Melatonin in the pathogenesis and treatment of metabolic liver diseases

The most common chronic liver pathology is metabolic disorders that lead to the development of so–called non-alcoholic fatty liver disease (NAFLD) (since 2020, a new name has been introduced - metabolically associated fatty liver disease (MHD) with its subsequent progression from steatosis, steatohepatitis, fibrosis, to cirrhosis and hepatocellular carcinoma. The disease is more common in developed countries, and, according to some estimates, it is observed in 1/3 of the world's population. The complex pathogenesis of the disease remains to be fully understood, and the hypotheses currently put forward cannot fully clarify the relationship between the individual pathogenetic mechanisms of the disease. The problem of treating CKD, which is aimed at eliminating insulin resistance, hepatoprotection and reducing the risks of progression of concomitant pathology, also seems to be quite difficult. Until now, no single specific drug strategies have been developed for the treatment of CKD. It is from a pharmacotherapeutic perspective that melatonin has attracted attention in recent years, as it has been shown to be able to eliminate most of the manifestations of metabolic syndrome. The review summarizes experimental data and the results of clinical experience with the use of melatonin (MT) (an indole compound synthesized in the pineal gland) for the correction of metabolic disorders of liver function. MT is able to control many physiological functions in the liver tissue both by influencing its own specific receptors and by interfering with intracellular processes, providing a modulating effect. The pronounced hepatoprotective effect of the substance in modeling liver pathology has been proven in experimental conditions on various animal species. The findings have already allowed the introduction of MT into clinical practice and suggest an expansion of its range of use in hepatology.