The epidemiology of selenium deficiency in the etiological study of endemic diseases in China

Methylmercury and nutrition: adult effects of fetal exposure in experimental models

Human exposure to the life-span developmental neurotoxicant, methylmercury (MeHg), is primarily via the consumption of fish or marine mammals. Fish are also excellent sources of important nutrients, including selenium and n-3 polyunsaturated fatty acids (PUFAs), such as docosahexaenoic acid (DHA). Laboratory models of developmental MeHg exposure can be employed to assess the roles of nutrients and MeHg and to identify potential mechanisms of action if the appropriate exposure measures are used. When maternal exposure is protracted, relationships between daily intake and brain mercury are consistent and orderly across species, even when large differences in blood:brain ratios exist. It is well established that low-level developmental MeHg produces sensory deficits. Recent studies also show that perseveration in reversal-learning tasks occurs after gestational exposures that produce low micromolar concentrations in the brain. A no-effect level has not been identified for this effect. These exposures do not affect the acquisition or performance of discrimination learning, set shifting (extradimensional shift), or memory. Reversal-learning deficits may be related to enhanced impact of reinforcers as measured using progressive ratio reinforcement schedules, an effect that could result in perseveration. Also reported is enhanced sensitivity to dopamine reuptake inhibitors and diminished sensitivity to pentobarbital, a GABA(A) agonist. Diets rich in PUFAs or selenium do not protect against MeHg's effects on reversal learning but, by themselves, may diminish variability in performance, enhance attention or psychomotor function and may confer some protection against age-related deficits in these areas. It is hypothesized that altered reward processing, dopamine and GABAergic neurotransmitter systems, and cortical regions associated with choice and perseveration are especially sensitive to developmental MeHg at low exposure levels. Human testing for MeHg's neurotoxicity should emphasize these behavioral domains.

Modulation of redox status in human lung cell lines by organoselenocompounds: selenazolidines, selenomethionine, and methylseleninic acid

Cancer prevention strategies utilizing selenium-containing compounds have demonstrated reduced cancer mortality and efficacy for some cancer types but considerable differences in cellular effects exist among the selenocompounds employed. The variability of the effects on cell viability, redox modulation, and disruption of subcellular compartments by the conventional selenium-containing amino acid, selenomethionine, the oxidized selenosugar metabolite, methylseleninic acid, and selenazolidines was investigated in A549 and BEAS-2B human lung cell lines. Selenomethionine had little effect whereas methylseleninic acid increased cellular thiols and stress in the endoplasmic reticulum. The cyclohexylselenazolidine increased mild oxidative stress in the adenocarcinoma cell line, A549, but the effects were attenuated in the normal, but virally transformed cell line, BEAS-2B. These data demonstrate that all selenocompounds are not equal and that the form of the organic selenocompound is a major determinant in the expected cellular response.

Selenium in food and the human body: a review

Selenium levels in soil generally reflect its presence in food and the Se levels in human populations. Se food content is influenced by geographical location, seasonal changes, protein content and food processing. Periodic monitoring of Se levels in soil and food is necessary. Diet is the major Se source and approximately 80% of dietary Se is absorbed depending on the type of food consumed. Se bioavailability varies according to the Se source and nutritional status of the subject, being significantly higher for organic forms of Se. Se supplements can be beneficial for subjects living in regions with very low environmental levels of Se. Several strategies have been followed: (1) employment of Se-enriched fertilizers; (2) supplementation of farm animals with Se; (3) consumption of multimicronutrient supplements with Se. Nevertheless, detailed investigations of possible interactions between Se supplements and other food components and their influence on Se bioavailability are needed. Suppliers also need to provide more information on the specific type of Se used in supplements. In addition, research is lacking on the mechanisms through which Se is involved in hepatocyte damage during hepatopathies. Although Se potential as an antioxidant for the prevention of cardiovascular diseases (CVD) is promising, additional long-term intervention trials are necessary. As a result, indiscriminate Se supplements cannot be reliably recommended for the prevention of CVD in human beings. Some interesting findings reported an association of Se intake with a reduced prevalence and risk for prostate and colon cancer. However, random trials for other cancer types are inconclusive. As a final conclusion, the general population should be warned against the employment of Se supplements for prevention of hepatopathies, cardiovascular or cancer diseases, because benefits of Se supplementation are still uncertain, and their indiscriminate use could generate an increased risk of Se toxicity.

The bacterial response to the chalcogen metalloids Se and Te

Microbial metabolism of inorganics has been the subject of interest since the 1970s when it was recognized that bacteria are involved in the transformation of metal compounds in the environment. This area of research is generally referred to as bioinorganic chemistry or microbial biogeochemistry. Here, we overview the way the chalcogen metalloids Se and Te interact with bacteria. As a topic of considerable interest for basic and applied research, bacterial processing of tellurium and selenium oxyanions has been reviewed a few times over the past 15 years. Oddly, this is the first time these compounds have been considered together and their similarities and differences highlighted. Another aspect touched on for the first time by this review is the bacterial response in cell-cell or cell-surface aggregates (biofilms) against the metalloid oxyanions. Finally, in this review we have attempted to rationalize the considerable amount of literature available on bacterial resistance to the toxic metalloids tellurite and selenite.

Food supplements and European regulation within a precautionary context: a critique and implications for nutritional, toxicological and regulatory consistency

In this paper, we review European legislation in the field of micronutrient food supplements and find it wanting. It is shown that the precautionary principle, embedded in European food legislation, pre-empts innovative developments in this field. In view of the scientific advances in micronutrients research, we subsequently critique the precautionary perspective and propose a novel outlook on micronutrients food supplements regulation. However, this requires a transition from the "survival" approach of the current deficiency-related RDAs to a "health-optimization" approach of a n(ew)-RDA. Genomic integrity is central in this envisioned transition.

Serum selenium level and other risk factors for breast cancer among patients in a Malaysian hospital

OBJECTIVE

The aim of this study is to investigate the association between breast cancer and serum selenium level as well as other risk factors for breast cancer.

METHODS

A matched case-control study was conducted in a hospital in Malaysia from July 2000 to January 2001 and from May 2001 to June 2001. Sixty-two newly diagnosed breast cancer patients were selected as the cases. Each control, selected from the same hospital population was matched to each case according to age, ethnic group, and menopausal status.

RESULTS

The mean selenium concentration among the cases was significantly lower than that among the control. There was a significant association (p<0.05) between breast cancer and low selenium serum level, nulliparity (OR=5.5,95% CI=1.22 to 24.81), exposure to cigarette smoke (OR=2.2, 95% CI=1.04 to 4.65) and use of oral contraceptives (OR=3.0, 95% CI=1.09 to 8.25) as determined by the McNemar test. Multivariate analysis showed that nulliparity (OR=10.08, 95% CI=1.48 to 68.52) and use of oral contraceptives (OR=3.66, 95% CI=1.36 to 9.87) were associated with increased breast cancer risk. An increased selenium concentration contributes to a reduced risk of breast cancer (OR=0.89, 95% CI=0.84 to 0.94).

CONCLUSION

The results suggest that use of oral contraceptive pills, being nulliparous, and a low serum selenium level are associated with breast cancer.

Selenium status in Southern Tasmania

OBJECTIVE

To assess the selenium status of Southern Tasmanians.

DESIGN

Cross-sectional.

SETTINGS

One thousand and five hundred adults randomly selected from the electoral roll living in the Greater Hobart region of Southern Tasmania, Australia, were invited to participate.

SUBJECTS

The overall response rate was 22% (335/1500).

INTERVENTIONS

A venous blood sample was collected and a questionnaire administered (consisting of brief demographic details and health questions) to subjects who granted informed consent. A previously validated assay using magnetic sector ICP-MS was employed for plasma analysis.

RESULTS

Total plasma selenium levels for this sample population were normally distributed with a mean level of 110 microg/l (range 67-268 microg/l) indicating that the majority of the subjects were not selenium-depleted (71% with levels greater than 100 microg/l). Adjustment for differential age/gender response rates produced similar values. More women under 50 (42%) and men over 50 (32%) had selenium levels <100 microg/l with the potential for sub-optimal selenoprotein activity. Low education attainment was associated with low total selenium level (P<0.02).

CONCLUSIONS

The majority of participants were not deficient in selenium. Given the narrow therapeutic window of supplementation, dietary advice to increase foods rich in selenium, particularly to higher risk groups, may be an effective means of increasing plasma selenium toward target levels.

Selenoproteins and their impact on human health through diverse physiological pathways

In the last few decades, the importance of selenium in human health has been the subject of numerous studies. It is believed that the physiological effects of selenium occur mainly through the function of selenoproteins, which incorporate selenium in the form of one or more selenocysteine residues. Recent advances in understanding the complex regulation of selenoprotein synthesis and functional characterization of several members of the selenoprotein family have contributed to an improved comprehension of the role(s) of selenium in human health and the great diversity of physiological pathways influenced by this trace element.

Selenium and antioxidant defenses as major mediators in the development of chronic heart failure

Increased oxidative stress is involved in the pathogenesis of chronic heart failure (CHF), the common end result of most cardiac diseases. Selenium is an "essential" trace element, which means that it must be supplied by our daily diet and that its blood and tissue concentrations are extremely low. Selenium has a variety of functions. It is a key component of several functional selenoproteins required for normal health. The best known of these are the antioxidant glutathione peroxidase (GPx) enzymes, which remove hydrogen peroxide and the harmful lipid hydroperoxides generated in vivo by oxygen-derived species. GPx deficiency exacerbates endothelial dysfunction, a major contributing factor in the severity of CHF symptoms, in various conditions such as hyperhomocysteinemia. This suggests that homocysteine may be involved in the CHF associated endothelial dysfunction through a peroxide-dependent oxidative mechanism. Selenium also plays a role in the control of thyroid hormone metabolism and in protection against organic and inorganic mercury. One possible additional mechanism by which low selenium may compromise cardiovascular condition may be through the effect of selenium on the synthesis and activity of deiodinases, enzymes converting thyroxin into the biologically active triiodothyronine. Selenium and iodine actually interact in cardiovascular physiology, and further studies are needed to examine their role, in isolation and in association, in the development of CHF. Thus, selenium (through its role in selenoenzymes, thyroid hormones, and interactions with homocysteine and endothelial function) appears to be a major mediator in several pathways potentially contributing to CHF development.

Effects of amino acids from selenium-rich silkworm pupas on human hepatoma cells

Selenium (Se) plays an important role in cancer-prevention. Silkworm pupas have been used as a Chinese traditional medicine since ancient time. In order to find effective carcinostatic agents, Se-rich amino acids were extracted from Ziyang silkworm pupas. The Se content of Ziyang pupas was measured to be 215 times higher than that of Luoyang normal ones, and the majority of Se was stored in proteins. Composition analysis showed that Se-rich amino acids from Ziyang pupas had higher amounts of selenomethionine, methionine, cystine, and tyrosine than normal amino acids from Luoyang pupas which were rich in amino acids containing alkyl side chains. When cultured with human hepatoma cells SMMC-7721, Se-rich amino acids at concentrations of 0.5, 1.5, and 2.5 micromol L(-1) Se significantly and dose-dependently inhibited cell viability, induced changes in cell morphology and cycle, and caused cell apoptosis. On the contrary, normal amino acids did not show any inhibitory effect on SMMC-7721 cells. Sodium selenite or selenomethionine at the same Se concentrations only slightly inhibited the hepatoma cells. Mechanism study showed that selenium-rich amino acids could increase the generation of intracellular reactive oxygen species (ROS) concentration-dependently. Antioxidant N-acetylcyteine partially inhibited the increase of ROS. Those results suggested that Se-rich amino acids were effective carcinostatic agents compared with sodium selenite and selenomethionine. The mechanism for their hepatoma-inhibitory effects was the induction of cellular apoptosis through ROS generation.

Are there functional consequences of a reduction in selenium intake in UK subjects?

Dietary Se levels in the UK have fallen over the last 20 years and recent surveys indicate that average Se intakes are 30-40 microg/d, which is well below the current UK reference nutrient intake for adult men (75 microg/d) or women (60 microg/d). Functional consequences of this decline have not been recognised, although epidemiological data suggest it may contribute to increased risk of infections and incidence of some cancers. Previous data have indicated that biochemical changes in Se-dependent proteins occur in otherwise healthy UK subjects given small Se supplements. The current studies have focused on the effect of small Se supplements on the immune response since there is evidence of specific interactions between Se intake and viral replication, and since the potential anti-cancer effects of Se may be mediated by non-antioxidant effects of Se such as changes in immune function. Data indicate that subjects given small Se supplements (50 or 100 microg Se/d) have changes in the activity of Se-dependent enzymes and evidence of improved immune function and clearance of an administered live attenuated virus in the form of poliovirus vaccine. Responses of individual subjects to Se supplements are variable, and current work is evaluating potential explanations for this variability, including genetic variability and pre-existing Se status.

Selenium status as determinant of connexin-43 dephosphorylation in ex vivo ischemic/reperfused rat myocardium

Recent studies have demonstrated that electrical uncoupling at gap junctions during ischemia is associated with cardiac Connexin-43 (Cx43) dephosphorylation. Whether oxidative stress is involved in this phenomenon still remains unclear. In the present study, we examined the influence of selenium intake on reperfusion-induced Cx43 dephosphorylation. Male Wistar rats were fed a diet containing either 0.05 mg/kg (Low-Se, n = 13) or 1.5 mg/kg (High-Se, n = 11) selenium for 8 weeks. At the end of this diet, hearts were isolated and subjected to 10 min regional ischemia followed by 10 min reperfusion. The level of dephosphorylated Cx43 was determined in tissue samples from ischemic/reperfused and non-ischemic regions of the hearts. At the end of the experiemental diet, the activity of the antioxidant enzyme glutathione peroxidase (GSH-Px) was increased in high-Se hearts compared with low-Se hearts (+ 13%; p < 0.05). After ischemia/reperfusion, in low-Se hearts, Cx43 dephosphorylation appeared significantly increased in the left ventricle compared to the non-ischemic right ventricle (+ 149%; p < 0.05). The high-Se diet significantly reduced Cx43 dephosphorylation in the left ventricle (p < 0.05 vs. low-Se diet). In conclusion, our results suggest that oxidative stress may be involved in Cx43 dephosphorylation during myocardial ischemia/reperfusion, thereby contributing to arrhythmogenesis.

Selenium concentrations in maternal and umbilical cord blood at 24-42 weeks of gestation: basis for optimization of selenium supplementation to premature infants

BACKGROUND & AIMS

Selenium (Se) deficiency may have deleterious effects on premature infants. Umbilical cord (UC) Se concentrations presumably reflect fetal Se concentrations and represent reference values that should be achieved in premature infants. We aimed to establish reference data of Se serum concentrations in parturient women and their neonates across gestation.

SUBJECTS AND METHODS

Parturient mothers and their newborn infants born after 24-42 weeks of gestation were enrolled. Only appropriate for gestational age (GA) singleton infants were included. Se serum concentrations were measured by atomic absorption spectrometry, in blood samples from parturient mothers and their infants (umbilical blood). Demographic, perinatal and labor data were obtained, and their correlations with umbilical Se serum concentrations, maternal Se serum concentrations, and the maternal-umbilical Se difference were examined.

RESULTS

UC Se serum concentrations increased as gestation progressed (P<0.01). A statistically significant linear relationship was found between UC Se serum concentrations and GA (R=0.341, P<0.0001), birth weight (R=0.237, P=0.002), and 5-min Apgar score (R=0.202, P<0.01). Using multiple regression analysis, only GA was significantly associated with UC serum Se concentration (P=0.012). Maternal Se serum concentration were stable throughout gestation, and maternal-umbilical Se difference was negatively correlated with GA (R=-0.337, P<0.0001) and birth weight (R=-0.369, P<0.0001).

CONCLUSIONS

UC Se serum concentration increases and the maternal-umbilical Se difference declines with gestation progression, probably reflecting fetal accretion of Se. With the current Se supplementation in premature infants, Se concentrations are lower than those measured in our study. We, therefore, suggest a two-fold increase or more in the recommended Se dosage.

Preischemic selenium status as a major determinant of myocardial infarct size in vivo in rats

Prospective epidemiological studies have shown that the incidence of numerous cardiovascular pathologies is correlated with body selenium status. However, it remains unclear whether selenium status also influences the outcome of myocardial infarction. The aim of the present study was to test whether dietary selenium intake affects myocardial necrosis induced by transient regional ischemia in vivo in rats. For this purpose, male Wistar rats received either a high-selenium (High-Se: 1.5 mg of Se/kg) or a low-selenium (Low-Se: 0.05 mg of Se/kg) diet for 10 weeks. Animals were subjected to 30 min of myocardial ischemia induced by coronary artery ligation followed by 60 min of reperfusion. Pre- and postischemic blood samples were collected for glutathione (GSH and GSSG) determination and for glutathione peroxidase (GSH-Px) assessment. Our results show that high-selenium intake reduces myocardial infarct size (High-Se: 25.16 +/- 1.19% versus Low-Se: 36.51 +/- 4.14%, p < 0.05), preserves postischemic GSH/GSSG ratio (High-Se: 1.37 +/- 0.37 versus Low-Se: 0.47 +/- 0.10, p < 0.05), increases plasma GSH-Px activity, and improves postischemic mean arterial pressure. In conclusion, preischemic body selenium status is a major determinant of the outcome of myocardial ischemia in vivo in rats probably because it influences the cellular redox status.

Molecular Actions of Selenium in the Brain: Neuroprotective Mechanisms of an Essential Trace Element

In addition to acting as an essential nutrient for the immune system and overall body function, it is apparent that selenium also plays a critical role in the operation of the nervous system. Selenium itself is a constituent of selenoproteins, which are primarily involved in antioxidant function and redox status. However, apart from its covalent incorporation into these proteins, selenium also performs neuroprotective actions independent of translational processes. Furthermore, low selenium intake has detrimental effects on proper brain function, such as epileptic episodes and neuronal cell death, which have, in turn, been shown to be mitigated by higher selenium levels. Understanding the mechanisms of selenium action will be crucial to determining its potential as a preventive and therapeutic agent against excitatory brain damage.

Selenoprotein-deficient transgenic mice exhibit enhanced exercise-induced muscle growth

Dietary intake of selenium has been implicated in a wide range of health issues, including aging, heart disease and cancer. Selenium deficiency, which can reduce selenoprotein levels, has been associated with several striated muscle pathologies. To investigate the role of selenoproteins in skeletal muscle biology, we used a transgenic mouse (referred to as i6A-) that has reduced levels of selenoproteins due to the introduction and expression of a dominantly acting mutant form of selenocysteine transfer RNA (tRNA[Ser]Sec). As a consequence, each organ contains reduced levels of most selenoproteins, yet these mice are normal with regard to fertility, overall health, behavior and blood chemistries. In the present study, although skeletal muscles from i6A- mice were phenotypically indistinguishable from those of wild-type mice, plantaris muscles were approximately 50% heavier after synergist ablation, a model of exercise overload. Like muscle in wild-type mice, the enhanced growth in the i6A- mice was completely blocked by inhibition of the mammalian target of rapamycin (mTOR) pathway. Muscles of transgenic mice exhibited increased site-specific phosphorylation on both Akt and p70 ribosomal S6 kinase (p70S6k) (P < 0.05) before ablation, perhaps accounting for the enhanced response to synergist ablation. Thus, a single genetic alteration resulted in enhanced skeletal muscle adaptation after exercise, and this is likely through subtle changes in the resting phosphorylation state of growth-related kinases.

Essentiality and toxicity of selenium and its status in Australia: a review

Selenium (Se) is an essential trace element for animals and humans because of its role in an antioxidant enzyme glutathione peroxidase. This enzyme protects cell membranes from damage caused by the peroxidation of lipids. The paper provides an overview of the effects of Se toxicity and deficiency in humans and animals. It is well established that Se deficiency causes health implications in humans and animals. Se is also very toxic and can cause Se poisoning (selenosis) in humans and animals. In Australia, Se deficiency has caused health problem to livestock; however, the problems were eliminated after the introduction of Se supplementation. Se toxicity has also been reported in some regions of Australia as a result of livestock feeding on Se accumulative plant species. The major source of Se is diet, and in many regions of the world the levels of Se in the soils generally reflect the Se status in human populations. In foods, the bioavailability and toxicity of Se depend on its chemical forms. Generally, organic forms of Se are more bioavailable and less toxic than the inorganic forms (selenites, selenates). The Se status in the Australian population and how this is compared with the rest of the world is also discussed.

Selenite inhibition of Coxsackie virus B5 replication: implications on the etiology of Keshan disease

Keshan disease is a cardiomyopathy of unknown origin reported in some areas of China. Because of epidemiologic features, this disease was ascribed to an infectious agent, likely a Coxsackie virus, but it has also been thought to depend on selenium deficiency, mainly because selenite is effective in its prophylaxis. We examined the hypothesis that pharmacological activity of selenite on Coxsackie virus growth was associated with prevention of Keshan disease. We studied the antiviral effects of three selenium compounds on Coxsackie virus B5 replication: five microM selenite reduced viral replication, whilst 10 microM selenate and selenomethionine did not exhibit any antiviral activity. The inhibitory activity of selenite on viral replication was due to its toxicity following its interaction with thiols, as that activity could be blocked by dithiothreitol, a sulfhydryl-protecting agent known to reverse several toxic effect of selenite. Zinc, another inhibitor of selenite toxicity, also counteracted the antiviral effect of selenite. The selenium compounds showed only limited activity against herpes simplex 1 virus and IHD strain of vaccinia virus. A direct inhibitory effect of selenite on Coxsackie virus replication might explain the efficacy demonstrated by this compound in the prophylaxis of Keshan disease.

Dietary and blood antioxidants in patients with chronic heart failure. Insights into the potential importance of selenium in heart failure

BACKGROUND

Chronic heart failure (CHF) seems to be associated with increased oxidative stress. However, the hypothesis that antioxidant nutrients may contribute to the clinical severity of the disease has never been investigated.

AIMS

To examine whether antioxidant nutrients influence the exercise capacity and left ventricular function in patients with CHF.

METHODS

Dietary intake and blood levels of major antioxidant nutrients were evaluated in 21 consecutive CHF patients and in healthy age- and sex-matched controls. Two indexes of the severity of CHF, peak exercise oxygen consumption (peak VO2) and left ventricular ejection fraction (LVEF), were measured and their relations with antioxidants were analysed.

RESULTS

Whereas plasma alpha-tocopherol and retinol were in the normal range, vitamin C (P=0.005) and beta-carotene (P=0.01) were lower in CHF. However, there was no significant association between vitamins and either peak VO2 or LVEF. Dietary intake (P<0.05) and blood levels of selenium (P<0.0005) were lower in CHF. Peak VO2 (but not LVEF) was strongly correlated with blood selenium: r=0.76 by univariate analysis (polynomial regression) and r=0.87 (P<0.0005) after adjustment for age, sex and LVEF.

CONCLUSIONS

Antioxidant defences are altered in patients with CHF. Selenium may play a role in the clinical severity of the disease, rather than in the degree of left ventricular dysfunction. Further studies are warranted to confirm the data in a large sample size and to investigate the mechanisms by which selenium and other antioxidant nutrients are involved in CHF.

Micronutrient deficiency in children

Malnutrition increases morbidity and mortality and affects physical growth and development, some of these effects resulting from specific micronutrient deficiencies. While public health efforts must be targeted to improve dietary intakes in children through breast feeding and appropriate complementary feeding, there is a need for additional measures to increase the intake of certain micronutrients. Food-based approaches are regarded as the long-term strategy for improving nutrition, but for certain micronutrients, supplementation, be it to the general population or to high risk groups or as an adjunct to treatment must also be considered. Our understanding of the prevalence and consequences of iron, vitamin A and iodine deficiency in children and pregnant women has advanced considerably while there is still a need to generate more knowledge pertaining to many other micronutrients, including zinc, selenium and many of the B-vitamins. For iron and vitamin A, the challenge is to improve the delivery to target populations. For disease prevention and growth promotion, the need to deliver safe but effective amounts of micronutrients such as zinc to children and women of fertile age can be determined only after data on deficiency prevalence becomes available and the studies on mortality reduction following supplementation are completed. Individual or multiple micronutrients must be used as an adjunct to treatment of common infectious diseases and malnutrition only if the gains are substantial and the safety window sufficiently wide. The available data for zinc are promising with regard to the prevention of diarrhea and pneumonia. It should be emphasized that there must be no displacement of important treatment such as ORS in acute diarrhea by adjunct therapy such as zinc. Credible policy making requires description of not only the clinical effects but also the underlying biological mechanisms. As findings of experimental studies are not always feasible to extrapolate to humans, the biology of deficiency as well as excess of micronutrients in humans must continue to be investigated with vigour.

Characterization of enterovirus isolates from patients with heart muscle disease in a selenium-deficient area of China

An association of enterovirus infection with endemic cardiomyopathy (Keshan disease [KD]) and outbreaks of myocarditis in selenium-deficient rural areas of southwestern China has been established. Enteroviruses have been isolated from patients with KD or during outbreaks of myocarditis in last two decades. Six of these isolates grew readily in cell lines (Vero or HEp-2) and were investigated by a novel molecular typing method apart from serotyping and pathogenicity. A neutralization assay identified two isolates from KD as coxsackievirus serotype B2 (CVB2) and two isolates from myocarditis as coxsackievirus serotype B6 (CVB6) but failed to type the remaining two isolates, also from myocarditis. Direct nucleotide sequencing of reverse transcription-PCR products amplified from the 5' nontranslated region (5'NTR) of these viruses confirmed that they belong to a phylogenetic cluster consisting of coxsackie B-like viruses, including some echovirus serotypes. Sequence analysis of the coding region for viral capsid protein VP1 showed that two isolates serotyped as CVB2 have the highest amino acid sequence homology with CVB2 and that the remaining four isolates, two CVB6 and the two unknown serotypes, are most closely related to the sequence of CVB6. Sequences among these isolates varied from 82.3 to 99% in the 5'NTR and from 69 to 99% in VP1, indicating no cross contamination. The pathogenicity of these viruses in adult and suckling mice was assessed. None caused pathologic changes in the hearts of adult MF-1 or SWR mice, although pancreatitis was evident. However, the four CVB6-like viruses caused death in suckling mice, similar to a virulent coxsackievirus group B3 laboratory strain. In conclusion, the sequence data confirm that coxsackievirus group B serotypes are predominant in the region in which KD is endemic and may be the etiological agents in outbreaks of myocarditis. VP1 genotyping of enteroviruses is accurate and reliable. Animal experiments indicate that isolates may differ in pathogenicity.

Selenium in biology: facts and medical perspectives

Several decades after the discovery of selenium as an essential trace element in vertebrates approximately 20 eukaryotic and more than 15 prokaryotic selenoproteins containing the 21st proteinogenic amino acid, selenocysteine, have been identified, partially characterized or cloned from several species. Many of these proteins are involved in redox reactions with selenocysteine acting as an essential component of the catalytic cycle. Enzyme activities have been assigned to the glutathione peroxidase family, to the thioredoxin reductases, which were recently identified as selenoproteins, to the iodothyronine deiodinases, which metabolize thyroid hormones, and to the selenophosphate synthetase 2, which is involved in selenoprotein biosynthesis. Prokaryotic selenoproteins catalyze redox reactions and formation of selenoethers in (stress-induced) metabolism and energy production of E. coli, of the clostridial cluster XI and of other prokaryotes. Apart from the specific and complex biosynthesis of selenocysteine, selenium also reversibly binds to proteins, is incorporated into selenomethionine in bacteria, yeast and higher plants, or posttranslationally modifies a catalytically essential cysteine residue of CO dehydrogenase. Expression of individual eukaryotic selenoproteins exhibits high tissue specificity, depends on selenium availability, in some cases is regulated by hormones, and if impaired contributes to several pathological conditions. Disturbance of selenoprotein expression or function is associated with deficiency syndromes (Keshan and Kashin-Beck disease), might contribute to tumorigenesis and atherosclerosis, is altered in several bacterial and viral infections, and leads to infertility in male rodents.

Oxidative injury induced by synthetic humic acid polymer and monomer in cultured rabbit articular chondrocytes

Humic substance has been proposed as one of the causative factors of Kashin-Beck disease (KBD), an endemic osteoarthritic disorder with necrosis of chondrocytes widely prevalent in some regions of China. In order to exclude the complications of natural humic substance, here we prepared phenolic polymers of synthetic humic acid (SHA) by oxidation of phenolic monomer, the protocatechuic acid (PCA). The biological effects of SHA and PCA on primary culture of rabbit articular chondrocytes were investigated. We found that not only SHA but also PCA caused chondrocyte injury, as evidenced by the loss of cell viability measured with methylthiazol tetrazolium (MTT) assay and the increased release of intracellular lactate dehydrogenase (LDH). Both SHA and PCA could result in lipid peroxidation and glutathione (GSH) depletion in chondrocytes, indicating that oxidative stress may be involved in chondrocyte injury. Furthermore, a marked increase in intracellular calcium level ([Ca2+]i) occurred after chondrocytes treated with SHA or PCA. These results suggest that chondrocyte injury elicited by SHA or PCA may be mediated through the occurrence of oxidative stress and the disruption of intracellular Ca2+ homeostasis. Data also suggest that the monomeric phenolic acid may be considered one of the causative factors of KBD in addition to humic substance.

Characterization of selenium status of inhabitants in the region Usti nad Orlici, Czech Republic by INAA of blood serum and hair and fluorimetric analysis of urine

Selenium is an essential trace element and its insufficient status may cause serious health complications for both individuals and the whole populations. To investigate the selenium status of the subpopulation in northeastern Bohemia represented by the region Ustí nad Orlicí, 253 serum, 469 urine, and 31 hair samples from 470 randomly selected volunteers between 6 and 65 yr of age have been analyzed for selenium concentration. Serum and hair Se were detected by instrumental neutron activation analysis (means: 55 +/- 11 micrograms Se/L sera, 0.268 +/- 0.040 microgram Se/g hair). Urine Se was measured by fluorimetry (12 +/- 5 micrograms Se/L urine) with coanalyses of Lyphocheck urine, SRM Urine 2670, and Seronorm urine for quality control of the method. Results proved significant age-dependent differences, but gender differences were not significant. The frequency plot of serum Se proved maximal frequencies in adults between 55 and 70 micrograms Se/L and in children in the range 45-55 micrograms Se/L. The same plots of urine Se for both age groups showed maximal frequency in the limits 8-15 micrograms Se/L. All indices used (Se in serum, urine, and hair) confirmed mild to severe selenium deficiency in the population of the region.

INAA of serum zinc of inhabitants in five regions of the Czech Republic

To investigate the Zn status of inhabitants of the Czech Republic, 1155 serum and 132 hair samples were analyzed for zinc content. Analyzed material was obtained from randomly selected volunteers of both sexes in the age range 6-65 yr. Subpopulations from five regions were included in the study. Analyses of both materials were performed by Instrumental Neutron Activation Analysis (INAA). Coanalyses of Standard Reference Materials (SRM) for quality control were performed. The results (mean 910 +/- 276 micrograms Zn/L serum and 189 +/- 45 micrograms Zn/g hair) demonstrate satisfactory zinc status of the searched population. Significant interregional differences and age-dependent differences, as well as sex-dependent differences have been detected by the use of correlation analysis. On the basis of these results, serum Zn concentration results of individual categories according to age and sex were evaluated, and on the grounds of mean +/- 2 standard deviations, indicative intervals were calculated. The frequency of individual serum Zn concentrations proved that the population of the Czech Republic does not suffer from severe zinc deficiency. On the other hand, about one-third of our inhabitants has their serum Zn concentrations below the cutoff value of 800 micrograms Zn/L serum, which means a marginal or mild Zn deficit of the organism.

Selenium and glutathione peroxidase activity in Hungarian children

Selenium (Se) in plasma, whole blood and erythrocytes as well as glutathione peroxidase (GSH-Px) activity in plasma and erythrocytes were investigated in 161 healthy Hungarian children aged 1-15 years. Se was determined by AAS with hydride generation. The estimation of GSH-Px activity was performed in plasma with tertbutyl-hydroperoxide (t-BOOH) and in erythrocytes with hydrogen peroxide (H2O2) as acceptor substrates. The Se content in plasma (0.63 +/- 0.12 mumol/L), whole blood (0.81 +/- 0.14 mumol/L) and erythrocytes (1.14 +/- 0.26 mumol/L, the GSH-Px activity in plasma (87 +/- 19 U/L) and erythrocytes (5.93 +/- 1.04 U/gHb) was low in Hungarian children in comparison to values for children from other European countries. Samples from a rural area in southeast Hungary showed even lower Se content than samples from an industrial city in the northwest or from the capital. The Se in plasma and whole blood as well as GSH-Px activity in the plasma exhibited a clear age dependency. There was a good correlation between plasma Se and GSH-Px activity in all children (r = 0.633, p < 0.001). In addition, in children from the northwestern city and from the capital a correlation was found between Se content and GSH-Px activity of erythrocytes (r = 0.625, p < 0.001). There is no indication that the high mortality in young Hungarian adults from cardiovascular diseases is mainly caused by a low Se supply because there are no corresponding findings in the surrounding countries of southeastern or central eastern Europe with similar low Se states.

Hormone-nuclear receptor interactions in health and disease. The iodothyronine deiodinases and 5'-deiodination

Two types of iodothyronine deiodinase (ID-I and ID-II) catalyse the 5'-deiodination of thyroxine (T4) to produce the biologically active triiodothyronine (T3). Under normal circumstances ID-I in liver and kidney provides the main source of T3 to the circulation, whilst ID-II is largely responsible for local T3 production in the CNS, brown adipose tissue and pituitary. In some circumstances ID-II in brown adipose tissue and ID-I in the thyroid may provide a significant source of plasma T3, and ID-I in the pituitary may be important for local T3 production in this gland. The IDs thus play a pivotal role in controlling the supply of T3 to the nuclear receptors. ID-I is a selenoenzyme and, although ID-II activity is reduced in selenium deficiency, this is a consequence of increased plasma T4 concentration, rather than ID-II activity being directly dependent on selenium. Changes in 5'-deiodination occur in a number of situations such as poor nutrition, illness, iodine and selenium deficiency, and drug therapy. In iodine deficiency these changes appear to have evolved to ensure that the plasma T3 level is maintained and also to provide the brain with a degree of protection from hypothyroxinaemia. Relatively little is known about the importance of selenium deficiency on thyroid function in humans but, in combination with iodine deficiency, selenium deficiency may prove to be a contributing factor in the pathogenesis of myxodematous cretinism. The changes that occur in ID-I and ID-II in illness produce abnormalities in thyroid function tests which, although of no direct clinical significance, may lead to interpretative problems.