n higher vertebrates that are active during theday (eg, humans, chicks, and dogs, but
not rats, which arenocturnal), nighttime melatonin secretion is temporallyassociated with sleep.Analysis of 24-h urine samples
fromyoung and elderly people alike (Figure
1), with or withoutinsomnia, clearly shows a direct correlation between
sleepand urinary excretion of 6-sulfatoxymelatonin.1 Subjectswith insomnia have a considerably reduced production
ofmelatonin from their pineal gland, which is due to adecrease in the level of the enzyme serotonin N-acetyl-transferase (NAT). Insomnia could therefore be
due to alack of this NAT enzyme in the pineal gland.These observations have led several groups to proposetreating sleep disorders by administration of melatoninor melatoninergic compounds, in order to compensate
forthe lack of melatonin observed in subjects with insomnia.Pineal melatonin secretion in humansWe have demonstrated that melatonin is a bioprecursor
ofhypnotic acetyl metabolites produced by enzymatic acetyl-ation of melatonin and 2-oxomelatonin under the controlof acetyltransferases, most probably the NAT enzymes.In 1994, in our laboratory, we developed a
specific andhighly sensitive gas chromatographymass spectrometry(GC-MS) method2 to
assay, simultaneously and distinctly,plasma concentrations of endogenous melatonin (D0-melatonin) and exogenous melatonin (D7-melatonin), inwhich 7 atoms of H have been substituted by 7 atoms
ofdeuterium. Using the same human volunteers (12
youngsubjects in June 1994 and 12 elderly subjects in October1994), we determined the pharmacokinetics of exogenous3 9 5B a s i c r e s e a r c hPharmacokinetic studies of melatonin in young andelderly human volunteers, and the
measurement of hyp-notic effects in chicks under alternate
lightdark or per-manent light conditions, show that
melatonin is a bio-precursor of hypnotic acetyl metabolites
produced by theenzymatic acetylation of both melatonin
and 2-oxomela-tonin under the control of serotonin N-acetyltransferases(NATs), which are present in the pineal
gland. The acetylmetabolite of melatonin, which we
call carbo2, is an N-acetyl--carboline.
The electroencephalographic (EEG)architecture of the sleep produced
by this compound issimilar to that of physiological sleep,
and is characterizedby the significant proportion of slow-wave
deep sleep andrapid eye movement sleep. This is
in sharp contrast to theEEG sleep architecture observed with
GABAergic (GABA,-aminobutyric acid) compounds. Since insomnia andsleep disorders are believed to be
due to a lack of NATenzymes in the pineal gland, a new
therapeutic approachof sleep disorders by administration of such hypnoticacetyl metabolites of melatonin, or synthetic analogsthereof, can be envisaged.Dialogues Clin Neurosci.
2002;4:395-401.Role of melatonin in the induction
and maintenance of sleepJean B. Fourtillan, PhDKeywords: melatonin; acetylation; N-acetyltransferase; sleep; hypnotic effect; chick;
beagleAuthor affiliations: Professor
of Medicinal Chemistry, Faculty of Medicine and Pharmacy,
University of Poitiers, France; Macef SA Research Center, 1, rue des Piliers
de Tutelle, Bordeaux, France.Address for correspondence: Jean
B. Fourtillan, PhD, 1, rue des Piliers deTutelle, 33000 Bordeaux, France(e-mail: jean-bernard.fourtillan@macef.net)I