This review summarizes the numerous observations published in recent years which have shown that one of the most significant of melatonin’s pleiotropic effects is the regulation of the immune system. The overview summarizes the immune effects of pinealectomy and the association between rhythmic melatonin production and adjustments in the immune system as markers of melatonin’s immunomodulatory actions. The effects of both in vivo and in vitro melatonin administration on non-specific, humoral, and cellular immune responses as well as on cellular proliferation and immune mediator production are presented. One of the main features that distinguishes melatonin from the classical hormones is its synthesis by a number of nonendocrine extrapineal organs, including the immune system. Herein, we summarize the presence of immune system-synthesized melatonin, its direct immunomodulatory effects on cytokine production, and its masking effects on exogenous melatonin action. The mechanisms of action of melatonin in the immune system are also discussed, focusing attention on the presence of membrane and nuclear receptors and the characterization of several physiological roles mediated by some receptor analogs in immune cells. The review focuses on melatonin’s actions in several immune pathologies including infection, inflammation, and autoimmunity together with the relation between melatonin, immunity, and cancer.

A review of the multiple actions of melatonin on the immune system

Melatonin modulates a wide range of physiological functions with pleiotropic effects on the immune system. Despite the large number of reports implicating melatonin as an immunomodulatory compound, it still remains unclear how melatonin regulates immunity. While some authors argue that melatonin is an immunostimulant, many studies have also described anti-inflammatory properties. The data reviewed in this paper support the idea of melatonin as an immune buffer, acting as a stimulant under basal or immunosuppressive conditions or as an anti-inflammatory compound in the presence of exacerbated immune responses, such as acute inflammation. The clinical relevance of the multiple functions of melatonin under different immune conditions, such as infection, autoimmunity, vaccination and immunosenescence, is also reviewed.

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Melatonin: buffering the immune system.

In this paper we review the historical milestones that first highlighted the existence of a relationship between melatonin and the immune system and we summarize data from experiments which correlate the rhythmic production of melatonin with the rhythmic activity of the immune system. The effects of pinealectomy and in vivo administration of melatonin on a variety of immune parameters, including specific and non-specific immunity are considered and we also present contradictory data concerning the effect of melatonin in cultured immunocompetent cells and a possible scheme of how melatonin regulates the production of a number of cytokines. Finally, the mechanism of action of melatonin in the immune system is discussed. Many data suggest the existence of both nuclear and membrane receptors for melatonin in the immune system. Both of these appear to be clearly identified but their specific physiological role is still under discussion. In summary, although there is overwhelming information demonstrating the immunoenhancing properties of melatonin, many questions related to the cytokines involved and the mechanisms of action of the indoleamine require answers.

Melatonin-immune system relationships.

Afterhe successful discovery of the melatonin molecule by Aaron B Lerner et al at Yale University in 1958, melatonin and the pineal gland, a tiny endocrine gland situated at the center of the human brain, have primarily been considered in terms of their effects on the endocrine and reproductive systems. During the last decade, a substantial body of research has defined melatonin as a remarkable molecule with pleiotropic effects on the immune system. Moreover, its synthesis cannot be considered as exclusively endocrine; key immunocompetent cells have the functional enzymatic machinery for melatonin synthesis, paving the wayfo r complex intracrine, autocrine and paracrine regulatory loops. The immunomodulatory role of melatonin, with regard to infection, inflammation and autoimmunity, is outlined here, and the evidence discussed in this review strengthens the notion that the nature of an immune response may be modified, and therefore therapeutically manipulated, by circadian effector signals.

The modulatory role of melatonin on immune responsiveness.

Melatonin increases antigen presentation and amplifies specific and non specific signals for T-cell proliferation

The effect of melatonin injection evaluated earlier with respect to placebo-treated controls is reevaluated, also with reference to spontaneous changes in natural killer cell activity. This effect consists, first, of stimulation of natural killer cell activity over and above any changes brought about by placebo (saline). After 6 h, the melatonin effect appears to be an inhibition as compared to values from placebo-treated subjects, or no effect as compared to values from untreated subjects. In this case, amplification and attenuation of the placebo effect by melatonin are found within the relatively short span of 1/4 of a day, rather than within a day or a week. An ultradian 'feed-sideward' by melatonin may be aligned with the corresponding previously reported circadian and infradian chronomodulation.

F Halberg

Papers

Ultradian chronomodulation by melatonin of a Placebo effect upon human killer cell activity