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Melatonin ingestion before intradialytic exercise improves immune responses in hemodialysis patients

  • Nephrology - Original Paper
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Abstract

Purpose

The present study aimed to investigate the effects of melatonin (MEL) intake on systemic inflammation and immune responses during intradialytic exercise.

Methods

Thirteen hemodialysis (HD) patients volunteered to participate in the current randomized-crossover study. Immunological responses were monitored in four HD sessions at different conditions: [Exercise (EX) + MEL], [EX + Placebo (PLA)], [Control (CON) + MEL] and [CON + PLA]. MEL (3 mg) or PLA was ingested 1 h before starting exercise or the equivalent time in CON condition. During all sessions, peripheral blood samples were collected to assess c-reactive protein, complete blood count, and immune cells phenotypes before HD (T0), immediately after exercise (T1) and 1 h after exercise (T2) or at corresponding times in the CON condition.

Results

HD therapy induced a significant decrease in natural killer (NK) (p = 0.001, d = 0.85; p < 0.001, d = 1.19, respectively) and CD8+ T-lymphocytes rates (p = 0.001, d = 0.57; p < 0.001, d = 0.75, respectively) at T1 and T2 compared to T0. MEL intake prevented the decrease in NK and CD8+ T-lymphocytes, increased the proportion of CD4+ T-lymphocytes at T1 and T2 compared to T0 (p = 0.002, d = 1.18; p = 0.001, d = 1.04, respectively) and decreased the proportion of CD14++CD16+ Monocytes at T2 compared to T0 (p = 0.02, d = 1.57) in peripheral blood during HD therapy. Similar results were found in [EX + MEL] and [EX + PLA] conditions.

Conclusion

This pilot study provides the first evidence that MEL intake alone or associated with intradialytic exercise displays potential immunoregulatory and anti-inflammatory effects. The combination of MEL with intradialytic exercise may be an appropriate anti-inflammatory therapy for HD patients.

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Acknowledgements

We would like to thank all the participants for accepting to be part of our sample population. Our thanks also go to Galpharma Laboratories, Sfax, Tunisia for kindly providing placebo.

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Authors and Affiliations

  1. Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia

    Houssem Marzougui, Omar Hammouda, Rami Maaloul, Fatma Ayadi & Mouna Turki

  2. High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia

    Houssem Marzougui, Imen Ben Dhia & Rami Maaloul

  3. Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000, Nanterre, France

    Omar Hammouda & Tarak Driss

  4. The Research Unit of the Assessment of Musculoskeletal Disorders, University of Sfax, UR12ES18, Sfax, Tunisia

    Imen Ben Dhia

  5. Nephrology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia

    Ikram Agrebi, Hanen Chaker, Khaoula Kammoun & Mohamed Ben Hmida

  6. Research Laboratory of Renal Pathology LR19ES11, Faculty of Medicine, University of Sfax, Sfax, Tunisia

    Ikram Agrebi, Hanen Chaker, Khaoula Kammoun & Mohamed Ben Hmida

  7. Biochemistry Laboratory, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia

    Fatma Ayadi & Mouna Turki

  8. Laboratory of Hematology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia

    Choumous Kallel

  9. Immunology Department, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia

    Hatem Masmoudi & Hend Hachicha

  10. Research Labratory, Autoimmunity Cancer and Immunogenetics, LR18/SP12, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia

    Hatem Masmoudi & Hend Hachicha

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  1. Houssem Marzougui
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  2. Omar Hammouda
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by HM, OH, IBD, RM, MT, HH. The first draft of the manuscript was written by HM, OH, IBD, HH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Omar Hammouda.

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The study received approval from the south institutional human research ethics committee (N°0059/2017) and followed the ethical principles of the Declaration of Helsinki (2013).

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Informed consent was obtained from all individual participants included in the study.

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Marzougui, H., Hammouda, O., Ben Dhia, I. et al. Melatonin ingestion before intradialytic exercise improves immune responses in hemodialysis patients. Int Urol Nephrol 53, 553–562 (2021). https://doi.org/10.1007/s11255-020-02643-3

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