Melatonin is a versatile molecule, synthesized not only in the pineal gland, but also
in many other organs. Melatonin plays an important physiologic role in sleep and circadian
rhythm regulation, immunoregulation, antioxidant and mitochondrial-protective functions,
reproductive control, and regulation of mood. Melatonin has also been reported as
effective in combating various bacterial and viral infections. Melatonin is an effective
anti-inflammatory agent in various animal models of inflammation and sepsis, and its
anti-inflammatory action has been attributed to inhibition of nitric oxide synthase
with consequent reduction of peroxynitrite formation, to the stimulation of various
antioxidant enzymes thus contributing to enhance the antioxidant defense, and to protective
effects on mitochondrial function and in preventing apoptosis. In a number of animal
models of septic shock, as well as in patients with septic disease, melatonin reportedly
exerts beneficial effects to arrest cellular damage and multiorgan failure. The significance
of these actions in septic shock and its potential usefulness in the treatment of
multiorgan failure are discussed.
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