Dissertations / Theses on the topic 'Melatonin. Nervous system'

Copper is an extremely toxic metal in biological systems and thus, its availability to the system, must be effectively and efficiently controlled. Copper is vital for life, as it is essential for critical enzymes in biological systems. It is free copper in the biological systems that is toxic, as free copper induces free radical generation, which disrupts lipid membranes, interacts with DNA causing mutations, and eventually leads to cell death. Wilson’s disease is a inherited copper disease, which results in hepatolenticular disease. Copper is unable to be excreted, and thus accumulates, eventually spilling over into the bloodstream from the liver, and “poisons” the patient. The Wilson’s disease patient leads a short life, due to neurological and hepatological problems. There is no cure for Wilson’s disease, only chelation therapy using potent chelators such as penicillamine and EDTA. Zinc, in high doses, can be used to compete with copper absorption. This has proved to be the only successful therapy at present. This study investigates the possible use of melatonin as a copper binder/chelator. Melatonin has been shown to interact with copper in vitro. By binding/chelating to copper, melatonin may inhibit copper-induced free radical generation, and thus prevent copper from interacting with DNA to cause mutations and act as a cytotoxin. In vivo studies on copper (2mg/kg) administered for 2-weeks and 6-weeks were carried out on Wistar rats. The potential of melatonin (12mg/kg) to prevent copper-induced cellular damage was investigated. The results indicate that melatonin does not protect the lipid membranes from copper-induced lipid peroxidation. In vitro investigations using 1mM, 5mM and 10mM copper and 5mM melatonin, show that melatonin prevents copper-induced lipid peroxidation at a copper concentration of 1mM (p<0.001). The 5mM and 10mM copper induces less lipid peroxidation, compared to the 1mM copper. It has been reported that metal ions, antioxidants and chelating agents can influence peroxide decomposition during the assay. Melatonin (5mM) administration does not significantly prevent copper-induced lipid peroxidation at 5mM and 10mM copper. It is possible that due to melatonin’s relatively low concentration, it is unable to inhibit lipid peroxidation induced by the copper. The chemical nature of the interaction between melatonin and copper was also investigated, using NMR, IR and electrochemistry techniques. The NMR and IR techniques show that melatonin coordinates with Cu²⁺ and not Cu¹⁺, at the carbonyl group of melatonin. The electrochemistry experiments using cyclic voltammetry and adsorptive stripping voltammetry, show that melatonin forms a strong bond with Cu¹⁺. Cu²⁺ prefers binding to oxygen, and that is clearly seen in the NMR and IR. Cu¹⁺ prefers binding to nitrogen and then oxygen, and this is seen in the electrochemistry, as Cu¹⁺ is forced to bind through one of the nitrogens on the melatonin. Previously, it has been shown that melatonin binds/chelates with Cu²⁺. Histochemical investigations show that copper administration for 2-weeks and 6-weeks, causes extensive mitochondrial damage in liver and kidney’s proximal convoluted tubule epithelium cells. Melatonin (12mg/kg) co-administration with copper for 2-weeks and 6-weeks did not significantly protect the mitochondria from copper-induced damage. Copper-specific stains (rhodanine, silver sulphide and rubeanic acid) were used to stain liver, brain and kidney tissue samples. Rhodanine and silver sulphide were equally sensitive in staining copper in the 2-week samples, but not at all in the 6-week samples. This could not be explained. Rubeanic acid was ineffective in all samples tested. Thus, it appears that specific copper stains cannot be used in making a definitive diagnosis in cases of copper overload, and that specific copper stains do not always correlate with a high concentration of copper present in tissues. Pineal organ culture was used to determine the effect of copper administration on pineal indole synthesis. Exogenous (³H) tryptophan was administered to the pineal organ cultures, and the level of (³H) pineal indoles synthesised, were measured. Pineals from 2-week and 6-week copper/melatonin treated animals exhibited paradoxical 5- methoxytryptophol (ML) levels, as compared to the 2-week and 6-week copper treated animals. The 2-week copper/melatonin administered animals, showed a decrease in the ML level (p<0.01), and the copper/melatonin administered for 6-weeks, showed an increase in the ML levels (p<0.01). This indicates that melatonin interacts with the HIOMT enzyme. Pineals from 6-week copper/melatonin treated animals, as compared to the 6-week copper treated animals, showed an increase in N-acetylserotonin levels. This indicates that melatonin prevents the inhibition of the NAT enzyme. The final experiment was to determine in vitro, the effect of Cu²⁺ and Cu¹⁺ administration, on mitochondrial electron transport chain. Rat liver homogenate was incubated with and solutions of Cu²⁺ (10mM) and Cu¹⁺ (10mM) and melatonin (10mM). Cu²⁺ administration caused an inhibition of the electron transport at t=0 and t=60, whereas Cu¹⁺ administration at t=0 caused an inhibition of electron transport, but at t=60, Cu¹⁺ administration stimulated electron transport. Melatonin administered with Cu²⁺, resulted in an inhibition of the electron transport chain at t=0 and t=60. The findings of this study indicate that melatonin might have a potentially beneficial effect in copper overloading, by binding/chelating copper.

Parkinson’s disease, one of the most common neurodegenerative disorders associated with ageing, is characterised by abnormal and profound loss of nigrostriatal dopaminergic neurons. The cause of Parkinson’s disease is unknown, but epidemiological studies suggest an association with pesticides and other environmental toxins, and biochemical studies implicate oxidative damage and mitochondrial impairment, particularly at the level of complex I enzyme. Recently, rotenone, a commonly used organic pesticide and a classical inhibitor of mitochondrial complex I has been reported to reproduce the specific features of Parkinson’s disease in rodents. The mitochondrial respiratory chain is one of the most important sites of reactive oxygen species production under physiological conditions. Toxic free radicals have been implicated in a variety of neurodegenerative diseases as well as ageing itself. Melatonin, a secretory product of the pineal gland is a multifaceted free radical scavenger and natural antioxidant. In the present study, the neuroprotective effects of melatonin against the environmental neurotoxin, rotenone was investigated. Initial studies showed that inhibition of mitochondrial complex I enzyme by rotenone induced superoxide radical generation. Melatonin, administered to the rat in vivo and in vitro was able to offer neuroprotection by curtailing the production of superoxide radicals induced by rotenone. Mitochondria, being the major target of rotenone, the effects of melatonin were investigated at the mitochondrial level. Melatonin was able to increase the electron transport chain activity thus preventing the respiratory inhibition by rotenone. The pineal hormone also counteracted the action of rotenone on complex I enzyme. These results suggest melatonin’s ability to potentially limit the free radical generation and thereby modulate the mitochondrial functions. The detection and measurement of lipid peroxidation is the evidence most frequently cited to support the involvement of free radical reactions in toxicology and in human disease. Melatonin also offered significant protection in vivo and in vitro against rotenone induced lipid peroxidation. Since iron plays a major role in oxidative damage and in the progression of Parkinson’s disease, the effect of melatonin on both rotenone and iron induced lipid peroxidation was investigated, the results of which show that melatonin affords protection and this was suggested to be due to its interaction with the rotenone-iron complex that might have formed. Electrochemical studies were further used to characterise the interactions between melatonin, rotenone and iron (III). Melatonin was shown to bind with iron and thus reducing their toxicity. Histological studies were undertaken to assess the effects of melatonin on rotenone induced toxicity on the dopaminergic neurons in the rat brain. Rotenone treated brains showed extensive neuronal damage whereas with melatonin less damage was observed. Rotenone induces apoptosis via reactive oxygen species production and apoptotic cell death has been identified in PD brains. Furthermore, the apoptotic cell death was detected and quantified by the TUNEL staining. Rotenone treated sections showed signs of apoptosis whereas with melatonin, less apoptotic damage was observed. The findings of this study indicate that the neurohormone, melatonin may protect against rotenone-induced neurodegeneration. Since melatonin production falls substantially during ageing, the loss of this antioxidant is theorized to be instrumental in the degenerative processes associated with advanced age. Considering how devastating diseases such as Parkinson’s disease, are to a patient and the patient’s families, the discovery of protective agents are a matter of urgency. Further investigations using the pesticide model will help to determine the involvement of environmental exposure in the pathogenesis of human diseases as well as to test therapeutic strategies for the treatment of such diseases.

Dopamine mechanisms in the central nervous system are important in the control of both normal and abnormal motor function. The recent observations in both animal and human studies, that melatonin, the principal hormone of the pineal gland, may have a role in the control of movement and the pathophysiology of movement disorders, have given rise to the concept that melatonin may have a modulatory influence on central dopaminergic neurotransmission. This study makes use of three animal behavioural models as well as a biochemical model of central dopaminergic function to further investigate the concept. Results from studies using the biochemical model, which investigated the effect of melatonin on dopamine and apomorphine stimulation of dopamine-sensitive adenylate cylase, suggest that melatonin is neither a competitive antagonist nor agonist at the D₁ receptor level, although the possibility of physiological stimulation or antagonism is not excluded. In behavioural studies, prior melatonin mg/kg administration (1 and 10 (8M) ip) inhibited apomorphine induced stereotypy and locomotor activity in normal rats, and apomorphine-induced rotational behaviour in 6-hydroxydopamine and quinolinic acid lesioned rats. The possibility that these results may have physiological significance is borne out by the observation that, under enviromental lighting conditions that are associated with raised endogeous melatonin levels, apomorphine- induced stereotypy and locomotor activity is attenuated. The general conclusion is that melatonin has an inhibitory influence on central nervous system dopaminergic function, suggesting therefore, that the pineal gland and melatonin may have a role in the pathophysiology and treatment of movement and behavioural disorders associated with dopaminergic dysfunction

Chez les Mammifères, les rythmes circadiens, présentant une rythmicité endogène proche de 24h sont sous le contrôle d'une horloge interne située dans les Noyaux Suprachiasmatiques de l'hypothalamus (NSC). Afin de mieux comprendre la distribution du message temps par les NSC, nous avons étudié spécifiquement le contrôle du rythme journalier de sécrétion de mélatonine, hormone sécrétée de nuit par la glande pinéale, partant du postulat selon lequel les NSC contrôleraient ce rythme en utilisant, pendant la journée, un signal inhibiteur de nature GABAergique pour inhiber la voie polysynaptique reliant les Noyaux paraventriculaires de l'hypothalamus (PVN) à la glande pinéale. Nos premiers travaux ont révélé, par lésions thermiques des différents noyaux intéressés, un rôle de simple relais de l'information pour les PVN, ainsi qu'une action inhibitrice des NSC sur la synthèse de mélatonine de jour associée à une action stimulatrice nocturne. A l'aide de la technique de microdialyse intracérébrale multiple, nous avons ensuite pu confirmer, in vivo, que l'activité neuronale nocturne des NSC était cruciale pour une stimulation nocturne de synthèse de mélatonine. De plus, un rôle important du neurotransmetteur glutamate a pu être montré pour cette action stimulatrice. Nous avons également montré que la chute de sécrétion de mélatonine en fin de nuit était due à une augmentation de sécrétion GABAergique par les NSC associée soit à la disparition du signal stimulateur soit à l'apparition d'un second signal inhibiteur. Par ailleurs, en corrélant l'expression neuronale des gènes de l'horloge Per1 et Per2 et la sécrétion de vasopressine par les NSC, nous avons révélé une régionalisation fonctionnelle des NSC. Ensemble, les résultats de cette thèse ont permis de réactualiser le concept du contrôle du rythme journalier de mélatonine par l'horloge biologique, exemple de moyen de distribution du message temps au reste de l'organisme via le système nerveux autonome
In mammals, circadian rhythms, i. E. Showing an endogenous rhythmicity close to 24h are under the control of a master biological clock, located in the suprachiasmatic nucleus of the hypothalamus (SCN). In order to further understand the mechanisms of time distribution by the SCN, we specifically studied the control of the daily secretion of melatonin, hormone strictly produced at night by the pineal gland, with the initial hypothesis that the SCN controls the daily rhythm of melatonin synthesis by imposing during daytime an inhibitory signal of GABAergic nature onto the polysynaptic pathway connecting the Paraventricular Nucleus of the hypothalamus (PVN) to the pineal gland. By lesioning or removing the different nuclei involved in this pathway, our first study revealed a simple role of information-relay for the PVN, as well as a combined inhibitory and stimulatory role for the SCN during the day and the night respectively. Using the multiple intracerebral microdialysis technique, we were then able to confirm in vivo that the SCN nocturnal activity is crucial for a nocturnal stimulation of melatonin synthesis and we showed as well that glutamatergic transmission is responsible for such a stimulatory action onto the melatonin synthesis. In addition, we revealed that the early morning drop of melatonin synthesis is due to the association of an increased GABAergic secretion derived by the SCN and either the disappearance of the stimularory signal or the appearance of a second inhibitory signal. Furthermore, correlating the neuronal expression of the clock genes Per1 and Per2 and the SCN vasopressin secretion, we revealed a clear functional compartmentalisation of the SCN. Together these results helped re-actualising the concept of the control of the daily rhythm of melatonin synthesis by the biological clock, which is a great example of time distribution to the rest of the organism via the autonomic nervous system

The duodenal mucosa is regularly exposed to acid, digestive enzymes and ingested noxious agents. It is thus critical to maintain a protective barrier to prevent the development of mucosal injury and inflammation, which are often observed in situations when barrier function is impaired. The rate of mucosal bicarbonate secretion, the regulation of epithelial paracellular permeability and motility are each key components of duodenal barrier function. The hormone melatonin is present in high levels in the gastrointestinal tract and it has been hypothesized that melatonin exerts protective properties. This thesis aims to investigate the impact of exogenous melatonin on the regulation of duodenal barrier function and motility in anesthetized rats in vivo. In addition, duodenal tissue was examined histologically and the expression levels of tight junction proteins and melatonin receptors were assessed with qRT-PCR. It was found that melatonin stimulated mucosal bicarbonate secretion and decreased basal paracellular permeability. Exposing the duodenal mucosa to the well-characterized barrier breaker ethanol increased mucosal bicarbonate secretion, paracellular permeability and motility. Omission of luminal Clˉ abolished, while pretreatment with a nicotinic receptor antagonist reduced, the ethanol-induced bicarbonate secretion suggesting that the secretory response to ethanol is meditated via Clˉ/HCO3ˉexchangers and enteric neural pathways. Melatonin reduced the ethanol-induced increases in paracellular permeability and motility either when injected intravenously or when administered in drinking water for two weeks. The actions of melatonin were abolished by the melatonin receptor antagonist luzindole and by nicotinic acetylcholine receptor inhibition. Two weeks oral administration of melatonin up-regulated the expression levels of melatonin receptors, down-regulated the expression of ZO-3 while the expression of ZO-1, ZO-2, claudin 2-4, occludin and myosin light chain kinase were unaffected. Superficial epithelial changes in a few villi were seen in response to ethanol exposure, an effect that was histologically unchanged by melatonin pretreatment. In conclusion, the results suggest that melatonin plays an important role in the neurohumoral regulation of gastrointestinal mucosal barrier function and motility via receptor- and enteric neural-dependent pathways in vivo in rats. Melatonin might be a candidate for treatment of barrier dysfunction in humans.

"Life" may be characterized as a controlled stationary flow equilibrium, maintained by energy consuming chemical reactions. The physiological functioning of these life systems include at least 28 of the elements isolated on the periodic table thus far, most of which are metals. However, as with Paracelsus Principle: "The dose makes the poison", there exists a definite link between metal levels, essential and toxic, and the onset of neurodegenerative diseases. The economic costs of brain dysfunction are enormous, but this pales in comparison to the staggering emotional toll on the victims themselves and their families. In an attempt to improve the understanding of the causes of neurodegeneration, this study focuses on one potential aspect: the possible link between metals and neurotransmitter homeostasis utilising a variety of electronanalytical techniques. Adsorptive cathodic stripping voltammetry was employed to investigate the binding affinities and complex formation of melatonin and its precursor serotonin with calcium, potassium, sodium, lithium and aluminium. The results showed that all the metals studied formed complexes with both pineal indoleamines. However, the stability and affmity of the ligands toward the various metals varied greatly. The study suggests a further role for melatonin, that of metalloregulator and possible metal detoxifier in the brain, the in vivo studies which followed will further substantiate this notion. This research additionally focused on the cholinergic system, in particular acetylcholine complex formation studies with mercury, lead, cadmium, copper and zinc using the adsorptive cathodic stripping voltammetry method. The formation and characterisation of a solid mercury-acetylcholine complex lent further strength to the in situ electrochemical complex formation observed. The results showed the preference of acetylcholine for environmentally toxic heavy metals (such as Cd²⁺) over those divalent cations that occur naturally in the body. The possible metalloregulatory role melatonin played in the three brain regIOns: cerebellum, cortex and corpus striatum of male Wistar rats was studied as an in vivo extension of the earlier in vitro studies. Anodic stripping voltammetry was employed to detect metal levels present. The results showed that daily injections of melatonin was responsible for significantly decreasing copper(I), cadmium(II) and lead(II) levels in various regions of the rat brain of those animals that had undergone a pinealectomy in comparison to the saline injected group having undergone the same treatment. Histological and electrochemical stripping techniques were applied to investigate the implications of high A1³⁺ levels in the brain regions, particularly the hippocampus. Melatonin showed signs of promise in indirect symptom alleviation and by significantly decreasing A1³⁺ levels in rats that had been dosed with melatonin prior to A1³⁺ treatments in comparison with the control groups. Finally a preliminary study outlining a method for the production of a calcium selective microelectrode was undertaken. Further work is still needed to optimise the microelectrode production as well as its possible applications. However, whilst the overall conclusions of this entire multidisciplinary study may indeed only be in effect one piece of a very large puzzle on neurodegenerative diseases, this piece will no doubt serve as a building block for further ideas and work in this field.

The duodenal lumen is exposed to aggressive factors with a high potential to cause damage to the mucosa. Bicarbonate secretion by the duodenal mucosa is accepted as the primary important defense mechanism against the hydrochloric acid intermittently expelled from the stomach.

The present thesis concerns the influence of the central nervous system and the effects of the hormone melatonin on bicarbonate secretion in anesthetized rats in vivo. Effects of melatonin on intracellular calcium signaling by duodenal enterocyte in vitro were examined in tissues of both human and rat origin. The main findings were as follows:

Melatonin is a potent stimulant of duodenal mucosal bicarbonate secretion and also seems to be involved in the acid-induced stimulation of the secretion. Stimulation elicited in the central nervous system by the α1-adrenoceptor agonist phenylephrine induced release of melatonin from the intestinal mucosa and a four-fold increase in alkaline secretion. The melatonin antagonist luzindole abolished the duodenal secretory response to administered melatonin and to central nervous phenylephrine but did not influence the release of intestinal melatonin. Central nervous stimulation was also abolished by synchronous ligation of the vagal trunks and the sympathetic chains at the sub-laryngeal level.

Melatonin induced release of calcium from intracellular stores and also influx of extracellular calcium in isolated duodenal enterocytes. Enterocytes in clusters functioned as a syncytium.

Overnight fasting rapidly and profoundly down-regulated the responses to the duodenal secretagogues orexin-A and bethanechol but not those to melatonin or vasoactive intestinal polypeptide.

In conclusion, the results strongly suggest that intestinal melatonin plays an important role in central nervous elicited stimulation of duodenal mucosal bicarbonate secretion. Sensitivity of this alkaline secretion to some peripheral stimulators markedly depends on the feeding status.

The duodenal epithelium is regularly exposed to HCl, digestive enzymes, bacteria and toxins, and sometimes also to ethanol and drugs. The imbalance of aggressive factors in the intestinal lumen and mucosal barrier function increases the risk of tissue injury and inflammation. The key components of the duodenal barrier function include mucosal permeability, bicarbonate transport and the secretion or absorption of fluids. This thesis aims to elucidate the role of melatonin, neuropeptide S (NPS) and short chain fatty acids (SCFAs) in the regulation of intestinal mucosal barrier function and motility in the anesthetized rat in vivo and in tissues of human origin in vitro. Melatonin was found to reduce ethanol-induced increases in paracellular permeability and motility by a neural pathway within the enteric nervous system involving nicotinic receptors. In response to luminal exposure of ethanol, signs of mild mucosal edema and beginning of desquamation were observed in a few villi only, an effect that was not influenced by melatonin. Melatonin did not modify increases in paracellular permeability in response to luminal acid. NPS decreased basal and ethanol-induced increases in duodenal motility as well as bethanechol stimulated colonic motility in a dose-dependent manner. Furthermore, NPS was shown to inhibit basal duodenal bicarbonate secretion, stimulate mucosal fluid absorption and increase mucosal paracellular permeability. In response to luminal exposure of acid, NPS increased bicarbonate secretion and mucosal paracellular permeability. All effects induced by the administration of NPS were dependent on nitrergic pathways. In rats, administration of NPS increased the tissue protein levels of the inflammatory biomarkers IL-1β and CXCL1. Immunohistochemistry showed that NPS was localized at myenteric nerve cell bodies and fibers, while NPSR1 and nNOS were only confined to the myenteric nerve cell bodies. Perfusing the duodenal segment with the SCFAs acetate or propionate reduced the duodenal mucosal paracellular permeability, decreased transepithelial net fluid secretion and increased bicarbonate secretion. An i.v. infusion of SCFAs reduces mucosal paracellular permeability without any effects on mucosal net fluid flux. However, it significantly decreased bicarbonate secretion. Luminal SCFAs changed the duodenal motility pattern from fasting to feeding motility while i.v. SCFAs was without effect on motility. The systemic administration of glucagon-like peptide-2 (GLP-2) induced increases in mucosal bicarbonate secretion and fluid absorption. An i.v. GLP-2 infusion during a luminal perfusion of SCFAs significantly reduced the duodenal motility. In conclusion, the results in the present thesis show that melatonin, NPS and SCFAs influence the neurohumoral regulation of intestinal mucosal barrier function and motility. Aberrant signaling in response to melatonin, NPS and to luminal fatty acids might be involved in the symptom or the onset of disease related to intestinal dysfunction in humans.

Research funders and strategic development areas:

- Bengt Ihre Foundation (grant SLS-177521)

- Socialstyrelsen(grant SLS-176671)

- Erik, Karin, and Gösta Selanders Foundation

- Emil and Ragna Börjesson Foundation

- Uppsala University 

- Ministry of Education of Malaysia

- Universiti Malaysia Sabah, Malaysia

AIDS Dementia Complex (ADC) is a neurodegenerative disorder implicated in HIV-1 infection that is associated with elevated levels of the neurotoxin, quinolinic acid (QA) which causes a cascade of events to occur, leading to the production of reactive oxygen species (ROS), these being ultimately responsible for oxidative neurotoxicity. In clinical studies, Non-nucleoside reverse transcriptase inhibitors (NNRTIs), efavirenz (EFV) and nevirapine (NVP) have been shown to potentially delay the progressive degeneration of neurons, thus reducing the frequency and neurological deficits associated with ADC. Despite these neuroprotective implications, there is still no biochemical data to demonstrate the mechanisms through which these agents offer neuroprotection. The present study aims to elucidate and further characterize the possible antioxidant and neuroprotective mechanisms of NVP and EFV in vitro and in vivo, using QA-induced neurotoxicity as a model. Research has demonstrated that antioxidants and metal chelators have the ability to offer neuroprotection against free radical induced injury and may be beneficial in the prevention or treatment of neurodegeneration. Hence the antioxidant and metal binding properties of these agents were investigated respectively. Inorganic studies, including the 1, 1-diphenyl-2 picrylhydrazyl (DPPH) assay, show that these agents readily scavenge free radicals in vitro, thus postulating the antioxidant property of these agents. The enhancement of superoxide radical generation and iron mediated Fenton reaction by QA is related to lipid peroxidation in biological systems, the extent of which was assayed using the nitroblue tetrazolium and thiobarbituric acid method respectively. Both agents significantly curtail QA-induced lipid peroxidation and potentially scavenge superoxide anions generated by cyanide in vitro. Furthermore, in vivo results demonstrate the ability of NVP and EFV to protect hippocampal neurons against lipid peroxidation induced by QA and superoxide radicals generated as a consequence thereof. The alleviation of QA-induced oxidative stress in vitro possibly occurs through the binding of iron (II) and / or iron (III), and this argument is further strengthened by the ability of EFV and not NVP to reduce iron (II)-induced lipid peroxidation in vitro directly. In addition the ferrozine and electrochemistry assay were used to measure the extent of iron (II) Fe[superscript 2+] and iron (III) Fe[superscript 3+] chelation activity. Both assays demonstrate that these agents bind iron (II) and iron (III), and prevent redox recycling of iron and subsequent complexation of Fe[superscript 2+] with QA which enhances neuronal damage. Both NNRTIs inhibit the endogenous biosynthesis of QA by inhibiting liver tryptophan 2, 3-dioxygenase activity in vivo and subsequently increasing hippocampal serotonin levels. Furthermore, these agents reduce the turnover of hippocampal serotonin to 5-hydroxyindole acetic acid. NVP and not EFV increase 5-hydroxyindole acetic acid and norepinephrine levels in the hippocampus. The results of the pineal indole metabolism study show that NVP increases the synthesis of melatonin, but decreases N-acetylserotonin, 5-hydroxyindole acetic acid and 5-hydroxytryptophol levels. Furthermore, it shows that EFV decreases 5-hydroxyindole acetic acid and melatonin synthesis. Behavioural studies using a Morris water maze show that the post-treatment of rats with NVP and EFV significantly improves QA-induced spatial memory deficits in the hippocampus. This study therefore provides novel information regarding the neuroprotective mechanisms of NVP and EFV. These findings strengthen the argument that these NNRTIs not only have antiviral effects but possess potential neuroprotective properties, which may contribute to the effectiveness of these drugs in the treatment of ADC.

Introdução: A fibromialgia (FM) é uma síndrome de dor crônica musculoesquelética difusa, cuja etiologia não está totalmente conhecida. A síndrome cursa com dor, alterações do humor e sintomas de ruptura do ritmo circadiano. Sabe-se que seu processo fisiopatogênico envolve um desbalanço entre os sistemas de modulação excitatório e inibitório da dor. A capacidade do sistema modulatório inibitório está enfraquecida, com hiperativação de neurônios e da neuroglia, constituindo um quadro de sensibilização central. Portanto, estudos adicionais são necessários para compreender a relação entre possíveis marcadores séricos da hiperativação neuronal, tais como o Brain Derived Neurotrophic Factor (BDNF) e a proteína S100 beta (S100B). Além disso, estudos que busquem opções terapêuticas com efeito em vias neurobiológicas alternativas, tais como a melatonina, uma indolamina com efeitos ressincronizador, analgésico, anti-inflamatório e em sistemas moduladores da dor, como o gabaérgico, opioidérgico e glutamatérgico. Objetivos: 1) Primário: Avaliar se os níveis séricos de BDNF e S100B teriam associação com a FM e se ambos os mediadores sorológicos poderiam ser associados com o limiar de dor à pressão. 2) Secundário: Testar o tratamento com melatonina isolada ou em combinação com amitriptilina é melhor que amitriptilina isolada para modificar o sistema modulatório da dor. Assim, para provar tais hipóteses, neste estudo foram quantificados a modulação condicionada da dor e níveis de BDNF sérico em pacientes que receberam tratamento com melatonina isolada ou associada com amitriptilina. Foi também testado se melatonina melhoraria os sintomas clínicos como dor, limiar de dor à pressão e qualidade do sono relacionado à FM. Métodos: Foram selecionadas pacientes com diagnóstico de FM de acordo com o American College of Rheumatology (ACR) 2010. No primeiro estudo, de desenho transversal, foram incluídas 56 mulheres com FM, com idades entre 18 e 65 anos. Foram avaliados o limiar de dor à pressão e dosagem sérica de BDNF e S100B. No segundo estudo, foram incluídas 63 pacientes com os mesmos critérios de inclusão descritos no estudo transversal. As pacientes foram randomizadas e receberam, ao deitar, amitriptilina (25mg) (n=21), melatonina (10mg) (n=21) ou melatonina (10 mg) + amitriptilina (25mg) (n=21), durante seis semanas. O sistema modulatório descendente da dor foi acessado pela modulação condicionada da dor, através da mensuração da escala numérica de dor (NPS(0-10)) durante aferição do limiar de dor ao calor. Resultados: O resultado do estudo transversal mostrou que BDNF e S100B séricos foram correlacionados. BDNF e S100B foram inversamente correlacionados com limiar de dor à pressão. BDNF sérico foi associado com limiar de dor à pressão, idade e transtorno obsessivo compulsivo, enquanto que S100B sérica foi apenas associada com limiar de dor à pressão. O ensaio clínico randomizado demonstrou que a melatonina aumentou a potência do sistema modulatório da dor inibitório e que a modulação condicionada da dor foi negativamente correlacionada com BDNF sérico. Conclusões: Os estudos desta tese demonstram que S100B e BDNF, ambos mediadores chave no processo de sensibilização central, foram inversamente correlacionados com o limiar de dor à pressão. BDNF sérico foi, ainda, inversamente correlacionado com a redução da dor. Portanto, a avaliação sérica de BDNF e S100B merece estudos adicionais para determinar seu potencial papel sinalizador no espectro da sensibilização central nessa doença.
Introduction: Fibromyalgia (FM) is a syndrome of chronic diffuse musculoskeletal pain whose etiology is not fully known. This syndrome causes pain, mood swings and symptoms of rupture of the circadian rhythm. Its pathophysiological process involves an imbalance between excitatory and inhibitory pain modulatory systems. The ability of inhibitory systems is weakened, providing a framework of central sensitization, with dysfunction in the descending pain modulatory system, hyper-activation of neurons and neuroglia. Therefore, additional studies are needed to understand the possible relationship between serum markers of neuronal hyperactivity, such as Brain Derived Neurotrophic Factor (BDNF) and S100B. Particularly, studies seeking therapeutic options with effect in neurobiological alternative pathways such as melatonin, a indolamine with resynchronization, analgesic, and anti-inflammatory effects and actions on the modulatory pain systems such as GABAergic, opiodergic and glutamatergic. Objectives: 1) Primary: Evaluate whether the serum levels of BDNF and S100B have association with FM and if both serological mediators could be associated with pressure pain threshold. 2) Secondary: To test the hypothesis that treatment with melatonin alone or in combination with amitriptyline is better than amitriptyline alone to modify the endogenous pain modulatory system. Thus, to prove these hypothesis, it was quantified the conditioned pain modulation and serum BDNF levels in FM patients receiving treatment with melatonin alone or in combination with amitriptyline. Also, it was tested whether melatonin would improve clinical symptoms such as pain, pressure pain threshold and quality of sleep related to FM. Methods: Patients with FM according to the American College of Rheumatology (ACR) 2010 were selected. In the first study, a cross-sectional design, 56 women aging 18-65 years old, with FM were included. It was evaluated the pressure pain threshold, and serum levels of BDNF and S100B. In the second study, 63 patients were included with the same inclusion criteria described in the cross-sectional study. Patients were randomized and received at bedtime amitriptyline (25 mg) (n = 21), melatonin (10 mg) (n = 21) or melatonin (10 mg) + amitriptyline (25 mg) (n = 21) for six weeks. The descending pain modulatory system was accessed by the conditioned pain modulation, measuring the numerical pain scale [NPS (0-10)] during the heat pain threshold. Results: On the cross-sectional study serum BDNF and S100B were correlated. Serum BDNF and S100B were correlated with the pressure pain threshold. Serum BDNF was associated with pressure pain threshold, age and obsessive compulsive disorder, while serum S100B was associated with pressure pain threshold, only. The randomized clinical trial showed that melatonin increased the efficacy of inhibitory pain modulatory system and the conditioned pain modulation was negatively correlated with serum BDNF. Conclusions: The studies of this thesis show that both key mediators of the central sensitization process, BDNF and S100B, were inversely correlated with the pressure pain threshold. They also showed that melatonin increased the inhibitory pain modutalory system. Furthermore, it emphasizes that serum BDNF was inversely correlated with pain reduction. Therefore, assessment of serum BDNF and S100B deserve further studies to determine their potential as a proxy for the central sensitization spectrum in FM.