Document Type : Review article
Authors
1
Neonatal Health Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2
Tehran University of Medical Sciences, Children's Medical Center, Pediatric Center of Excellence, Tehran, Iran
3
Department of Cell and Molecular Biology, GO.C, Islamic Azad University, Gorgan, Iran
Abstract
Background: Melatonin, a neurohormone primarily recognized for regulating circadian rhythm, also demonstrates immunomodulatory and anti-inflammatory properties. These effects suggest potential benefits in the management of pediatric infections.
Materials and Methods: A systematic search was conducted in PubMed, Scopus, and Web of Science for studies published from January 2000 to December 2024. Eligible studies included randomized controlled trials (RCTs), cohort studies, and case-control studies involving children (0–18 years) receiving melatonin for immune enhancement or infection treatment. Data on study design, sample size, melatonin dosage, and outcomes were extracted. Random-effects models were applied to calculate pooled effect sizes.
Results: Twelve studies including 709 pediatric patients met the inclusion criteria. Melatonin doses ranged from 2 to 20 mg per day. Most studies reported improvements in immune function, such as enhanced natural killer (NK) cell activity and reductions in inflammatory cytokines, particularly Interleukin 6 (IL-6). Clinically, several studies indicated that melatonin shortened the duration of symptoms in viral infections, while no consistent benefit was observed for bacterial infections. Variability among studies was likely related to differences in design, dosing, and infection type.
Conclusion: Melatonin shows promise as an adjunct therapy in pediatric viral infections, improving immune response and reducing symptom duration. However, evidence for bacterial infections remains inconclusive. Large-scale RCTs are warranted to confirm efficacy, clarify mechanisms, and determine optimal dosing strategies in children.
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