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EN
Melatonin (MT) exerts a beneficial action in the treatment of many diseases, among them also in irritable bowel syndrome (IBS). Its secretion decreases with age, particularly, in the postmenopausal period in women. It has not been determined whether these changes can have an impact on the clinical picture of IBS. The study aimed at evaluating the urinary excretion of the main MT metabolite - 6-hydroxymelatonin sulphate (6-HMS) in women at different age with IBS. The investigations were carried out in five groups of 30 women each. Group Ia (the controls) – premenopausal healthy women (20-39 years), group Ib (the controls) – postmenopausal healthy women (46-66 years), group II – women with constipation predominant IBS (IBS-C; 19-42 years), group III – women with diarrhoea predominant IBS (IBS-D; 20-39 years), group IV- women with IBS-C (49-68 years), group V – women with IBS-D (48-69 years). The diagnosis of IBS was based on the Rome III Criteria after excluding other diseases. On the day of the study the patients remained on the same liquid diet (Nutridrink – 3x400 ml) and 1500 ml of still mineral water. 6-HMS concentration in urine was measured by ELISA method applying IBL antibodies (RE-54031, Immunological Laboratories). The results showed that 24-hour urinary 6-HMS excretion in the studied premenopausal women were as follows: group Ia – 15.13±5.83 µg/24 h, group II – 28.85±12.59 µg/24 h (p<0,01), group III – 26.10±11.76 µg/24 h (p<0,01) and in the postmenopausal subjects they were: group Ib – 10.66±3.23 µg/24 h, group IV – 13.73±5.09 µg/24 h ((p=0,02), group V – 21.39±10.88 µg/24 h (p<0,01). In women with IBS-C the obtained results of 24-hour 6-HMS urinary excretion were independent on the intensity of clinical symptoms. On the other hand, in women with IBS-D, both in the group III and V, higher intensity of ailments was accompanied by significantly increased 6-HMS urinary excretion. The results of the study allowed drawing the following conclusions: (1). 24-hour 6-HMS urinary excretion in women with the constipation-predominant (IBS-C) as well as the diarrhoea-predominant IBS (IBS-D) is higher than in healthy persons both in the premenopausal and postmenopausal period. (2). Relatively high 6-HMS urinary excretion in postmenopausal women with IBS-D indicates an adaptive increase in MT secretion from EC in the gut.
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EN
Ulcerative colitis (UC) is a chronic disease characterized by the variable clinical picture with the inflammatory changes which can involve the whole colon or its distal part. The current treatments for UC are mostly nonspecific, not always effective, and often accompanied by serious side effects. Therefore, there is a considerable interest in finding alternative and more tolerable treatments for this serious disease. Several lines of experimental studies have shown that melatonin (MEL) regulates the extensive gut immune system and exerts antiinflammatory and immunomodulatory effects suggesting its beneficial action in UC by reducing and controlling inflammation. The study aimed at evaluating the effect of MEL on the activity of inflammatory process and sustaining the remission in patients with UC. It comprised 60 patients with left-sided UC, divided in two equal groups of 30 patients each (38 women and 22 men, aged 26-49 years), similar in both groups, who were in clinical remission for the last 12 months. Patients, during a next period of 12 months, were given mesalazine in daily doses 2 x 1.0 g and melatonin 5 mg daily at bedtime (group I) or placebo (group II). All the patients on MEL adjuvant treatment remained in remission during 12 months of observation with The Mayo Clinic Disease Activity Index (MCDAI) values 1.50±0.51 at the beginning and 2.75±1.86 points after 12 months. In the placebo group significantly higher MCDAI values were observed than in patients on MEL after 6, 9 and 12 months. At the inclusion MCDAI was 1.61±0.68 points and at the end of observation it reached the value of 5.10±2.22 points. In MEL group CRP level remained within the normal range during the course of the study (from 3.49±1.40 to 4.17±2.10 mg/dl). Whereas in the placebo group from the end of the third month the steady rise in CRP blood concentration was noted from 3.85±1.29 to 13.13±6.08 mg/dl. Parallelly to CRP rise a significant decrease in hemoglobin concentration in blood from 12.05±0.69 to 10.93±0.81 g/dl was observed in patients receiving placebo and the values significantly differed between the groups after 3 (p<0.05), 6, 9 and 12 months (p<0.01). The level of anxiety and the intensity of depression in patients on adjuvant MEL decreased during the study but there were no statistical differences noted between the groups. The results of the study allowed drawing the conclusion that adjuvant melatonin therapy may help in sustaining remission in patients with UC.
5
Content available remote Nocturnal secretion of melatonin in patients with upper digestive tract disorders
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EN
Recently, the results of many experimental investigations have shown that melatonin possesses gastroprotective properties. On the other hand its role in pathogenesis of upper digestive tract diseases in man still remains unclear. The aim of the study was to investigate nocturnal secretion of melatonin in patients with functional and organic diseases of the upper part of digestive tract. The investigations were carried out in 149 persons, aged 21-51 years, including healthy subjects (group I, n=30), and patients with non-erosive gastroduodenal reflux (NERD, group II, n=24), with gastroesophageal reflux disease (GERD, group III, n=25), with functional dyspepsia (FD, according to the Rome III Criteria, group IV, n=36) and with recurrent duodenal ulcer (DUD, group V, n=34). Diagnoses were established on the basis of endoscopic imaging and histological examination, 24-hour pH-metry and laboratory tests. Melatonin serum concentration was measured with ELISA method. Blood samples were taken for examination in red-lighted room at 10 p.m. and on the following day at 2 and 6 a.m. The highest concentration of melatonin in all examined groups was determined at 2 a.m. The average melatonin concentration in healthy subjects was 34,7 ± 4,8 pg/ml. In patients with GERD and DUD melatonin concentration was lower than in healthy subjects - 27,2 ± 8,5 pg/ml and 25,5 ± 6,2 pg/ml respectively (p < 0,05; p < 0,01). The highest concentration of melatonin was found in patients with NERD and FD - 43,2 ± 10,8 pg/ml and 42,4 ± 10,1 pg/ml (p < 0,01; p < 0,05). The findings of this study support the notion that melatonin exerts beneficial influences on the upper digestive tract. It is likely that high or relatively correct secretion of melatonin is sufficient to prevent peptic changes in esophageal and duodenal mucosa.
EN
The pathogenesis of stomach cells can be associated with their susceptibility to exogenous dietary irritants, like nitrosamines such as dimethylnitrosamines (DMNA), and to the effects of non-dietary factors, including Helicobacter pylori infection. We used N-methyl-N'-nitro N-nitrosoguanidyne (MNNG) as a surrogate agent that induces a spectrum of DNA damage similar to DMNA. Using the alkaline comet assay, we showed that antioxidants--vitamins C and E, quercetin, and melatonin--reduced the genotoxic effect of MNNG in H. pylori-infected and non-infected human gastric mucosa cells (GMCs). To compare the sensitivity of the stomach and the blood, the experiment was also carried out in peripheral blood. We observed a higher level of DNA damage induced by MNNG in H. pylori-infected than in noninfected GMCs. We did not note any difference in the efficacy of the repair of the damage in either type of GMC. H. pylori infection may play an important role in the pathogenesis of GMCs, as it can modulate their susceptibility to dietary mutagens/carcinogens, thus contributing to gastric cancer.
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