Melat Mela o t nin Dr Nenad Dikić
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1 Melatonin Dr Nenad Dikić
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6 Biološki ritmovi Biloški ritam Vremenski period Primer Cirkanualni godišnje migratorni ciklusi ptica Infradijalni manje od godine menstrualni ciklus Cirkadijalni kd dnevno ciklus spavanje Ultradijalni manje od dana ciklus ishrana
7 Sezonske promene
8 Dnevne promene
9 Uticaj svetla
10 Nukleus suprahiazmatikus
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13 SCN (suprachiasmatic nucleus)
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15 PVN paraventricular nucleus SCG superior cervical ganglia N Acetylserotonin O methyltransferase NE Norepinephrine NAT N acetyltransferase Fig. The biochemical mediation system for serotonin transformation to melatonin in the pinealocytes showing the signal transduction pathways from the retina to the cell and the cell receptor, through cyclic AMP and NAT to the transformation process, Reiter (1994).
16 24 h ciklus stvaranja melatonina EEG-α wave
17 Melatonin Hormon koji stvara epifiza sadrži ćelije osteljive na svetlost nervima vezan za oči pretvara serotonin u melanin Ciklus Melatonin/Serotonin melatonin serotonin neurotransmiter u centrima za spavanje ti triptofant U mleku
18 Šta je Melatonin? Melatonin je hormon hipofize koji osigurava normalan ritam spavanja. Sinteza i lučenje melatonina dostiže vrhunac tokom noći, a sinteza je inhibirana izlaganjem svetlosti. Osim uloge u regulisanju sna, melatonin reguliše i lučenje hormonarasta i gonadotropnihhormonai ima antioksidativno delovanje. Pomaže: kod nesanice i isprekidanog sna osobama koje menjaju vremensku zonu Kako se koristi? Jednom dnevno, neposredno pre spavanja, staviti tabletu pod jezik i ostaviti da se ona otopi.
19 Melatonin1 mg tablete su preporučuju: Osobama koje imaju problema sa spavanjem tako što smanjuje vreme potrebno da se zaspi. Povoljan efekat se postiže uzimanjem 1 tablete pre odlaska na spavanje. Osobama koje menjaju vremenske zone tako što doprinosi ublažavanjusubjektivnog osećajajetlag jet lag a. a Povoljan efekat se postiže uzimanjem 1 tablete pre odlaskana spavanje nadanputovanja i narednih nekoliko dana nakon dolaska na destinaciju.
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21 Funkcija melatonina Melatonin ima FDA orphan drug status Vitalni deo mnogih biohemijskih procesa Uključujući spavanje i učenje sleep and learning Čistač slobodnih radikala u ćelijama Potentni antioksidant sa anti aging gianti cancer svosjtvima Utiče na razvoj fetusa Posreduje kod mnogih hormonskih funkcija Pomaže u održavanju dž imunog sistema it i štiti od virusa
22 Tipovi insomnije Insomnija jet lag Hronični poremećaji cirkadijalnog ritma Lečenje Melatonin i agonisti melatonina relativnoblagineželjeni efekti bez uticaja na šemu spavanja Antidepresivi Antihistaminici
23 Melatonin ijet lag Many reviews and reports confirm the effectiveness of melatonin ingestion, generally 3 5 mg, being taken 2 3 h before bedtime. Saletu B. Melatonin a natural sleeping pill? Wein Klin Woch 1997; 109: Bubenik G, Blask D, Brown G, et al. Prospects of the clinical utilization of melatonin. Biol Signals Recept 1998; 7: Zisapel N. Circadian rhythm sleep disorders pathophysiology and potential approaches to management. CNS Drugs 2001; 15: Cajochen C, Krauchi K, Wirz Justice A. Role of melatonin in the regulation of human circadianrhythmsand rhythms and sleep. J Neuroendocrinol 2003; 15: Reiter R. Melatonin: clinical relevance. Best Pract Res Clin Endocrinol Metab 2003; 17: Arendt J, Skene D. Melatonin as a chronobiotic. Sleep Med Rev 2005; 9:
24 Sprečavanje jet laga Ako putovanje prelazi manje od tri vremenske zone onda jet lagverovatno neće biti problem za većinu ljudi. Ako boravak prekratak za prilagođavanje biološkogčasovnika (za većinu ljudi, manje od 3 dana), većina funkcioniše u vremenskoj zoni kaokod kdkućeiimaproblemać oko dnevnog angažovanje i spavanja. Ukolikojeputovanje krozviše odtri vremenske zone i boravak je više od 3 dana, jet lag se može kontrolisati. Nakon leta, saveti se odnose na : prilagođavanja biloškog časovnika na svetlost promocija sna pomoćumelatonina održavanje dnevne budnosti Piloti ne smeju da ga koriste
25 Potencijalne medicinske indikacije Karcinom Imunologija Menstrualniciklus fertilitet Pubertet Učenječ i memorija Uticaj na cirkadijalni ritam Promene raspoloženja Poremćajispavanja kod slepih osoba bez percepcije svetlosti
26 Melatonin kod različitih malignih stanja Melatonin ( 20 mg / dan ) povećava kratkotrajno preživljavanje (jedna godina) i poboljšava kontrolu bolesti kod kolorektalnog i drugih vrsta karcinoma.
27 Melatonin i tinitus Dvostrukoslepo, placebo kontrolisanastudija sa melatoninom od 3 mg pred spavanje je pokazala da da nema prednost nad placebom u ublažavanju tinitusa. Među pacijentima koji su imali problem sa spavanjem 46,7 % izjavilo da sveukupno poboljšanje nakon uzimanja melatonina upoređenju sa 20 % kod placebo grupe. M.D. Seidman, S. Babu / Otolaryngol Clin N Am 36 (2003) 359
28 Autizam spavanje Melatonin se koristi od 10,8 do 14,6 % slučajve kodtretiranja poremećaja spavanja kod osoba sa auatizmom.
29 Anti aging products include chondroitin sulfate, dehydroepiandrosterone (DHEA), garlic, ginkgo biloba, ginseng, glucosamine, growth hormone, melatonin, omega 3 fatty acids (fish oil), saw palmetto, shark cartilage, St John s wort, valerian and others.
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31 Životni ciklus melatonina
32 Seksualne aktivnosti i fertilitet
33 Negativni efekti Generalno nema neželjene efekte kod kratkotrajnog korišćenja Dnevna pospanost Glavobolja Vrtoglavica Konfuzija Iritabilnost Gastro nelagodnost
34 Drank Promising extreme relaxation that will slow your roll, Drank is a combination of valerian, melatonin, B vitamins, and high fructose corn syrup.
35 FDA komentar za Drank piće It was reported to increase spontaneous malignant tumor incidence when administered orally to female CBA mice (Anisimov et al., Journal of Gerontology: Biological Sciences, 56A:B311 B323, 2001) Chronic exposure to natural or artificial light and simultaneous intake of melatonin may potentially contribute to a significant loss of photoreceptor cells in the aging retina. (Wiechmann et al., Experimental Eye Research, 86: , 2008) May cause drops in blood pressure, increase atherosclerotic plaque, gynecomastia has beenreported in men, decreased sperm count. Use of melatonin in children (younger than 18 years) and safety has not been established. Should be avoided in womenwhowho are pregnant or attempting to become pregnant, alterations of pituitary ovarian function and potential inhibition of ovulation or uterine contractions. High levels of melatonin during pregnancy may increase the risk of developmental disorders. (Natural Standard)
36 Seasonal affective disorder (SAD) Promena raspoloženja Normani bioritam je poremećen tokom sezone, posebno jeseniii zime Simptomi preterano spavanje / prejedanje/ problemi u koncentraciji / depresija Lečenje Terapija svetlom i suplementacija melatoninom
37 Seasonal affective disorder (SAD) Tuga Anksioznost Razdražljivost Smanjena fizička aktivnost Povećani apetit Žudnja za ugljenim hidratima Povećanje težina Raniji odlazak na spavanja Kasnijebuđenje j Povećano vreme spavanja Isprekidan, ne osvežavajući san Dnevna pospanost Smanjenje j libida Menstrualni problemi Poteškoćeu radu Međuljudske poteškoće
38 Izlaganje ljudi veštačkom jakom svetlu, barem 2500 luksa
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42 Regulacijasekrecije j melatonin Ganglioni Količina svetla SCN (suprachiasmatic nucleus) Obrađujeinformacije j o dužini dana i noći feedback(nepoznat): Smanjuje j aktivnost t epifza SCN melatonin
Pediatrics Grand Rounds 16 July University of Texas Health Science Center at San Antonio
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