Abstract:  Melatonin, or N‐acetyl‐5‐methoxytryptamine, is a compound derived from tryptophan that is found in all organisms from unicells to vertebrates. This indoleamine may act as a protective agent in disease conditions such as Parkinson's, Alzheimer's, aging, sepsis and other disorders including ischemia/reperfusion. In addition, melatonin has been proposed as a drug for the treatment of cancer. These disorders have in common a dysfunction of the apoptotic program. Thus, while defects which reduce apoptotic processes can exaggerate cancer, neurodegenerative disorders and ischemic conditions are made worse by enhanced apoptosis. The mechanism by which melatonin controls cell death is not entirely known. Recently, mitochondria, which are implicated in the intrinsic pathway of apoptosis, have been identified as a target for melatonin actions. It is known that melatonin scavenges oxygen and nitrogen‐based reactants generated in mitochondria. This limits the loss of the intramitochondrial glutathione and lowers mitochondrial protein damage, improving electron transport chain (ETC) activity and reducing mtDNA damage. Melatonin also increases the activity of the complex I and complex IV of the ETC, thereby improving mitochondrial respiration and increasing ATP synthesis under normal and stressful conditions. These effects reflect the ability of melatonin to reduce the harmful reduction in the mitochondrial membrane potential that may trigger mitochondrial transition pore (MTP) opening and the apoptotic cascade. In addition, a reported direct action of melatonin in the control of currents through the MTP opens a new perspective in the understanding of the regulation of apoptotic cell death by the indoleamine.

Aerobic cells use oxygen for the production of 90–95% of the total amount of ATP that they use. This amounts to about 40 kg ATP/day in an adult human. The synthesis of ATP via the mitochondrial respiratory chain is the result of electron transport across the electron transport chain coupled to oxidative phosphorylation. Although ideally all the oxygen should be reduced to water by a four‐electron reduction reaction driven by the cytochrome oxidase, under normal conditions a small percentage of oxygen may be reduced by one, two, or three electrons only, yielding superoxide anion, hydrogen peroxide, and the hydroxyl radical, respectively. The main radical produced by mitochondria is superoxide anion and the intramitochondrial antioxidant systems should scavenge this radical to avoid oxidative damage, which leads to impaired ATP production. During aging and some neurodegenerative diseases, oxidatively damaged mitochondria are unable to maintain the energy demands of the cell leading to an increased production of free radicals. Both processes, i.e., defective ATP production and increased oxygen radicals, may induce mitochondrial‐dependent apoptotic cell death. Melatonin has been reported to exert neuroprotective effects in several experimental and clinical situations involving neurotoxicity and/or excitotoxicity. Additionally, in a series of pathologies in which high production of free radicals is the primary cause of the disease, melatonin is also protective. A common feature in these diseases is the existence of mitochondrial damage due to oxidative stress. The discoveries of new actions of melatonin in mitochondria support a novel mechanism, which explains some of the protective effects of the indoleamine on cell survival.

Mitochondria do not contain catalase and are therefore largely dependent on reduced glutathione (GSH) and glutathione peroxidases for its antioxidant protection. When GSH levels are greatly decreased, hydrogen peroxide accumulates leading to extensive mitochondrial damage. Melatonin has antioxidant properties and prevents toxic effects of reactive oxygen species by maintaining cellular GSH homeostasis. Thus, we examined the influence of melatonin and other classical antioxidants such as vitamins C and E on GSH content and the activity of the GSH‐related enzymes (glutathione peroxidase and reductase) in isolated rat liver and brain mitochondria treated with t‐butyl hydroperoxide (i‐BHP). In control mitochondria melatonin (100 nM) significantly increases GSH content and glutathione peroxidase and reductase activities. After incubation with 100 μM i‐BHP, the mitochondrial hydroperoxides level increased, 90% of mitochondrial GSH was oxidized to GSSH, and the activities of GSH‐related enzymes were almost totally inhibited. Melatonin (100 nM) counteracted the changes in GSH, GSH‐related enzymes and hydroperoxides induced by i‐BHP in cultured mitochondria. In the presence of 100 nM melatonin, the activity of the respiratory chain complexes I and IV, measured in submitochondrial particles prepared from rat liver and brain mitochondria, increased significantly. Vitamin C was virtually without effect, and only 1 mM vitamin E increased GSH and reduced hydroperoxide mitochondrial contents. Our results suggest that melatonin, but not vitamins C and E, prevents the toxic effects of hydroperoxides on mitochondria by regenerating their GSH content.