Melatonin and inflammatory bowel disease: From basic mechanisms to clinical application

Inflammatory bowel disease is a chronic inflammatory disease and has periods of recurrence and remission. Improper immune responses to gut flora bacteria, along with genetic susceptibility, appear to be involved in causing this complex disease. It seems dysbiosis and oxidative stress may also be involved in IBD pathogenesis. A significant number of clinical studies have shown an interesting association be-tween sleep disturbances and IBD. Studies in animal models have also shown that sleep deprivation has a significant effect on the pathogenesis of IBD and can aggravate inflammation. These interesting findings have drawn attention to melatonin, a sleep-related hormone. Melatonin is mainly produced by the pineal gland, but many tissues in the body, including the intestines, can produce it. Melatonin can have an interesting effect on the pathogenesis of IBD. Melatonin can enhance the intestinal mucosal barrier, alter the composition of intestinal bacteria in favor of bacteria with anti-inflammatory properties, regulate the immune response, alleviate inflammation and attenuate oxidative stress. It seems that, melatonin sup-plementation is effective in relieving inflammation and healing intestinal ulcers in IBD animal models. Some clinical studies have also shown that melatonin supplementation as an adjuvant therapy may be helpful in reducing disease activity in IBD patients. In this review article, in addition to reviewing the effects of sleep disturbances and melatonin on key mechanisms involved in the pathogenesis of IBD, we will review the findings of clinical studies regarding the effects of melatonin supplementation on IBD treatment.(c) 2022 Published by Elsevier B.V.

Automated summary

Inflammatory bowel disease (IBD) is a chronic inflammatory disease characterized by periods of recurrence and remission. Improper immune responses and genetic susceptibility are believed to be involved in IBD pathogenesis, along with dysbiosis and oxidative stress. Sleep disturbances have been found to be associated with IBD, and animal studies suggest that sleep deprivation can worsen inflammation. Melatonin, a sleep-related hormone, has shown promising effects in regulating the immune response, reducing inflammation, and healing intestinal ulcers in IBD animal models. Clinical studies have also suggested that melatonin supplementation may be helpful in reducing disease activity in IBD patients. This review article aims to examine the effects of sleep disturbances and melatonin supplementation on IBD, including their mechanisms of action and clinical implications.