Pathophysiological and pharmacological modulation of melatonergic system

Abstract

Pineal gland once considered as rudimentary or vestigial, has become a principal endocrine gland that regulates the body’s internal environment, after the discovery of melatonin - a hormone produced by it. Melatonin is also synthesized from extra-pineal sites such as retina, skin, platelets, bone marrow, and gastrointestinal tract. The chronobiological property of this hormone in maintaining the circadian rhythm by synchronizing with the dark-light cycle is well-established. Melatonin also possesses anti-inflammatory, anti-depressant, anti-oxidant, oncostatic, immunomodulatory, antiepileptic, and glucose-regulating properties. These pleiotropic effects of melatonin on diverse organ systems either through a receptor or non-receptor mediated pathways are under investigation. This review highlights the pathophysiological and pharmacological actions of melatonin along with melatonergic agonists in “real life” clinical practice.