HISTOLOGY AND HISTOPATHOLOGY

Cellular and Molecular Biology

 

Review

Therapeutic implications of melatonin in cerebral edema

Gurugirijha Rathnasamy, Eng-Ang Ling and Charanjit Kaur

Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Offprint requests to: Professor Charanjit Kaur, Department of Anatomy, MD10, 4 Medical Drive, Yong Loo Lin School of Medicine, National Uiversity of Singapore, Singapore-117597. e-mail: antkaurc@nus.edu.sg


Summary. Cerebral edema/brain edema refers to the accumulation of fluid in the brain and is one of the fatal conditions that requires immediate medical attention. Cerebral edema develops as a consequence of cerebral trauma, cerebral infarction, hemorrhages, abscess, tumor, hypoxia, and other toxic or metabolic factors. Based on the causative factors cerebral edema is differentiated into cytotoxic, vasogenic, osmotic and interstitial cerebral edema. Treatment of cerebral edema depends on timely diagnosis and medical assistance. Pragmatic treatment strategies such as antihypertensive medications, nonsteroidal anti-inflammatory drugs, barbiturates, steroids, glutamate and N-methyl-D-aspartate receptor antagonists and trometamol are used in clinical practice. Although the above mentioned treatment approaches are being used, owing to the complexity of the mechanisms involved in cerebral edema, a single therapeutic strategy which could ameliorate cerebral edema is yet to be identified. However, recent experimental studies have suggested that melatonin, a neurohormone produced by the pineal gland, could be an effective alternative for treating cerebral edema. In animal models of stroke, melatonin was not only shown to reduce cerebral edema but also preserved the blood brain barrier (BBB) integrity. Melatonin’s beneficial effects were attributed to its properties, such as being a potent anti-oxidant, and its ability to cross the BBB within minutes after its administration. This review summarizes the beneficial effects of melatonin when used for treating cerebral edema. Histol Histopathol 29, 1525-1538 (2014)

Key words: Cerebral edema, Melatonin, Cytotoxic cerebral edema, Vasogenic cerebral edema, BBB disruption, Vascular endothelial growth factor, Aquaporin, Matrix metalloproteinases, Nitric oxide

DOI: 10.14670/HH-29.1525