The use of melatonin as a neuroprotector in the therapy of ischemic stroke

Abstract

Statistics of the World Health Organization (WHO) show that the cerebrovascular disease is the second most frequent cause of death and the third – as the main disabling factor in the working age population. Timely treatment is the key to quickly recovering ischemic tissue. According to the different ischemic cascade stages, the variety of the treatment combinations are proposed. American Stroke Association guidelines 2018 contains no neuroprotectors. In this regard, there remains a need for a biochemical agent successfully blocking one or more stages of the ischemic cascade, preventing cell apoptosis. Melatonin is also considered as such substance due to its neuroprotective properties. The main function of melatonin is the regulation of the sleep-wake cycle. The nuclear and membrane receptors in various organs determines other biological effects of this hormone. The ability of melatonin to regulate the blood pressure, oncogenesis, ovaries cycle, retina function and differentiation of osteoblasts was found. The significant neuroprotective potential of melatonin is realized through the antioxidant, anti-excitotoxic and anti-inflammatory properties. The positive effect on the ischemic lesion size and stroke-related pathological conditions (delirium, insomnia) has been demonstrated both in animal experiments and in clinical studies.

Keywords

• cerebral ischemia
• melatonin
• stroke
• ischemic stroke
• neuroprotection