Melatonin
Natural compound
Overview
Melatonin, an indoleamine, is a natural compound produced by various organisms, including bacteria and eukaryotes. Its discovery in 1958 by Aaron B. Lerner and colleagues stemmed from the isolation of a substance from the pineal gland of cows that could induce skin lightening in common frogs. This compound was later identified as a hormone secreted in the brain during the night, playing a crucial role in regulating the sleep-wake cycle, also known as the circadian rhythm, in vertebrates.
In vertebrates, melatonin's functions extend to synchronizing sleep-wake cycles, encompassing sleep-wake timing and blood pressure regulation, as well as controlling seasonal rhythmicity (circannual cycle), which includes reproduction, fattening, molting, and hibernation. Its effects are mediated through the activation of melatonin receptors and its role as an antioxidant. In plants and bacteria, it serves as a defense mechanism against oxidative stress, indicating its evolutionary significance. Mitochondria, key organelles, are the main producers of melatonin, underscoring its "ancient origins" and its fundamental role in protecting the earliest cells from reactive oxygen species.
In addition to its endogenous functions as a hormone and antioxidant, melatonin is also administered exogenously as a dietary supplement and medication. Melatonin is used medically primarily for sleep-related problems: for example, prolonged-release melatonin (Circadin) is approved in several countries for short-term treatment of insomnia in people aged 55 years of age or older. It is used in the treatment of sleep disorders, including insomnia and various circadian rhythm sleep disorders.
Numerous studies suggest that disruption of melatonin production may underlie the association between light exposure before and during sleep and impaired sleep quality. It has also been suggested that light-induced disruption of melatonin production may potentially affect cognitive, emotional, cardiovascular, and metabolic functions.
Source: English Wikipedia, "Melatonin".
Mechanism of Action
Mechanism of melatonin biosynthesis The mechanism of melatonin biosynthesis initiates with the hydroxylation of L-tryptophan, a process that requires the cofactor tetrahydrobiopterin (THB) to react with oxygen and the active site iron of tryptophan hydroxylase. Although the complete mechanism is not entirely understood, two main mechanisms have been proposed: The first mechanism involves a slow transfer of one electron from THB to molecular oxygen (O2), potentially producing a superoxide (O−2). This superoxide could then recombine with the THB radical to form 4a-peroxypterin. 4a-peroxypterin may either react with the active site iron (II) to create an iron-peroxypterin intermediate or directly transfer an oxygen atom to the iron, facilitating the hydroxylation of L-tryptophan.
Alternatively, the second mechanism proposes that oxygen interacts with the active site iron (II) first, forming iron (III) superoxide. This molecule could then react with THB to form an iron-peroxypterin intermediate.
Following the formation of iron (IV) oxide from the iron-peroxypterin intermediate, this oxide selectively attacks a double bond to yield a carbocation at the C5 position of the indole ring. A subsequent 1,2-shift of the hydrogen and the loss of one of the two hydrogen atoms on C5 would restore aromaticity, producing 5-hydroxy-L-tryptophan.
The decarboxylation of 5-hydroxy-L-tryptophan to produce 5-hydroxytryptamine is then facilitated by a decarboxylase enzyme with pyridoxal phosphate (PLP) as a cofactor. PLP forms an imine with the amino acid derivative, facilitating the breaking of the carbon–carbon bond and release of carbon dioxide. The protonation of the amine derived from tryptophan restores the aromaticity of the pyridine ring, leading to the production of 5-hydroxytryptamine and PLP.
Serotonin N-acetyltransferase, with histidine residue His122, is hypothesized to deprotonate the primary amine of 5-hydroxytryptamine. This deprotonation allows the lone pair on the amine to attack acetyl-CoA, forming a tetrahedral intermediate. The thiol from coenzyme A then acts as a leaving group when attacked by a general base, producing N-acetylserotonin.
What the Evidence Shows
Dementia A 2020 Cochrane review found no evidence that melatonin helped sleep problems in people with moderate to severe dementia due to Alzheimer's disease. A 2019 review found that while melatonin may improve sleep in minimal cognitive impairment, after the onset of Alzheimer's disease it had little to no effect. Melatonin may, however, help with sundowning (increased confusion and restlessness at night) in people with dementia.
Pain A 2026 meta-analysis concluded that people taking melatonin supplements may experience relief from musculoskeletal pain similar in magnitude to the effects of typical analgesics. Although melatonin may be considered as an adjunct option for pain relief, it had only modest effects, and the quality of evidence for efficacy was low to moderate.
^ McCleery J, Sharpley AL (November 2020). "Pharmacotherapies for sleep disturbances in dementia". The Cochrane Database of Systematic Reviews. 2020 (11) CD009178. doi:10.1002/14651858.CD009178.pub4. PMC 8094738. PMID 33189083.
^ Spinedi E, Cardinali DP (2019). "Neuroendocrine-Metabolic Dysfunction and Sleep Disturbances in Neurodegenerative Disorders: Focus on Alzheimer's Disease and Melatonin". Neuroendocrinology. 108 (4): 354–364. doi:10.1159/000494889. hdl:11336/86560. PMID 30368508. S2CID 53101746.
^ Gao C, Scullin MK, Bliwise DL (2019). "Mild Cognitive Impairment and Dementia". In Savard J, Ouellet MC (eds.). Handbook of Sleep Disorders in Medical Conditions. Academic Press. pp. 253–276. doi:10.1016/b978-0-12-813014-8.00011-1. ISBN 978-0-12-813014-8. S2CID 88265944.