Controversial results concerning melatonin and insulin resistance and glucose tolerance have been published. In postmenopausal women application of melatonin reduced glucose tolerance and insulin sensitivity. Pregnant women should avoid melatonin, since its teratogenic effect is not known. Patients suffering from non-hormone dependent tumors, like leukemia, should avoid melanin, since tumor growth was promoted in animal experiments. It can be expected that melatonin will receive wide consideration for treatment of sleeping disturbances, jet lag, and fibromyalgia once an oral formulation becomes available in Europe.

Melatonin in elderly patients with insomnia. A systematic review.

Melatonin is a hormone and antioxidant produced by the pineal gland of which four neurobiological roles have been claimed in the aged population: anti-ageing agent; free-radical scavenger; regulator of circadian rhythm; endogeneous sleep-inducer. The "melatonin replacement" hypothesis states that 1) the well-evidenced age-related decline contributes to insomnia and that 2) replacement with physiological doses of melatonin improves sleep. The aim of this review was to determine the evidence for the efficacy of melatonin in elderly insomniacs. MEDLINE's database from 1990-2000 was searched with "melatonin", "geriatrics" and "(frail)-elderly" as major sub-headings. This resulted in 78 articles: only studies with empirical treatment data were reviewed (N = 12). Six reports (abstract, research letter, retrospective case study, 3 open label studies) showed a trend towards efficacy of melatonin: sleep quality improved and in patients with Alzheimer's disease sundowning was reduced. In 6 double blind, randomised crossover trials, a total number of 95 patients (mean ages: 65-79 yrs) were treated. Melatonin doses ranged from 0.5 mg to 6 mg; most took a single dose 30-120 min before bedtime. In 3 studies a slow release form was used. Sleep quality was objectively measured by wrist actigraphy (n = 4) and polysomnography (n = 2), and additionally subjective sleep quality was assessed (n = 2). Sleep latency decreased significantly in 4 studies. In 3 studies other measures of sleep quality (sleep efficiency, total sleep time and wake time during sleep) improved. Subjective sleep quality did not improve. No early-morning sleepiness occurred. Comparison of the studies suggests that melatonin is most effective in elderly insomniacs who chronically use benzodiazepines and/or with documented low melatonin levels during sleep. There is sufficient evidence that low doses of melatonin improve initial sleep quality in selected elderly insomniacs. However, larger randomized controlled trials, with less strict inclusion criteria are necessary to yield evidence of effectiveness (i.e. clinical and subjective relevance) in geriatric patients who suffer from insomnia, before wide-spread use can be advocated.

Reproductive Phase Dependent Photosensitivity of Gonad and Pineal Gland of a Short-Nosed Fruit Bat, Cynopterus sphinx

Photoperiodic sensitivity of gonad in relation to pineal gland activity was noted during two important reproductive phases i.e. reproductively active (February- March) and inactive (July- August) phases of nocturnal flying mammal, Cynopterus sphinx of Indian tropical origin. They were exposed to experimental long (Light: Dark in hours; 16L: 8D) and short (8L: 16D) photoperiods for 30 days during both the reproductive phases. Exposure to the long photoperiod (LP) during reproductively active phase had no significant effect on pineal gland, gonad and its hormonal concentration. However, exposure to short photoperiod (SP) induced a decrease in gonadal activity and increase in pineal activity (as judged by the gland weight, histology, low level of estradiol / testosterone and high level of melatonin in plasma). Increased melatonin and decreased estrogen levels following the short photoperiod exposure caused abortion in females, which were undergoing delayed embryonic development during reproductive inactive phase. Exposure to LP during reproductively inactive phase reactivated the gonadal axis and inhibited the pineal activity (as judged by the gland weight, histology, high level of estradiol / testosterone and low level of melatonin in plasma), while exposure to SP had no significant effect on pineal and gonad during this phase.From these observations, it is suggested that depending upon the reproductive status, short and long photo-period affected differently the gonadal and pineal gland activity of this bat. SP induced gonadal regression during reproductive active phase and LP reactivated the gonadal axis during reproductive inactive phase. Under experimental condition the inverse relationship between pineal and gonadal activity was maintained as observed in nature.

Circadian Disturbances After Night-Shift Work Onboard a Naval Ship

The aim of the present study was to investigate how night duties can affect the circadian rhythms of military personnel working onboard a naval ship. Twenty individuals on a regular day-work schedule from 9:00 a.m. to 6:00 p.m. (serving as controls) and 40 individuals on night-shift duties participated in the study. Salivary melatonin and cortisol profiles were established within two 24-hour periods from 2-hour saliva samplings. Under the condition of abrupt shift in work/rest schedule, the majority of the navy officers (52%) retained their normal melatonin profiles. Twelve percent displayed a right phase shift in melatonin rhythm after night work. Nineteen percent exhibited distortions in the form of abnormal peaks or troughs, and 17% showed signs of disrupted rhythm in the form of low daytime levels of melatonin throughout the sampling period. No consistent relationship was found between the melatonin changes and various work stations of the ship. Prominent changes in the cortisol profile included unexpected peaks or troughs that may be related to the conditions that individuals were exposed to, i.e., high noise level in the engine room, as well as to performing intense tracking operations. The findings of this study (1) show the possible detrimental effects of shift duties on circadian rhythms, (2) highlight a wide interindividual variation in the manner in which the circadian systems respond to an abrupt phase shift in work/rest schedules, and (3) form the basis for further investigations into effective strategies to help military personnel cope with shift work, thereby maintaining health and high working standards while on duty.

Reentrainment of the spontaneous locomotor activity rhythm to a daylight reversal in C57BL/6 and C3H/He mice: Implication of melatonin

The adaptation of the locomotor activity rhythm to a daylight reversal was previously found to be faster in C57BL/6 mice, which present a low level of melatonin, than in C3H/He mice, which exhibit a large nocturnal melatonin peak. Because pinealectomy has been shown to accelerate resynchronisation time in rats after a daylight reversal, we investigated the involvement of melatonin in the resynchronisation rate of locomotor activity rhythm in C57BL/6 and C3H/He strains. We first tested the effects of melatonin, administered at zeitgeber time (ZT) 20 (with ZT0 corresponding to light onset) for the 3 days preceding the daylight reversal, on the reentrainment of locomotor activity rhythm in both strains. Second, the effects of S-22153, a melatonin receptor antagonist, on the reentrainment of locomotor activity rhythm in C3H/He mice were examined. S-22153 was administered for the 3 days preceding the daylight reversal either at ZT12 or at ZT20, i.e., when endogenous melatonin levels are respectively low and high. Melatonin significantly delayed the resynchronisation of locomotor activity rhythm in C57BL/6 mice without affecting this parameter in C3H/He mice. S-22153 significantly accelerated the resynchronisation in C3H/He mice when administered at ZT20, but had no effect when administered at ZT12. These results support the hypothesis that the differences between C3H/He and C57BL/6 in the reentrainment of their locomotor activity rhythm depend, at least in part, on the interstrain differences in melatonin synthesis.

Melatonin Suppression by Light in Euthymic Bipolar and Unipolar Patients

Previous studies have suggested that bipolar patients are supersensitive to light suppression of melatonin and that this may be a trait marker for genetic vulnerability. The present study was an attempt to replicate and extend this observation. Propranolol hydrochloride effects were compared with light effects because of the documented influence of beta-adrenergic receptors on melatonin production. Nighttime levels of corticotropin and cortisol were also examined as potential trait vulnerability markers. Melatonin levels in euthymic bipolar patients (n= 29) were tested before and after 500-lux light was administered between 2 and 4 AM and on a separate night in the dark. Results were compared with those of a group of patients with unipolar depression (n= 24) and with those of a group of non-psychiatrically ill control subjects (n= 50). Lithium effects and propranolol effects were tested in subgroups. No group differences were seen in light suppression among bipolar patients, unipolar patients, and controls; an analysis of the whole group did not reveal differences in propranolol effect, differences in corticotropin or cortisol levels, or evidence for a lithium effect. However, patients with bipolar I affective disorder showed the following: (1) significantly lower melatonin levels on the light night, at baseline and following light exposure; and (2) a later peak time for melatonin on the dark night. The general hypothesis of increased light sensitivity in bipolar patients was not supported. However, melatonin secretion abnormalities were confirmed in the subgroup with bipolar I disorder. Further assessments of circadian rhythm disruption as a vulnerability marker in bipolar illness are indicated.

Melatonin in postmenopausal females.

There is little information about the interaction between melatonin, sexual steroids and neuroendocrine system in postmenopausal females, even if former research showed that melatonin is clearly involved in human physiology and pathophysiology. We evaluated the overnight urinary excretion of 6-sulfatoxymelatonin (6-SMT) using a radioimmunoassay in 60 postmenopausal women. The group has been divided into patients with insomnia (10), hyperprolactinemia (7), depression (9), obesity (7) and controls (27). Compared to controls 6-SMT values were significantly higher in depressive females. Patients with hyperprolactinemia showed a trend toward a significantly elevated average nocturnal melatonin concentration. Melatonin levels were significantly lower in patients with insomnia and obese postmenopausal females than in controls. Since previous studies described lower melatonin levels in postmenopausal than in premenopausal women, the indication of melatonin therapy, especially for sleep disorders in this collective, can be handled more generously. Melatonin should be prescribed restrictively in patients with depression and in those with hyperprolactinemia. The role of melatonin in obese females remains unclear.

Circadian Disturbances after Night-Shift Work Onboard a Naval Ship

The aim of the present study was to investigate how night duties can affect the circadian rhythms of military personnel working onboard a naval ship. Twenty individuals on a regular day-work schedule from 9:00 a.m. to 6:00 p.m. (serving as controls) and 40 individuals on night-shift duties participated in the study. Salivary melatonin and cortisol profiles were established within two 24-hour periods from 2-hour saliva samplings. Under the condition of abrupt shift in work/rest schedule, the majority of the navy officers (52%) retained their normal melatonin profiles. Twelve percent displayed a right phase shift in melatonin rhythm after night work. Nineteen percent exhibited distortions in the form of abnormal peaks or troughs, and 17% showed signs of disrupted rhythm in the form of low daytime levels of melatonin throughout the sampling period. No consistent relationship was found between the melatonin changes and various work stations of the ship. Prominent changes in the cortisol profile included unexpected peaks or troughs that may be related to the conditions that individuals were exposed to, i.e., high noise level in the engine room, as well as to performing intense tracking operations. The findings of this study (1) show the possible detrimental effects of shift duties on circadian rhythms, (2) highlight a wide interindividual variation in the manner in which the circadian systems respond to an abrupt phase shift in work/rest schedules, and (3) form the basis for further investigations into effective strategies to help military personnel cope with shift work, thereby maintaining health and high working standards while on duty.

Effects of photoperiod and melatonin on lymphocyte activities in male broiler chickens

Understanding the role of the pineal gland in regulating the immune response and the role of photoperiod in influencing pineal gland secretions are becoming increasingly important. The purposes of the present experiments were to investigate the effects of different photoperiod regimens on T- and B-lymphocyte activities in broiler chickens. Next, the influence of different photoperiod regimens on the responsiveness of lymphocytes to melatonin in vitro was examined. The effect of melatonin in vitro on lymphocyte activities was also studied, regardless of the photoperiod received. Finally, the effects of photoperiod on the profiles of different splenocyte cell types were investigated. To study the effect of photoperiod on lymphocyte activities, different photoperiod regimens were used. These were: constant lighting, 23 h light:1 h darkness; intermediate lighting, 12 h light:12 h darkness; and intermittent lighting, 1 h light:3 h darkness. Peripheral blood and splenic lymphocyte activities were tested at 3 and 6 wk of age by performing a mitogen cell-proliferation assay with a polyclonal T-cell mitogen, concanavalin A (Con A), and T-dependent B-cell mitogen, pokeweed mitogen (PWM). To study the effect of photoperiod on the responsiveness of lymphocytes to melatonin in vitro or the effect of melatonin in vitro on lymphocyte activities regardless of photoperiod received, lymphocytes from the chickens that were exposed to the different photoperiod regimens were incubated with mitogen and different concentrations of melatonin. To study the effect of photoperiod on profiles of different cell types, the percentages of splenocyte subpopulations from birds exposed to different photo-periods were determined using flow cytometry with CD4+, CD8+, CD3+, and B-cell markers. The results of these studies indicate that splenic T and B lymphocytes from 6-wk-old chickens grown in intermittent lighting had higher activities than those from chickens grown in constant lighting. Peripheral blood and splenic lymphocytes from chickens raised under constant lighting were more responsive to melatonin in vitro than those from chickens raised under intermittent lighting. This difference in response may be due to lower levels of melatonin in birds receiving constant lighting, making them more sensitive to melatonin in vitro. Melatonin in vitro enhanced the mitogenic response of peripheral blood T lymphocytes from 6-wk-old chickens, splenic T lymphocytes from 3-wk-old chickens, and splenic T and possibly B lymphocytes from 6-wk-old chickens. Finally, intermittent lighting increased the percentages of splenic CD4+, CD8+, and CD3+ cells but not B-cell subpopulations at 6 wk of age, presumably because of increased levels of melatonin in birds receiving intermittent lighting. Our results re-emphasize the importance of melatonin in regulating host immune response; this regulation could be accomplished through exposing broiler chicks to intermittent lighting.

Highly sensitive and specific assay of plasma melatonin using high-performance liquid chromatography with fluorescence detection preceded by solid-phase extraction.

This paper describes a new, highly sensitive, rapid method for the determination of low levels of endogenous melatonin, the pineal and retinal hormone, in fish plasma samples. The combination of solid-phase extraction and high-performance liquid chromatography with fluorescence detection significantly improves the separation and increases the sensitivity of the assay. The proposed method may be a useful alternative to previously reported procedures. The assay should be applicable to plasma and tissue samples from other animals, including humans, with only minor modifications.

Prostate cancer and tumor stage-dependent circadian neuroendocrine disturbances

The aim of this study was to analyze the circadian profiles of central and peripheral circulating hormones in patients with unoperated primary localized prostate cancer and to test whether any specific endocrine disturbances occur in the presence and/or during the growthf these tumors. The hormones analyzed in serum included melatonin, total testosterone, luteinizing hormone (LH), prolactin, Cortisol, total thyroxine, and thyroid stimulating hormone (TSH). Blood was collected at 4-hourly intervals over one complete 24-h cycle from 18 patients with prostate cancer, from 20 patients with unoperated benign prostatic hyperplasia (BPH) serving as age-matched controls, and from 18 young men. The single cosinor method was used for the mathematical analysis of circadian rhythmicity. The most obvious result was that the circadian amplitude of melatonin was drastically depleted in prostate cancer patients compared to those with BPH (-71%). Prostate cancer patients with primary tumors staged as T2 and higher showed extremely low melatonin levels, leading to the loss of detectable circadian rhythms. A similar trend was observed for prolactin in prostate cancer patients. A further prominent finding was that the MESOR (rhythm-adjusted 24-h mean) of TSH was clearly depleted in prostate cancer patients compared to those with BPH (-46%), showing very low values in patients with T2 and T3/T4 tumors in spite of normal total thyroxine concentrations. The circadian profiles of total testosterone, LH and Cortisol did not exhibit any marked cancer-specific changes, indicating that neither the pituitary-gonadal nor the pituitary-adrenal axis was affected by malignant growth. The observed circadian endocrine disturbances in prostate cancer patients thus show clear central endocrine disturbances. It is at present unclear whether these changes may bear any direct functional significance for the progression and prognosis of prostate cancer. It is, furthermore, unknown how these changes are generated and whether the depression of pineal melatonin secretion may be functionally involved in the observed disturbed circadian secretion of prolactin and TSH.

Circadian profiles of melatonin in melancholic depressed patients and healthy subjects in relation to cortisol secretion and sleep

Circadian secretion of melatonin was measured in melancholic depressed patients (n=9) and age- and sex-matched healthy control patients (n=9). The mean age of the depressed patients was 29 years, i.e. younger than in most earlier studies, and a drug-free interval of 3 weeks preceded the investigations. Melatonin secretion was similar in depressed patients and healthy subjects with no significant differences at any of the time points, thus not confirming earlier studies in which depressed patients were found to have lower melatonin levels than control patients. The discrepancy between our result and earlier studies may be explained by different patient characteristics such as age, duration of illness, previous treatment, and alcohol intake. It is conceivable that a diminution of nocturnal melatonin secretion in depressed patients might only occur during the long-term course of the depressive illness and/or its pharmacological treatment.© 1997 Elsevier Science Ireland Ltd.

24-h-Melatonin-Serumprofile bei Mammakarzinom-Patientinnen im Vergleich zu einer tumorfreien Kontrollgruppe

24-hour serum profiles of melatonin were determined in 48 female postmenopausal mammary carcinoma patients in comparison to a tumour-free control group and correlated with the status of steroid hormone receptors and histopathological parameters. The day-night oscillation that is typical for melatonin with the lowest values by midday and maximum values by night, was found with individual differences of the absolute values in all of the female tumour patients just as in the control group. Large primary tumours with marked invasion of lymphatic nodes displayed lower levels of melatonin in serum than tumours classified as T 1 N 0 M 0 . No relation between melatonin serum levels and the nuclear grading or the histological type of tumour was found. The same result was confirmed for the differentiation of steroid receptor-positive and negative tumours. There was no correlation of melatonin serum levels with the time of survival in patients who were free from metastases: The results obtained in this study show that melatonin is not a suitable prognostic factor for mammary carcinoma.

The pineal complex and melatonin affect the expression of the daily rhythm of behavioral thermoregulation in the green iguana.

Daily variation in the body temperature of the green iguana (Iguana iguana) was studied by telemetry in laboratory photo-thermal enclosures under a 12Light:12Dark (L:D) photoperiod. The lizards showed robust daily rhythms of thermoregulation maintaining their body temperatures (Tb) at higher levels during the day than during the night. Some animals maintained rhythmicity when kept in constant darkness. On light:dark cycles parietalectomy produced only a transient increase of median Tb in the first or second night following the operation. Pinealectomized lizards on the other hand maintained their body temperatures as significantly lower levels during the day and at significantly higher levels during the night than did sham-operated or intact lizards. This effect was apparently permanent, since one month after pinealectomy lizards still displayed the altered pattern. Plasma melatonin levels in intact animals were high during the night and low during the day and were unaffected by parietalectomy. Pinealectomized lizards showed low levels of plasma melatonin during both the day and the night. A daily intraperitoneal injection of melatonin in pinealectomized animals given a few minutes after the light to dark transition decreased the body temperatures selected by the lizards during the night and increased the body temperatures selected during the following day. Control injections of saline solution had no effect. The significance of these results is discussed in relation to the role of the pineal complex and melatonin in the mediation of thermoregulatory behavior.

Pineal microdialysis of the melatonin in conscious sheep: methodology, application to a diurnal rhythm and effect of isoproterenol.

This paper describes the development of a new technique to measure melatonin contents in the pineal gland of moving sheep: the microdialysis. A dialysis probe was used to collect extracellular fluid in the sheep pineal gland, but also to inject directly into it different drugs such as isoproterenol at a very low concentration. The probe was implanted the day before the beginning of the experiment in order to obtain low levels of melatonin. This technique makes it possible to measure melatonin in the dialysate and plasma of rams submitted to 8L:16D. No melatonin either in the dialysate or in the plasma was found during the light phase. Shortly after lighting off, the melatonin concentration increased in the dialysate and plasma and remained stable during the dark phase. Melatonin concentrations began to decrease before lighting on and no detectable levels were found during the following light phase. The secretion of melatonin is, at least, under adrenergic regulation. Local infusion of isoproterenol (90 microliters at 10(-6) M), an agonist of beta adrenergic receptor, through the probe, increased melatonin levels during 2 h, even when infusions were repeated 3 times. This demonstrates the presence of beta adrenergic receptors. The technique presented in this paper could be of considerable interest for studying sheep pineal gland and its main secretion, melatonin, for example during diurnal rhythms or for studying its regulation.

Daily Melatonin Treatments Regulate the Circadian Melatonin Rhythm in the Adult Djungarian Hamster

The present study tested the hypothesis that daily melatonin treatments influence the biological clock mechanism controlling the circadian melatonin rhythm. Adult male and female Djungarian hamsters in light:dark = 16L:8D (lights on 0300-1900 h) were administered melatonin subcutaneously (s.c.) each day (5 micrograms/0.2 ml saline) in the morning at 1000 h (AM) or late afternoon at 1700 h (PM); controls received a vehicle injection (CON). After 14 days, pineal and serum melatonin concentrations were determined at various times on the last day of treatment and the next day in constant darkness (no treatment). The rhythm in pineal gland melatonin content was similar in each of the three groups on the last day of treatment (about 6 h duration). On the next day in constant dark, the rising phase was advanced and duration extended by 2 h or more in melatonin-treated hamsters compared to that in CONs (ANOVA). In circulation, the melatonin rhythm in AM and PM groups was phase advanced (onset and peak) on both days of the study. Thus duration was extended by up to 4.5 h compared to that in saline-treated controls. Moreover, amplitude of the nighttime serum melatonin rise was elevated up to fivefold relative to that in the CON group (ANOVA and Accumulated Sums analysis). The effects of repeated melatonin treatments on amplitude and phase of the serum melatonin rhythm raise the possibility that the circadian clock that controls pineal gland production of melatonin may also regulate melatonin secretion. From this and another study, the apparent half-life of melatonin in circulation was estimated to be 7.5 min; the melatonin injection initially produced pharmacological concentrations that were followed by low serum melatonin levels within 2 h. Thus, in both melatonin treatment groups, the data suggest that two distinct periods of elevated serum melatonin were present each day. The cellular mechanism for melatonin action must take into consideration how a brief interruption in elevated melatonin in circulation (about 1 h in the PM group) is recognized as a continuous duration (short daylength), whereas a more extended baseline period is transduced as an abbreviated or long daylength (about 7 h in the AM group). These data further suggest that the biological clock mechanism that generates the circadian melatonin rhythm is responsive to the influence of daily melatonin treatments and presumably to the feedback action of endogenous melatonin on its own rhythm in the Djungarian hamster in long days.

Hepatic hydroxylation of melatonin in the rat is induced by phenobarbital and 7,12-dimethylbenz[a]anthracene--implications for cancer etiology.

The protective function of the pineal hormone melatonin in the etiology of cancer and carcinogenic activation is increasingly well-established. Low melatonin levels seem to parallel cancer growth. The question arises as to which factors cause the depression of melatonin levels and what the direct effects are. Melatonin is known to be metabolized in the liver by hydroxylation and subsequent conjugation yielding 6-sulfatoxymelatonin as a main product. Nevertheless, the microsomal monoxygenases catalyzing the first step have been poorly investigated. To further characterize these enzymes, typical inducers of three different sub-classes, namely phenobarbital, 7,12-dimethylbenz[a]anthracene, and 17 beta-estradiol, were administered to female Fischer rats. Circadian urinary excretion patterns of melatonin and 6-sulfatoxymelatonin were determined over a 24-hour period on the third (second) day of induction. Liver homogenates were used to monitor the in vitro conversion of melatonin or 6-hydroxymelatonin to 6-sulfatoxymelatonin. Results of both approaches showed the microsomal monoxygenases catalyzing the 6-hydroxylation of melatonin to be strongly inducible by phenobarbital and to a lesser degree by the polyaromatic hydrocarbon 7,12-dimethylbenz[a]anthracene. The dramatic depletion of circulating melatonin as a result of these induction patterns and its possible implications for oncogenesis are discussed.

Idiopathic pain and depression.

This report summarizes research on the hypothesis that idiopathic chronic pain syndromes and depressive disorders share certain common pathogenetic mechanisms. There is increasing evidence that this may be partly true. Not only do chronic pain syndromes respond to treatment with antidepressants, but there are also striking clinical similarities between these syndromes and depressive syndromes. However, important differences do exist (e.g., the courses of these disorders are usually dissimilar). Family studies show that affective disorders are common in first-degree relatives of patients with idiopathic pain syndromes, but it is impossible to conclude from this that clear-cut genetic factors are of importance. Factors common to both syndromes include common personality traits, shortened rapid eye movements in sleep EEG, hypercortisolaemia and pathological dexamethasone suppression tests, low levels of melatonin in serum and urine and high levels of endorphins and Fraction I in cerebro-spinal fluid. One important common pathogenetic mechanism seems to be disturbances in the serotoninergic system.

Melatonin disturbances in anorexia nervosa and bulimia nervosa.

The pineal gland releases melatonin into the blood stream in response to sympathetic noradrenergic stimulation of pinealocytes. This process is inhibited by light via the retino-hypothalamic-pineal pathway. Hence melatonin is predominantly released in darkness. Because serotonin is a precursor of melatonin, the intake of dietary tryptophan may also influence melatonin levels. Although the exact physiological role of melatonin in humans is unclear, it appears to be implicated in reproductive physiology, especially in terms of the onset of menarche. Low levels of melatonin also occur in depression. In this review, studies of melatonin in patients with anorexia nervosa and bulimia nervosa are considered in relation to potential abnormalities of noradrenergic function and circadian rhythm. The influence of weight loss, binging and purging, and depression on melatonin is discussed. Other studies involving the assessment of melatonin in relation to menstrual function are required.