Effects of melatonin on the acute inflammatory response associated with endoscopic retrograde cholangiopancreatography: A randomized, double-blind, placebo-controlled trial

Endoscopic retrograde cholangiopancreatography (ERCP) is associated with an acute inflammatory response and melatonin has a variety of immunomodulatory and antioxidant effects studied experimentally in pancreatobiliary pathology. The aim of our study was to evaluate the effects of peri-procedural ad...

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Bibliographic Details
Published in:Revista de gastroenterología de México 2016-07, Vol.81 (3), p.141-148
Main Authors: Hernández-Velázquez, B, Camara-Lemarroy, C R, González-González, J A, García-Compean, D, Monreal-Robles, R, Cordero-Pérez, P, Muñoz-Espinosa, L E
Format: Article
Language:eng ; spa
Subjects:
Adult
Aged
Antioxidants - adverse effects
Antioxidants - therapeutic use
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Choledocholithiasis - complications
Choledocholithiasis - diagnosis
Cytokines - blood
Double-Blind Method
Female
Humans
Inflammation - etiology
Inflammation - prevention & control
Lipid Peroxidation - drug effects
Male
Melatonin - adverse effects
Melatonin - therapeutic use
Middle Aged
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Summary:Endoscopic retrograde cholangiopancreatography (ERCP) is associated with an acute inflammatory response and melatonin has a variety of immunomodulatory and antioxidant effects studied experimentally in pancreatobiliary pathology. The aim of our study was to evaluate the effects of peri-procedural administration of melatonin on the inflammatory response and lipid peroxidation associated with ERCP. In this proof-of-concept clinical trial, 37 patients with a high probability of choledocholithiasis were randomized to receive peri-procedure (ERCP) melatonin or placebo. We measured the serum concentration of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), lipid peroxidation, amylase, and liver function tests 24h before and after the procedure. We found no pre-procedure or post-procedure differences between the melatonin group or the placebo group (P>.05) in the serum concentrations of TNF-alpha (melatonin: 153.8 vs. 149.4ng/m; placebo: 103.5 vs. 107.3ng/ml), IL-6 (melatonin: 131.8 vs. 133.3ng/ml; placebo: 177.8 vs. 197.8ng/ml), or VEGF (melatonin: 157.3 vs. 157.8pg/ml; placebo: 97.3 vs. 97.8pg/ml), or in relation to lipid peroxidation (melatonin: 39.2 vs. 72.3μg/ml; placebo: 66.4 vs. 90.5μg/ml). After ERCP, a significant decrease in the AST, ALT, and total bilirubin levels was found only in the melatonin group (P
ISSN:0375-0906
DOI:10.1016/j.rgmx.2016.03.003