Clinical significance of melatonin level in patients with chronic obstructive pulmonary disease

The objective of this study was to analyze an impact of melatonin on clinical course, cytokine profile and surfactant protein D level in patients with COPD. Methods. The study involved 88 patients (62 men and 26 women) with stable moderate-to-severe COPD (GOLD stages II – IV), the "frequent exacerbator" phenotype (group D), aged 40 to 80 years (mean age, 68.61 ± 0.72 years). The patients were divided into three groups according to COPD stage: 31 patients (22 men and 9 women; mean age, 67.42 ± 1.38 years) with COPD GOLD stage II); 29 patients (19 men and 10 women; mean age, 68.83 ± 1.21 years) with COPD GOLD stage III); and 28 patients (21 men and 7 women; mean age, 69.71 ± 1.09 years) with COPD GOLD stage IV. Clinical and laboratory parameters were assessed at baseline and in 1 year of the follow-up. Results. Severe COPD course with frequent exacerbations, prominent clinical signs and significant impact on quality of life was directly and statistically significantly related to lower melatonin level. This was also associated with different sleep disorders, high-grade chronic systemic inflammation, and lower surfactant protein D (SP-D) level. Conclusion. Lower melatonin level in COPD patients could cause sleep disorders, decrease the antioxidant defense and SP-D level, increase the pro-inflammatory activity and decrease the anti-inflammatory activity.

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