Melatonin on Clock Genes in Parkinson's Disease
Summary
Parkinson's disease (PD) is the second most important neurodegenerative disease that affects about 2% of the population over 60 years of age. About 40% of the Mexican population with PD suffer from sleep disorders, which has been linked to a deregulation of the circadian cycle and therefore of the clock genes. Melatonin is a hormone produced by the pineal gland that regulates the sleep-wake cycle, at pharmacological doses, it is used to decrease sleep disorders; it is suggested that is used could also normalize the levels of the clock genes expression. In rats with PD, a decrease in clock genes levels has been observed, which are restored by administering melatonin. The aim of the study is to evaluate the effect of melatonin on the expression of the PER1 and BMAL1 clock genes in patients with PD during 12 months. A controlled, double-blind, randomized clinical trial will be carried out in patients with a diagnosis of PD. A survey will be applied in order to know the course of the disease and two more tests to rule out some sleep disorder, at the beginning of the study, at the 6th month and at the 12th month. A blood sample (approximately 15 ml) will be taken every 3 months for a year. By random assignment, the participant will be given Melatonin or placebo, which should be taken every day in the morning and evening after meals for one year.
Timeline
- Start
- 2021-05
- Primary completion
- 2022-07
- Completion
- 2022-08
Publications
- Background Poewe W, Seppi K, Tanner CM, Halliday GM, Brundin P, Volkmann J, Schrag AE, Lang AE. Parkinson disease. Nat Rev Dis Primers. 2017 Mar 23;3:17013. doi: 10.1038/nrdp.2017.13.
- Background Barzilai A, Melamed E. Molecular mechanisms of selective dopaminergic neuronal death in Parkinson's disease. Trends Mol Med. 2003 Mar;9(3):126-32. doi: 10.1016/s1471-4914(03)00020-0.
- Background Shadrina MI, Slominsky PA, Limborska SA. Molecular mechanisms of pathogenesis of Parkinson's disease. Int Rev Cell Mol Biol. 2010;281:229-66. doi: 10.1016/S1937-6448(10)81006-8.
- Background Chung S, Bohnen NI, Albin RL, Frey KA, Muller ML, Chervin RD. Insomnia and sleepiness in Parkinson disease: associations with symptoms and comorbidities. J Clin Sleep Med. 2013 Nov 15;9(11):1131-7. doi: 10.5664/jcsm.3150.
- Background Breen DP, Vuono R, Nawarathna U, Fisher K, Shneerson JM, Reddy AB, Barker RA. Sleep and circadian rhythm regulation in early Parkinson disease. JAMA Neurol. 2014 May;71(5):589-595. doi: 10.1001/jamaneurol.2014.65.
- Background Cai Y, Liu S, Sothern RB, Xu S, Chan P. Expression of clock genes Per1 and Bmal1 in total leukocytes in health and Parkinson's disease. Eur J Neurol. 2010 Apr;17(4):550-4. doi: 10.1111/j.1468-1331.2009.02848.x. Epub 2009 Nov 12.
- Background Videnovic A, Willis GL. Circadian system - A novel diagnostic and therapeutic target in Parkinson's disease? Mov Disord. 2016 Mar;31(3):260-9. doi: 10.1002/mds.26509. Epub 2016 Jan 30.
- Background Cardinali DP, Pagano ES, Scacchi Bernasconi PA, Reynoso R, Scacchi P. Melatonin and mitochondrial dysfunction in the central nervous system. Horm Behav. 2013 Feb;63(2):322-30. doi: 10.1016/j.yhbeh.2012.02.020. Epub 2012 Feb 25.
- Background Videnovic A, Golombek D. Circadian Dysregulation in Parkinson's Disease. Neurobiol Sleep Circadian Rhythms. 2017 Jan;2:53-58. doi: 10.1016/j.nbscr.2016.11.001. Epub 2016 Nov 12.
- Background Elbaz A, Carcaillon L, Kab S, Moisan F. Epidemiology of Parkinson's disease. Rev Neurol (Paris). 2016 Jan;172(1):14-26. doi: 10.1016/j.neurol.2015.09.012. Epub 2015 Dec 21.
- Background Perfeito R, Cunha-Oliveira T, Rego AC. Reprint of: revisiting oxidative stress and mitochondrial dysfunction in the pathogenesis of Parkinson disease-resemblance to the effect of amphetamine drugs of abuse. Free Radic Biol Med. 2013 Sep;62:186-201. doi: 10.1016/j.freeradbiomed.2013.05.042. Epub 2013 Jun 3.
- Background Abou-Sleiman PM, Muqit MM, Wood NW. Expanding insights of mitochondrial dysfunction in Parkinson's disease. Nat Rev Neurosci. 2006 Mar;7(3):207-19. doi: 10.1038/nrn1868.
- Background Mattam U, Jagota A. Daily rhythms of serotonin metabolism and the expression of clock genes in suprachiasmatic nucleus of rotenone-induced Parkinson's disease male Wistar rat model and effect of melatonin administration. Biogerontology. 2015 Feb;16(1):109-23. doi: 10.1007/s10522-014-9541-0. Epub 2014 Nov 28.
- Background Ortiz GG, Benitez-King GA, Rosales-Corral SA, Pacheco-Moises FP, Velazquez-Brizuela IE. Cellular and biochemical actions of melatonin which protect against free radicals: role in neurodegenerative disorders. Curr Neuropharmacol. 2008 Sep;6(3):203-14. doi: 10.2174/157015908785777201.
- Background Ortiz GG, Pacheco-Moises FP, Gomez-Rodriguez VM, Gonzalez-Renovato ED, Torres-Sanchez ED, Ramirez-Anguiano AC. Fish oil, melatonin and vitamin E attenuates midbrain cyclooxygenase-2 activity and oxidative stress after the administration of 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine. Metab Brain Dis. 2013 Dec;28(4):705-9. doi: 10.1007/s11011-013-9416-0. Epub 2013 May 24.
- Background Trotti LM, Bliwise DL. Treatment of the sleep disorders associated with Parkinson's disease. Neurotherapeutics. 2014 Jan;11(1):68-77. doi: 10.1007/s13311-013-0236-z.
- Background Medeiros CA, Carvalhedo de Bruin PF, Lopes LA, Magalhaes MC, de Lourdes Seabra M, de Bruin VM. Effect of exogenous melatonin on sleep and motor dysfunction in Parkinson's disease. A randomized, double blind, placebo-controlled study. J Neurol. 2007 Apr;254(4):459-64. doi: 10.1007/s00415-006-0390-x. Epub 2007 Apr 3.
- Background Videnovic A, Zee PC. Consequences of Circadian Disruption on Neurologic Health. Sleep Med Clin. 2015 Dec;10(4):469-80. doi: 10.1016/j.jsmc.2015.08.004. Epub 2015 Sep 26.
- Background Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427-42. doi: 10.1212/wnl.17.5.427. No abstract available.
- Background Jankovic J. An update on the treatment of Parkinson's disease. Mt Sinai J Med. 2006 Jul;73(4):682-9.
- Background Fernandez HH. Updates in the medical management of Parkinson disease. Cleve Clin J Med. 2012 Jan;79(1):28-35. doi: 10.3949/ccjm.78gr.11005.
- Background Bolitho SJ, Naismith SL, Rajaratnam SM, Grunstein RR, Hodges JR, Terpening Z, Rogers N, Lewis SJ. Disturbances in melatonin secretion and circadian sleep-wake regulation in Parkinson disease. Sleep Med. 2014 Mar;15(3):342-7. doi: 10.1016/j.sleep.2013.10.016. Epub 2014 Jan 21.
- Background Zhang Y, Chen J, Qiu J, Li Y, Wang J, Jiao J. Intakes of fish and polyunsaturated fatty acids and mild-to-severe cognitive impairment risks: a dose-response meta-analysis of 21 cohort studies. Am J Clin Nutr. 2016 Feb;103(2):330-40. doi: 10.3945/ajcn.115.124081. Epub 2015 Dec 30.
- Background Taghizadeh M, Tamtaji OR, Dadgostar E, Daneshvar Kakhaki R, Bahmani F, Abolhassani J, Aarabi MH, Kouchaki E, Memarzadeh MR, Asemi Z. The effects of omega-3 fatty acids and vitamin E co-supplementation on clinical and metabolic status in patients with Parkinson's disease: A randomized, double-blind, placebo-controlled trial. Neurochem Int. 2017 Sep;108:183-189. doi: 10.1016/j.neuint.2017.03.014. Epub 2017 Mar 22.
- Background Mayo JC, Sainz RM, Tan DX, Antolin I, Rodriguez C, Reiter RJ. Melatonin and Parkinson's disease. Endocrine. 2005 Jul;27(2):169-78. doi: 10.1385/ENDO:27:2:169.
- Background Reiter RJ, Korkmaz A, Paredes SD, Manchester LC, Tan DX. Melatonin reduces oxidative/nitrosative stress due to drugs, toxins, metals, and herbicides. Neuro Endocrinol Lett. 2008 Oct;29(5):609-13.
- Background Castellani RJ, Nunomura A, Rolston RK, Moreira PI, Takeda A, Perry G, Smith MA. Sublethal RNA oxidation as a mechanism for neurodegenerative disease. Int J Mol Sci. 2008 May;9(5):789-806. doi: 10.3390/ijms9050789. Epub 2008 May 20.
- Background Reiter RJ. Oxidative damage in the central nervous system: protection by melatonin. Prog Neurobiol. 1998 Oct;56(3):359-84. doi: 10.1016/s0301-0082(98)00052-5.
- Background Korkmaz A, Reiter RJ, Topal T, Manchester LC, Oter S, Tan DX. Melatonin: an established antioxidant worthy of use in clinical trials. Mol Med. 2009 Jan-Feb;15(1-2):43-50. doi: 10.2119/molmed.2008.00117. Epub 2008 Nov 4.
- Background Mack JM, Schamne MG, Sampaio TB, Pertile RA, Fernandes PA, Markus RP, Prediger RD. Melatoninergic System in Parkinson's Disease: From Neuroprotection to the Management of Motor and Nonmotor Symptoms. Oxid Med Cell Longev. 2016;2016:3472032. doi: 10.1155/2016/3472032. Epub 2016 Oct 18.
- Background Panigel M. [Application of new methods to the anatomical study of the human and animal placenta]. Bull Assoc Anat (Nancy). 1989 Sep;73(222):47-53. No abstract available. French.
- Background Hartter S, Nordmark A, Rose DM, Bertilsson L, Tybring G, Laine K. Effects of caffeine intake on the pharmacokinetics of melatonin, a probe drug for CYP1A2 activity. Br J Clin Pharmacol. 2003 Dec;56(6):679-82. doi: 10.1046/j.1365-2125.2003.01933.x.
- Background Weishaupt JH, Bartels C, Polking E, Dietrich J, Rohde G, Poeggeler B, Mertens N, Sperling S, Bohn M, Huther G, Schneider A, Bach A, Siren AL, Hardeland R, Bahr M, Nave KA, Ehrenreich H. Reduced oxidative damage in ALS by high-dose enteral melatonin treatment. J Pineal Res. 2006 Nov;41(4):313-23. doi: 10.1111/j.1600-079X.2006.00377.x.
- Background Anderson G, Seo M, Berk M, Carvalho AF, Maes M. Gut Permeability and Microbiota in Parkinson's Disease: Role of Depression, Tryptophan Catabolites, Oxidative and Nitrosative Stress and Melatonergic Pathways. Curr Pharm Des. 2016;22(40):6142-6151. doi: 10.2174/1381612822666160906161513.
- Background Vural EM, van Munster BC, de Rooij SE. Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature. Drugs Aging. 2014 Jun;31(6):441-51. doi: 10.1007/s40266-014-0178-0.
- Background Lewy AJ, Sack RL, Miller LS, Hoban TM. Antidepressant and circadian phase-shifting effects of light. Science. 1987 Jan 16;235(4786):352-4. doi: 10.1126/science.3798117.
- Background Belaid H, Adrien J, Karachi C, Hirsch EC, Francois C. Effect of melatonin on sleep disorders in a monkey model of Parkinson's disease. Sleep Med. 2015 Oct;16(10):1245-51. doi: 10.1016/j.sleep.2015.06.018. Epub 2015 Jul 14.
- Background Innominato PF, Lim AS, Palesh O, Clemons M, Trudeau M, Eisen A, Wang C, Kiss A, Pritchard KI, Bjarnason GA. The effect of melatonin on sleep and quality of life in patients with advanced breast cancer. Support Care Cancer. 2016 Mar;24(3):1097-105. doi: 10.1007/s00520-015-2883-6. Epub 2015 Aug 11.
- Background Ortiz GG, Morales-Sanchez EW, Pacheco-Moises FP, Jimenez-Gil FJ, Macias-Islas MA, Mireles-Ramirez MA, Gonzalez-Usigli H. [Effect of melatonin administration on cyclooxygenase-2 activity, serum levels of nitric oxide metabolites, lipoperoxides and glutathione peroxidase activity in patients with Parkinson's disease]. Gac Med Mex. 2017;153(Supl. 2):S72-S81. doi: 10.24875/GMM.M000008. Spanish.
- Background Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008 May;10(5):348-54. doi: 10.1111/j.1751-7176.2008.07572.x.
Drugs
| Evaluation | Drug | Modality | Dose | Route |
|---|---|---|---|---|
| Subject | Melatonin | Small molecule | 25 mg | Oral |