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The Redox Homeostasis Alteration Is Restored by Melatonin Treatment in COVID-19 Patients

Jan 2024  
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Prospective study of 17 hospitalized COVID-19 patients showing restored redox homeostasis, decreased oxidative stress, improved antioxidant enzyme activity, modulated glucose homeostasis, and inhibited Warburg effect with melatonin treatment. Melatonin capsules (5mg) were administered every 12 hours for 5 days. The results suggest that melatonin may restore altered redox homeostasis in COVID-19 through antioxidant and anti-inflammatory effects, and could be used as an adjuvant therapy.
Soto et al., 31 Jan 2024, prospective, Israel, preprint, 9 authors. Contact: (corresponding author), (corresponding author),,,,,,,,
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The Redox Homeostasis Alteration Is Restored by Melatonin Treatment in COVID-19 Patients
María Elena Soto, Israel Pérez-Torres, Linaloe Manzano-Pech, Adrían Palaciós-Chavarría, Rafael Ricardo Valdez-Vázquez, Verónica Guarner-Lans, Elizabeth Soria-Castro, Eulises Díaz-Díaz, Vicente Castrejón-Tellez
Type II pneumocytes are the target of SARS-CoV-2 which alters their redox homeostasis to increase reactive oxygen species (ROS). Melatonin (MT) has antioxidant proprieties and protects mitochondrial function. Here we evaluated whether the treatment with MT compensated for the redox homeostasis alteration in serum from COVID-19 patients. We determined oxidative stress (OS) markers such as carbonyls, glutathione (GSH), total antioxidant capacity (TAC), thiols, nitrites (NO2 -), lipid peroxidation (LPO), and thiols groups in serum. We also studied the enzymatic activities of glutathione peroxidase (GPx), -S-transferase (GST), reductase (GR), thioredoxin reductase (TrxR), extracellular superoxide dismutase (ecSOD) and peroxidases. There was a significant increase in LPO and carbonyls (p≤0.03) and a decrease in TAC, NO2 -, thiols, GSH, (p<0.001) in COVID-19 patients. The activities of the ecSOD, TrxR, GPx, GST, GR and peroxidases were decreased (p≤ 0.04). The treatment with MT favored the activity of the antioxidant enzymes which contributed to increase TAC and restored the lost redox homeostasis. MT also modulated glucose homeostasis functioning as a glycolytic agent and inhibited the Warburg effect. Thus, MT restores the redox homeostasis which is altered in COVID-19 patients and can be used as adjuvant therapy in the SARS-CoV-2 infection.
Institutional Review Board Statement: The studies involving human participants were reviewed and approved by ethical approval from the local ethics committee on 19 August 2020 (Control-9867/2020, register REG. CONBIOETICA-09 CEI-011-20160627). A written informed consent for enrollment or consent to use patient data was obtained from each patient or their legal surrogate. The protocol was registered (TRIAL REGISTRATION: Identifier: NCT 04570254). Informed Consent Statement: The patients/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request. Conflicts of Interest: The authors declare no conflicts of interest. The authors declare that they have no known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.
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