CPPS, darkness and melatonin

There is also the possibility that winter darkness worsens CPPS. Instead of absence of vitamin D. or possibly both. So how may winter darkness affect CPPS? Perhaps through melatonin level variation.

Melatonin is thought to affect the “inner clock” (synchronizing the photoperiod of an organism), reproduction, metabolism, thermoregulation and immune function. The effect on the “inner clock” is known since long, while the effects on the immune system are a pretty new area of research.

Recent research indicate that melatonin has an immuno-stimulating effect. It stimulates the production of e.g. IL-1, IL-2, IL-6, IL-12 and gamma-interferon, but not IL-4. Human studies “suggest that melatonin may favour a Th1 cell response”. Th1 regulation needs, as we just saw, vitamin D.

Excessive “melatonin production may be involved in glucocorticoid resistance”, which usually causes inflammation. Sufferers of rheumatoid arthritis (RA) have been found to have higher levels and longer night time peaks of melatonin and thus a more marked up-regulation of immune function than controls. RA sufferers do also normally have more pain and/or muscle/joint stiffness in the morning than in the evening.

What is interesting, is that levels of melatonin, some cytokines and interleukins was higher the more northerly RA-patients lived, thus explaining the higher prevalence of RA in Balto-Scandinavian countries compared to Mediterranean countries. The same study also measured cortisol levels and found no differences in those. “A diurnal rhythmicity in healthy humans between cellular (Th1 type) or humoral (Th2 type) immune responses has been found and related to immunomodulatory actions of cortisol and melatonin.” (1,2)

As CP/CPPS shows a similar south to north gradient it would be very interesting to study if CP/CPPS sufferers show a similar pattern of melatonin secretion. Decreased night-time melatonin secretion during the longer summer daylight above 50 degrees of latitude may explain summer (and early fall) remission in addition to vitamin D. RA has also been shown to improve with higher levels of vitamin D.(3) A bit odd though as a low night-time melatonin (and if the nighttime peak occurs too early or late) level is correlated with e.g. seasonal depression and prostate cancer growth, while CPPS is not correlated with prostate cancer but with winter time depression. On the other hand high night-time levels are correlated with higher anxiety, which seems more common during winter in CPPS.

Andra bloggar om CPPS, kroniskt bäckenbottensmärtsyndrom, kronisk abakteriell prostatit, NIHIIIb, överaktiv blåsa, köld, värme, vinter, sommar, D-vitamin, auto-immun sjukdom, Th1/Th2, melatonin.
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(1) Cutolo M, Maestroni GJM. The melatonin-cytokine connection in rheumatoid arthritis.Ann Rheum Dis 64:1109-1111, 2005.
(2) Cutolo M, Sulli A, Pizzorni C, Secchi ME, Soldano S, Seriolo B, Straub RH, Otsa K, Maestroni GJ. Circadian rhythms: glucocorticoids and arthritis. Ann N Y Acad Sci. 1069:289-299, 2006.
(3) Pelajo CF, Lopez-Benitez JM, Miller LC. Vitamin D and Autoimmune Rheumatologic Disorders. Autoimmun Rev. 2010 Feb 8. [Epub ahead of print]