[Use of melatonin in combined treatment for inflammatory bowel diseases].

AIM: to provide rationale for and develop treatment regimens using melatonin for inflammatory bowel diseases (IBD). SUBJECTS AND METHODS: Prior to and 30 days after treatment, colonic mucosal biopsy specimens were studied by electron microscopy in 40 patients with Crohn's disease (CD) and ulcerative colitis (UC) in whom the diagnosis was verified by the examination and morphological study of the colonic mucosa. The patients were divided into 2 groups: 1) traditional pathogenetic therapy; 2) combined therapy using melatonin.
RESULTS: Following 30-day therapy using melatonin, signs of inflammatory infiltration were absent in 77.8% of the patients with CD. Minor inflammatory infiltrates consisting mainly of lymphoid cells and solitary granulocytes persisted in the mucosa and submucosal layer in 44.4% of the CD patients receiving the therapy without melatonin. The surface of columnar cells exhibited villi in 77.8%; however, a brush border failed to form in all cells. One month after therapy using melatonin, the ultrastructure of the colonic mucosa was normal in the patients with UC. Inflammatory infiltration and dystrophy were absent in 88.8% of cases. Small inflammatory infiltrates consisting of lymphocytes were seen in occasional mucosal portions in 50% of the melatonin-untreated patients with UC. There was focal plethora in the vessels.
CONCLUSION: The use of melatonin in combined therapy for IBD considerably improves the results of treatment and promotes a more complete ultrastructural recovery of the colonic mucosa.