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Melatonin: Roles in influenza, Covid-19, and other viral infections.

Reviews in medical virology
May 1, 2020
George Anderson et al. (2 authors)
Journal ArticleReviewMolecular Study
Study Details

Study Goal

The researchers aimed to explore the role of melatonergic pathways in viral infections, particularly influenza and COVID-19, and how melatonin influences immune responses and mitochondrial metabolism.

Results Summary

The study found that melatonin regulates immune cell phenotypes by influencing mitochondrial metabolism via the Bmal1/PDC pathway, countering viral suppression. It also highlighted that viral and cytokine-driven disruptions of melatonin pathways contribute to immune dysregulation and gut permeability, exacerbating symptoms.

Population

Not specified (theoretical focus on viral infections, particularly influenza and COVID-19).

Effective Dosage

Not provided

Duration

Not specified

Interactions

None mentioned

Extracted Claims (20)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Viral, or preexistent, suppression of pineal melatonin
increase
neutrophil attraction
-
-
disinhibits
#1
Viral, or preexistent, suppression of pineal melatonin
increase
initial "cytokine storm"
-
-
contributing to
#2
Melatonin
increase
the circadian gene, Bmal1
-
-
induces
#3
Bmal1
increase
the pyruvate dehydrogenase complex (PDC)
-
-
disinhibits
#4
PDC
increase
mitochondrial conversion of pyruvate to acetyl-coenzyme A (acetyl-CoA)
-
-
drives
#5
PDC
increase
the tricarboxylic acid cycle
-
-
increasing
#6
PDC
increase
oxidative phosphorylation
-
-
increasing
#7
PDC
increase
ATP production
-
-
increasing
#8
Pineal melatonin suppression
decrease
circadian "resetting" of mitochondrial metabolism
-
-
attenuates this
#9
Shifting metabolism from glycolytic to oxidative phosphorylation
change
cells from reactive to quiescent phenotypes
immune cells
-
switches
#10
Acetyl-CoA
increase
initiating the melatonergic pathway
-
-
providing an acetyl group to serotonin
#11
Pineal melatonin
neutral
mitochondrial melatonin
-
-
regulates
#12
Pineal melatonin
neutral
immune cell phenotype
-
-
regulates
#13
Virus- and cytokine-storm-driven control of the pineal and mitochondrial melatonergic pathway
neutral
immune responses
-
-
regulates
#14
Virus-and cytokine storm-driven changes
increase
gut permeability
-
-
increase
#15
Virus-and cytokine storm-driven changes
increase
dysbiosis
-
-
increase
#16
Virus-and cytokine storm-driven changes
decrease
levels of the short-chain fatty acid, butyrate
-
-
suppressing
#17
Virus-and cytokine storm-driven changes
increase
circulating lipopolysaccharide (LPS)
-
-
increasing
#18
The alterations in butyrate and LPS
increase
viral replication
-
-
can promote
#19
The alterations in butyrate and LPS
increase
host symptom severity
-
-
can promote
#20
Abstract

There is a growing appreciation that the regulation of the melatonergic pathways, both pineal and systemic, may be an important aspect in how viruses drive the cellular changes that underpin their control of cellular function. We review the melatonergic pathway role in viral infections, emphasizing influenza and covid-19 infections. Viral, or preexistent, suppression of pineal melatonin disinhibits neutrophil attraction, thereby contributing to an initial "cytokine storm", as well as the regulation of other immune cells. Melatonin induces the circadian gene, Bmal1, which disinhibits the pyruvate dehydrogenase complex (PDC), countering viral inhibition of Bmal1/PDC. PDC drives mitochondrial conversion of pyruvate to acetyl-coenzyme A (acetyl-CoA), thereby increasing the tricarboxylic acid cycle, oxidative phosphorylation, and ATP production. Pineal melatonin suppression attenuates this, preventing the circadian "resetting" of mitochondrial metabolism. This is especially relevant in immune cells, where shifting metabolism from glycolytic to oxidative phosphorylation, switches cells from reactive to quiescent phenotypes. Acetyl-CoA is a necessary cosubstrate for arylalkylamine N-acetyltransferase, providing an acetyl group to serotonin, and thereby initiating the melatonergic pathway. Consequently, pineal melatonin regulates mitochondrial melatonin and immune cell phenotype. Virus- and cytokine-storm-driven control of the pineal and mitochondrial melatonergic pathway therefore regulates immune responses. Virus-and cytokine storm-driven changes also increase gut permeability and dysbiosis, thereby suppressing levels of the short-chain fatty acid, butyrate, and increasing circulating lipopolysaccharide (LPS). The alterations in butyrate and LPS can promote viral replication and host symptom severity via impacts on the melatonergic pathway. Focussing on immune regulators has treatment implications for covid-19 and other viral infections.

Medical Subject Headings (MeSH)
AnimalsBetacoronavirusBiosynthetic PathwaysCOVID-19Circadian RhythmCircadian Rhythm Signaling Peptides and ProteinsCoronavirus InfectionsCytokinesHumansInfluenza, HumanMelatoninMitochondriaOrthomyxoviridaePandemicsPineal GlandPneumonia, ViralSARS-CoV-2Viruses
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations146
Citations/Year29.2
Relative Citation Ratio9.63
NIH Percentile97.7%
Research Impact Scores
APT Score0.95
Weight Score1.40
Normalized Score0.66
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