The importance of selenium to human health

Selenium and selenoproteins in the brain and brain diseases

Over the past three decades, selenium has been intensively investigated as an antioxidant trace element. It is widely distributed throughout the body, but is particularly well maintained in the brain, even upon prolonged dietary selenium deficiency. Changes in selenium concentration in blood and brain have been reported in Alzheimer's disease and brain tumors. The functions of selenium are believed to be carried out by selenoproteins, in which selenium is specifically incorporated as the amino acid, selenocysteine. Several selenoproteins are expressed in brain, but many questions remain about their roles in neuronal function. Glutathione peroxidase has been localized in glial cells, and its expression is increased surrounding the damaged area in Parkinson's disease and occlusive cerebrovascular disease, consistent with its protective role against oxidative damage. Selenoprotein P has been reported to possess antioxidant activities and the ability to promote neuronal cell survival. Recent studies in cell culture and gene knockout models support a function for selenoprotein P in delivery of selenium to the brain. mRNAs for other selenoproteins, including selenoprotein W, thioredoxin reductases, 15-kDa selenoprotein and type 2 iodothyronine deiodinase, are also detected in the brain. Future research directions will surely unravel the important functions of this class of proteins in the brain.

Determination of selenium in nuts by cathodic stripping potentiometry (CSP)

The aim of this work was to determine the selenium content in nut samples by cathodic stripping potentiometry. Dry-powdered nuts were digested by HNO(3) and dissolved with concentrated hydrochloric acid. To avoid the interference of natural oxygen, the potentiometric determination of selenium was carried out in an electrolyte solution consisting of 2 M CaCl(2) and 4 M HCl. The analysis was executed applying an electrolysis potential of -150 mV for 60 s and a constant current of -30 microA. Under these conditions, detection limits lower than 1.0 ng g(-)(1) were obtained for selenium analysis in nuts. The relative standard deviation of these measurements (expressed as rsd %) ranged from 0.44 to 0.88% while recoveries ranged from 90.2 to 95.3%. The results obtained with the proposed method were compared with those obtained via hydride vapor generation atomic absorption spectroscopy, a common method for determining selenium. The results of the two methods agreed within 5% for almond, hazelnut, and pistachio samples. The mean concentrations of selenium determined in Sicilian samples of almond, hazelnut, and pistachio were 531 +/- 1, 865 +/- 1, and 893 +/- 4 microg/kg, respectively.

Presentation serum selenium predicts for overall survival, dose delivery, and first treatment response in aggressive non-Hodgkin's lymphoma

PURPOSE

This study was undertaken to test the hypothesis that serum selenium concentration at presentation correlates with dose delivery, first treatment response, and overall survival in patients with aggressive B-cell non-Hodgkin's lymphoma.

PATIENTS AND METHODS

The patients presented between July 1986 and March 1999 and received anthracycline-based chemotherapy, radiotherapy, or both. The total selenium content was retrospectively analyzed in 100 sera, frozen at presentation, using inductively coupled plasma mass spectrometry.

RESULTS

The serum selenium concentration ranged from 0.33 to 1.51 micromol/L (mean, 0.92 micromol/L; United Kingdom adult reference range, 1.07 to 1.88 micromol/L). Serum selenium concentration correlated closely with performance status but with no other clinical variable. Multivariate analysis revealed that increased dose delivery, summarized by an area under the curve, correlated positively with younger age (P <.001), advanced stage (P =.001), and higher serum selenium concentration (P =.032). Selenium level also correlated positively with response (odds ratio, 0.62; 95% confidence interval [CI], 0.43 to 0.90; P =.011) and achievement of long-term remission after first treatment (log-rank test, 4.38; P =.036). On multivariate analysis, selenium concentration was positively predictive of overall survival (hazard ratio [HR], 0.76 for 0.2 micromol/L increase; 95% CI, 0.60 to 0.95; P =.018), whereas age indicated negative borderline significance (HR, 1.09; 95% CI, 0.99 to 1.18; P =.066).

CONCLUSION

Serum selenium concentration at presentation is a prognostic factor, predicting positively for dose delivery, treatment response, and long-term survival in aggressive non-Hodgkin's lymphoma. Unlike most existing prognostic factors in aggressive non-Hodgkin's lymphoma, selenium supplementation may offer a novel therapeutic strategy in this frequently curable malignancy.

Beneficial effect of goat milk on bioavailability of copper, zinc and selenium in rats

We studied the effects of dietary inclusion of freeze-dried goat and cow milk on the utilization of copper, zinc and selenium, and on the metabolic fate of copper and zinc, in rats using a standard (non-milk) control diet recommended by the American Institute of Nutrition and diets based on goat or cow milk. For animals given the goat milk diet, the apparent digestibility coefficient (ADC) of copper is similar to that obtained with the standard diet and higher than that in animals given the cow milk diet. The copper balance was higher among the rats given the goat milk and the standard diets than among those given cow milk. The ADC and retention of zinc and selenium were higher for the goat milk diet than for the other two diets. The copper content in the kidneys and in the femur was greater when the animals consumed a goat milk diet than a cow milk diet. Zn deposits in femur, testes, liver, kidney, heart and longissimus dorsi muscle were greatest with the goat-milk diet, followed by the standard diet and were lowest for the rats given cow-milk diet. This study shows that the goat-milk has an important and beneficial effect on the bioavailability of copper, zinc and selenium.

Skeletal muscle disorders associated with selenium deficiency in humans

Skeletal muscle disorders manifested by muscle pain, fatigue, proximal weakness, and serum creatine kinase (CK) elevation have been reported in patients with selenium deficiency. The object of this report was to review the conditions in which selenium deficiency is associated with human skeletal muscle disorders and to evaluate the importance of mitochondrial alterations in these disorders. A systematic literature review using the Medline database and Cochrane Library provided 38 relevant articles. The main conditions associated with selenium deficiency fell into three categories: (1) insufficient selenium intake in low soil-selenium areas; (2) parenteral or enteral nutrition, or malabsorption; and (3) chronic conditions associated with oxidative stress, such as chronic alcohol abuse and human immunodeficiency virus (HIV) infection. In low soil-selenium areas, reversibility of muscle symptoms was similar after selenium supplementation and placebo administration, suggesting a role for other factors in the development of disease. In parenteral or enteral nutrition, or malabsorption, muscle symptoms improved after selenium supplementation in 18 of 19 patients (median delay: 4 weeks). The reason that only a minority of selenium-deficient patients present with skeletal muscle disorders is unclear and is possibly related to cofactors, such as viral infections and drugs. Prospective studies of selenium-deficient myopathies would be useful in critically ill patients, alcohol abusers, and HIV-infected patients.

Characterization of mammalian selenoproteomes

In the genetic code, UGA serves as a stop signal and a selenocysteine codon, but no computational methods for identifying its coding function are available. Consequently, most selenoprotein genes are misannotated. We identified selenoprotein genes in sequenced mammalian genomes by methods that rely on identification of selenocysteine insertion RNA structures, the coding potential of UGA codons, and the presence of cysteine-containing homologs. The human selenoproteome consists of 25 selenoproteins.

Determination of inorganic selenium species by miniaturised isotachophoresis on a planar polymer chip

The use of miniaturised isotachophoresis to allow the simultaneous determination of two inorganic selenium species has been investigated using a poly(methyl methacrylate) chip with a 44-mm-long, 200-microm-wide, 300-microm-deep separation channel. The miniaturised device included an integrated on-column, dual-electrode conductivity detector and was used in conjunction with a hydrodynamic fluid transport system. A simple electrolyte system has been developed which allowed the separation of selenium(IV) and selenium(VI) species to be made in under 210 s. The limits of detection were calculated to be 0.52 mg L(-1) for selenium(IV) and 0.65 mg L(-1 )for selenium(VI). The method allowed the separation of the selenium species from a range of common anions including fluoride, nitrate, nitrite, phosphate, sulfate and sulfite.

Marginal dietary selenium intakes in the UK: are there functional consequences?

Much data indicate that overt selenium deficiency induces a number of pathologies in animals and humans. The effects of chronic marginal undernutrition of this element are unclear, although it has been argued that such subjects will be at increased risk of developing various cancers. The dietary intake of selenium in the UK has fallen over the last 25 years, although no functional consequences of this have been recognized. Recent data demonstrate that restoration of selenium intakes in UK subjects induces biochemical effects with increased activity of selenium-dependent enzymes. Whether such biochemical changes are associated with functional changes is currently unclear and the subject of current investigation.

Selenium in the treatment of radiation-associated secondary lymphedema

PURPOSE

The aim of this explorative study was to evaluate the impact of selenium in the treatment of lymphedema after radiotherapy.

MATERIALS AND METHODS

Between June 1996 and June 2001, 12 patients with edema of the arm and 36 patients with edema of the head-and-neck region were treated with selenium for therapy-related lymphedema. Of these 36 patients, 20 had interstitial endolaryngeal edema associated with stridor and dyspnea. All patients received sodium selenite over 4 to 6 weeks.

RESULTS

Self-assessment using a visual analog scale (n = 48) showed a reduction of 4.3 points when comparing pre- and posttreatment values (p < 0.05). Of 20 patients with endolaryngeal edema, 13 underwent no tracheostomy, 5 underwent a temporary tracheostomy, and only 2 underwent a permanent tracheostomy. Ten of 12 patients with arm edema showed a circumference reduction of the edematous limb and improvement in the Skin-Fold Index by 23.3 points. An improvement of one stage or more was shown by the Földi or the Miller score (n = 28) in 22 (Földi score) and in 24 (Miller score) patients.

CONCLUSIONS

Treatment with sodium selenite is well tolerated and easy to deliver. Additionally, our results suggest that sodium selenite has a positive effect on secondary-developing lymphedema caused by radiation therapy alone or by irradiation after surgery.

Antioxidant supplementation and tapering exercise improve exercise-induced antioxidant response

OBJECTIVE AND METHODS

The present controlled-training, double-blind study (supplemented, n = 7; placebo, n = 9) investigated whether taper training (TT) and antioxidant supplementation, i.e., 150 micro g of selenium, 2000 IU of retinol, 120 mg of ascorbic acid and 30 IU of alpha-tocopherol, modulates antioxidant potential, redox status and oxidative damage occurrence both at rest and in response to exercise. Two weeks of TT followed four weeks of overloaded training. Dietary intakes were recorded. Before and after TT, triathletes did a duathlon consisting of 5-km run, 20-km bike and 5-km run. Biological studies were conducted at rest and after exercise.

RESULTS

Whatever the nutritional status, TT induced a decrease in resting blood reduced glutathione (GSH) concentration (p < 0.001), erythrocyte superoxide dismutase (SOD) activity (p < 0.0001) and plasma total antioxidant status (TAS) (p < 0.05). Only in the supplemented group (Su) with TT, did plasma glutathione peroxidase (GSH-Px) activity decrease (p < 0.05) and CD4(+) cell concentration increase (p < 0.05). However, antioxidant supplementation increased plasma TAS increase in response to exercise and TT (p < 0.05). After exercise, TT also induced a lower decrease in blood reduced and oxidized (GSSG) glutathione (p < 0.01) in both groups, but TT had no effect on lipoperoxidation as estimated by plasma thiobarbituric reactive substances or on muscular damage occurrence estimated by plasma creatine kinase isoenzyme MB mass.

CONCLUSION

During TT, antioxidant supplementation at nutritional doses reinforces antioxidant status response to exercise, with an effect on exercise-induced oxidative stress, and no effect on oxidative damage.

Selenium-dependent enzymes in endothelial cell function

Glutathione peroxidases and thioredoxin reductases are the main selenoproteins expressed by endothelial cells. These enzymes reduce hydroperoxides, their role in endothelial cell physiology, however, by far exceeds prevention of oxidative damage. Reactive oxygen and nitrogen species, especially superoxide, hydroperoxides, and nitric oxide, are crucial signaling molecules in endothelial cells. Their production is regulated by vascular NAD(P)H oxidases and the endothelial nitric oxide synthase. Their metabolism and physiological functions are coordinated by glutathione peroxidases and the thioredoxin/thioredoxin reductase system. Endothelial selenoproteins are involved in the regulation of the vascular tone by maintaining the superoxide anion/nitric oxide balance, of cell adhesion by controlling cell adhesion molecule expression, of apoptosis via inhibition/activation of apoptosis signal-regulating kinase-1, and of eicosanoid production by controlling the activity of cyclooxygenases and lipoxygenases. Accordingly, they regulate inflammatory processes and atherogenesis. The underlying mechanisms are various and differ between individual selenoproteins. Scavenging of hydroperoxides not only prevents oxidative damage, but also interferes with signaling cascades and enzymes involved. Modulation of proteins by hydroperoxide-driven thiol/disulfide exchange is a novel mechanism that needs to be further investigated. A better understanding of the complex interplay of selenoproteins in regulating endothelial cell functions will help to develop a rationale for an improvement of health by an optimum selenium supply.

Inhibition of influenza infection by glutathione

Infection by RNA virus induces oxidative stress in host cells. Accumulating evidence suggests that cellular redox status plays an important role in regulating viral replication and infectivity. In this study, experiments were performed to determine whether the thiol antioxidant glutathione (GSH) blocked influenza viral infection in cultures of Madin-Darby canine kidney cells or human small airway epithelial cells. Protection against production of active virus particles was observed at a low (0.05-0.1) multiplicity of infection (MOI). GSH inhibited expression of viral matrix protein and inhibited virally induced caspase activation and Fas upregulation. In BALB/c mice, inclusion of GSH in the drinking water decreased viral titer in both lung and trachea homogenates 4 d after intranasal inoculation with a mouse-adapted influenza strain A/X-31. Together, the data suggest that the thiol antioxidant GSH has an anti-influenza activity in vitro and in vivo. Oxidative stress or other conditions that deplete GSH in the epithelium of the oral, nasal, and upper airway may, therefore, enhance susceptibility to influenza infection.

Insulin-like and non-insulin-like selenium actions in 3T3-L1 adipocytes

In insulin-sensitive 3T3-L1 adipocytes, selenium stimulates glucose transport and antilipolysis and these actions of selenium, like insulin actions, are sensitive to wortmanin, an inhibitor of phosphatidylinositol-3-kinase (PI3K). Selenium stimulates PI3K activity that is sustained up to 24 h. Selenium after 5-10 min increases tyrosine phosphorylation of selective cellular proteins, but after 24 h overall tyrosine phosphorylation is increased. Tyrosine phosphorylation of insulin receptor substrate 1 is detected when enriched by immunoprecipitation with anti-PI3K antibody. Selenium, however, does not stimulate insulin receptor tyrosine kinase activity. Selenium also increases phosphorylation of other insulin signaling proteins, including Akt and extracellular signal regulated kinases. Selenium-stimulated glucose transport is accompanied by increases in glucose transporter-1 content in the plasma membrane. These data are consistent with similar selenium action in glucose transport in 3T3-L1 fibroblasts expressing mainly GLUT1. In chronic insulin-induced insulin resistant cells, selenium unlike insulin fully stimulates glucose transport. In summary, selenium stimulates glucose transport and antilipolysis in a PI3K-dependent manner, but independent of insulin receptor activation. Selenium exerts both insulin-like and non-insulin-like actions in cells.

A putative glutathione peroxidase of Drosophila encodes a thioredoxin peroxidase that provides resistance against oxidative stress but fails to complement a lack of catalase activity

Cellular defense systems against reactive oxygen species (ROS) include thioredoxin reductase (TrxR) and glutathione reductase (GR). They generate sulfhydryl-reducing systems which are coupled to antioxidant enzymes, the thioredoxin and glutathione peroxidases (TPx and GPx). The fruit fly Drosophila lacks a functional GR, suggesting that the thioredoxin system is the major source for recycling glutathione. Whole genome in silico analysis identified two non-selenium containing putative GPx genes. We examined the biochemical characteristics of one of these gene products and found that it lacks GPx activity and functions as a TPx. Transgene-dependent overexpression of the newly identified Glutathione peroxidase homolog with thioredoxin peroxidase activity (Gtpx-1) gene increases resistance to experimentally induced oxidative stress, but does not compensate for the loss of catalase, an enzyme which, like GTPx-1, functions to eliminate hydrogen peroxide. The results suggest that GTPx-1 is part of the Drosophila Trx antioxidant defense system but acts in a genetically distinct pathway or in a different cellular compartment than catalase.

Low blood selenium concentrations in schizophrenic patients on clozapine

AIMS

To compare plasma and red-cell selenium concentrations of schizophrenic patients treated with clozapine, with healthy controls and patients with mood disorders.

METHODS

Plasma and red-cell selenium concentrations were measured in random venous blood samples from four groups: mood disorder (n = 36), schizophrenics treated with clozapine (n = 54), schizophrenics not treated with clozapine (n = 41) and a healthy control group (n = 56). Assays were performed by an independent laboratory that was blinded to the patient groups and specializes in estimating trace metal concentrations.

RESULTS

Selenium concentrations in plasma and red cells were found to be significantly lower in schizophrenic patients treated with clozapine as compared with all other groups.

CONCLUSIONS

Selenium is an essential antioxidant. Its deficiency has been implicated in myocarditis and cardiomyopathy. Low selenium concentrations in clozapine-treated patients may be important in the pathogenesis of life threatening cardiac side-effects associated with clozapine. Further clinical studies are being conducted to explore this important clinical observation and its therapeutic implications.

Metabolic and nutritional support in acute cardiac failure

PURPOSE OF REVIEW

Cardiovascular disease is one of the most important causes of morbidity and mortality in western countries, generating an increasing number of admissions to intensive care units. Cardiac failure has long been associated with nutritional disorders, malnutrition and cachexia being frequent during the late phases of congestive heart failure: undernutrition is also a determinant of outcome, even after cardiac transplantation.

RECENT FINDINGS

It has been shown that early metabolic support can improve the recovery of the ischaemic heart. This paper reviews recent findings on substrates that can support the failing myocardium, which are mainly glucose-insulin, glutamine, taurine, selenium, thiamine, folic acid, and omega-3 fatty acids. Ischaemia-reperfusion generates tissue lesions that can be partly prevented through substrate manipulation.

SUMMARY

Shifting the substrate metabolism from lipids to carbohydrates and reinforcing the antioxidant status reduces the deleterious biological and clinical consequences of acute ischaemic events. The use of the glucose-insulin-potassium infusion has become widespread with the re-discovery of its value in modulating cellular metabolism and accelerating recovery of the ischaemic myocardium. Antioxidants have gained acceptance in the perioperative phase, as well as in chronic heart failure. This constitutes another piece of evidence in favour of early metabolic and nutritional intervention. There also appears to be room for the prevention of acute deterioration of cardiac function after surgery with the preoperative administration of oral supplements containing omega-3 fatty acids.

Selenium supplements do not increase plasma total homocysteine concentrations in men and women

Studies in rats indicate that plasma total homocysteine (tHcy) is decreased in selenium deficiency and increases with selenium supplementation. The aim of this study was to determine the effect of selenium supplements on plasma tHcy concentrations in a population that has suboptimal selenium status. Subjects from Dunedin, New Zealand (n = 189) were randomly assigned to receive a supplement containing 200 micro g selenium or placebo for 20 wk. At baseline, 67% (n = 112) of the participants had plasma selenium concentrations < 1.2 micro mol/L, a concentration believed to be that necessary for full glutathione peroxidase (Gpx) activity. At 20 wk, plasma selenium concentration and Gpx activity increased in the selenium group by 1.2 micro mol/L [95% confidence interval (CI): 1.1, 1.3] and 5.1 nkat/g protein (3.7, 6.5), respectively, changes that were significantly greater than the changes in the placebo group (P < 0.001). At 20 wk, mean changes in plasma tHcy concentrations were 0.1 micro mol/L (95% CI: -0.4, 0.5) and -0.2 micro mol/L (-0.7, 0.3) in the supplemented and placebo groups, respectively, compared to baseline. There was no difference in the mean changes in plasma tHcy between the supplemented and placebo groups (P = 0.54). These results suggest that selenium supplementation does not influence plasma tHcy concentrations in healthy populations in developed countries, whose selenium status is characterized by lower plasma selenium concentrations.

Determinants of inorganic arsenic methylation capability among residents of the Lanyang Basin, Taiwan: arsenic and selenium exposure and alcohol consumption

The objective of this study was to assess individual variation in inorganic arsenic methylation capability and the association between selenium levels in urine and blood, and inorganic arsenic methylation capability among residents of the Lanyang Basin who drank groundwater and were exposed to high concentrations of inorganic arsenic. According to the arsenic concentration of their drinking water, they were equally and randomly classified into four groups of 252 persons. It turned out that the higher the concentration of arsenic in well water was and thus the cumulative arsenic exposure, the higher the total inorganic arsenic metabolites in urine (total As(i)) and the overall inorganic and organic arsenic in urine (overall As(i+o)) were. The percentage of inorganic arsenic significantly decreased and the DMA percentage significantly increased as the concentration of urinary selenium and serum alpha-tocopherol increased. It appeared that urinary selenium levels increased the metabolism by methylation of arsenic, a finding that requires further investigation.

Halving the selenophosphate synthetase gene dose confers hypersensitivity to oxidative stress in Drosophila melanogaster

Several lines of evidence indicate that selenoproteins mainly act as cellular antioxidants. Here, we test this idea comparing the sensitivity to oxidative stress (paraquat and hydrogen peroxide) between wild type and heterozygous flies for the selenophosphate synthetase selD(ptuf) mutation. Whereas under normal laboratory conditions no difference in life span is observed, a significant decrease is seen in heterozygous flies treated with oxidant agents. In contrast, overexpression of the selD gene in motoneurons did not extend longevity. Our results strongly suggest that selD haploinsufficiency makes heterozygous flies more sensitive to oxidative stress and add further evidence to the role of selenoproteins as cellular antioxidants.

Selenium in soil

Selenium (Se) is an essential microelement, necessary for normal functioning of human and animal organisms. Its deficiency in food and feed causes a number of diseases. In high concentrations, selenium is toxic for humans animals and plants. Soil provision with selenium affects its level in food and feed via nutrition chain. However, selenium reactivity and bioavailability depends not only on its total content in soil but also on its chemical forms. Distribution of the different forms of selenium depends on soil properties such as reaction, aeration, contents of clay and organic matter and microbiological activity.

Dietary intake of arsenic, mercury and selenium by children from a German North Sea island using duplicate portion sampling

The dietary intake of arsenic, selenium and mercury was studied for children living on the North Sea island Amrum, Germany. Altogether, 98 duplicate portions were collected from 14 children (age 1.5-5.5 years) in April and May 1995 over a sampling period of 7 days, respectively. The element concentrations in duplicate samples were measured by atomic absorption spectrometry. The weekly As and Hg intake (median and range) was 2.31 and 0.89-6.75 microg/(kg(bw) x week) for As and 0.13 and 0.060-0.62 microg/(kg(bw) x week) for Hg. Compared with the provisional tolerable weekly intake (PTWI) for As and Hg as proposed by the WHO, German children from coastal areas reveal no health risks due to As and Hg dietary intake. The daily Se intake (median and range) was 19 and 6-160 microg/day. The appropriate Se intake of 10-40 microg/day, as recommended by the Austrian, German, and Swiss Nutrition Councils for 1-4 years-old children, was not reached in 8 out of 49 cases (16.3%), whereas the recommended Se intake, fixed at 15-45 microg/day for the 4-7 years-old children, was not reached in 15 out of 48 cases (31.3%).

Selenium in the treatment of autoimmune thyroiditis

We recently conducted a prospective, placebo-controlled clinical study, where we could demonstrate, that a substitution of 200 microg sodium selenite for three months in patients with autoimmune thyroiditis reduced thyroid peroxidase antibody (TPO-Ab) concentrations significantly. Forty-seven patients from the initially 70 patients agreed to participate in a follow-up cross-over study for further six months. One group (n = 13), which initially received selenium continued to take 200 microg sodium selenite (Se-Se), one group stopped taking selenium (Se-0) ( n = 9), another group which received placebo started to take 200 microg selenium (n = 14) (Plac-Se) and the last group was without selenium substitution (Plac-0) (n = 11). TPO-Ab concentrations were measured at beginning and the end of the study. In the Se-Se group, the TPO-Ab concentrations further significantly p = 0.004) decreased from 625 +/- 470 U/ml to 354 +/- 321 U/ml, in the Se-0 group the TPO-Ab concentrations increased significantly p = 0.017) from 450 +/- 335 to 708 +/- 313 U/ml. In the placebo group, the TPO-Ab concentrations in those patients who were followed without selenium substitution were unchanged (1351 +/- 940 vs. 1724 +/- 1112 U/ml, p = 0.555). In contrast, the patients who received 200 microg sodium selenite after placebo, the TPO-Ab concentrations decreased significantly (p = 0.029) from 1182 +/- 723 to 643 +/- 477 U/ml.

Selenium measurement in human plasma with Zeeman effect electrothermal atomic absorption spectrometry: sample stability and calibration method

The dual aim of the present study is the investigation of the stability of plasma samples for selenium determination with time and temperature and the assessment of the calibration method. A comparative study is performed, using two calibration methods: standard addition to each sample and matrix matched curve. Our findings show that, in general, significant differences in the selenium content are observed when comparing the results obtained with these two calibration methods. Plasma samples stored at -20 degrees C are stable relative to the selenium content for a period of at least one year.

Selenium supplementation to prevent short-term morbidity in preterm neonates

BACKGROUND

Selenium is an essential trace element and component of a number of selenoproteins including glutathione peroxidase, which has a role in protecting against oxidative damage. Selenium is also known to play a role in immunocompetence. Blood selenium concentrations in newborns are lower than those of their mothers and lower still in preterm infants. In experimental animals low selenium concentrations appear to increase susceptibility to oxidative lung disease. In very preterm infants low selenium concentrations have been associated with an increased risk of chronic neonatal lung disease and retinopathy of prematurity.

OBJECTIVES

To assess the benefits and harms of selenium supplementation in preterm or very low birthweight infants.

SEARCH STRATEGY

Searches were made of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2003), MEDLINE (1966-May 2003), and Embase (1980-May 2003). The reference lists of recent trials were also searched and abstracts from the Society for Pediatric Research from 1990 were hand-searched.

SELECTION CRITERIA

Randomised controlled trials which compared selenium supplementation either parenterally or enterally with placebo or nothing from soon after birth in preterm or very low birthweight infants and which reported clinical outcomes were considered for the review.

DATA COLLECTION AND ANALYSIS

Data on selenium supplementation dose, formulation and route of administration; mortality, oxygen requirement at 28 days and 36 weeks post-menstrual age, retinopathy of prematurity, and one or more episodes of sepsis; blood selenium and glutathione peroxidase concentrations at or close to 28 days, were excerpted by both reviewers independently. Data analysis was conducted according to the standards of the Cochrane Neonatal Review Group.

MAIN RESULTS

Three eligible trials were identified. Two trials, including one trial with a much larger sample size than the others combined, were from geographical areas with low population selenium concentrations. Meta-analysis of the pooled data showed a significant reduction in the proportion of infants having one or more episodes of sepsis associated with selenium supplementation [summary RR 0.73 (0.57, 0.93); RD -0.10 (-0.17, -0.02); NNT 10 (5.9, 50)]. Supplementation with selenium was not associated with improved survival, a reduction in neonatal chronic lung disease or retinopathy of prematurity.

REVIEWER'S CONCLUSIONS

Supplementing very preterm infants with selenium is associated with benefit in terms of a reduction in one or more episodes of sepsis. Supplementation was not associated with improved survival, a reduction in neonatal chronic lung disease or retinopathy of prematurity. Supplemental doses of selenium for infants on parenteral nutrition higher than those currently recommended may be beneficial. The data are dominated by one large trial from a country with low selenium concentrations and may not be readily translated to other populations.

Selenium deficiency increases susceptibility to glutamate-induced excitotoxicity

Excitotoxic brain lesions, such as stroke and epilepsy, lead to increasing destruction of neurons hours after the insult. The deadly cascade of events involves detrimental actions by free radicals and the activation of proapoptotic transcription factors, which finally result in neuronal destruction. Here, we provide direct evidence that the nutritionally essential trace element selenium has a pivotal role in neuronal susceptibility to excitotoxic lesions. First, we observed in neuronal cell cultures that addition of selenium in the form of selenite within the physiological range protects against excitotoxic insults and even attenuates primary damage. The neuroprotective effect of selenium is not directly mediated via antioxidative effects of selenite but requires de novo protein synthesis. Gel shift analysis demonstrates that this effect is connected to the inhibition of glutamate-induced NF-kappaB and AP-1 activation. Furthermore, we provide evidence that selenium deficiency in vivo results in a massive increase in susceptibility to kainate-induced seizures and cell loss. These findings indicate the importance of selenium for prevention and therapy of excitotoxic brain damage.

Selenium supplementation acting through the induction of thioredoxin reductase and glutathione peroxidase protects the human endothelial cell line EAhy926 from damage by lipid hydroperoxides

The human endothelial cell line EAhy926 was used to determine the importance of selenium in preventing oxidative damage induced by tert-butyl hydroperoxide (tert-BuOOH) or oxidised low density lipoprotein (LDLox). In cells grown in a low selenium medium, tert-BuOOH and LDLox killed cells in a dose-dependent manner. At 555 mg/l LDLox or 300 microM tert-BuOOH, >80% of cells were killed after 20 h. No significant cell kill was achieved by these agents if cells were pre-incubated for 48 h with 40 nM sodium selenite, a concentration that maximally induced the activities of cytoplasmic glutathione peroxidase (cyGPX; 5.1-fold), phospholipid hydroperoxide glutathione peroxidase (PHGPX;1.9-fold) and thioredoxin reductase (TR; 3.1-fold). Selenium-deficient cells pre-treated with 1 microM gold thioglucose (GTG) (a concentration that inhibited 25% of TR activity but had no inhibitory effect on cyGPX or PHGPX activity) were significantly (P<0.05) more susceptible to tert-BuOOH toxicity (LC(50) 110 microM) than selenium-deficient cells (LC(50) 175 microM). This was also the case for LDLox. In contrast, cells pre-treated with 40 nM selenite prior to exposure to GTG were significantly more resistant to damage from tert-BuOOH and LDLox than Se-deficient cells. Treatment with GTG or selenite had no significant effect on intracellular total glutathione concentrations. These results suggest that selenium supplementation, acting through induction of TR and GPX, has the potential to protect the human endothelium from oxidative damage.

Trends in selenium biochemistry

The biochemistry of selenium-containing natural products, including selenoproteins, is reviewed up to May 2002. Particular emphasis is placed on the assimilation of selenium from inorganic and organic selenium sources for selenoprotein synthesis, the catalytic role of selenium in enzymes, and medical implications of an unbalanced selenium supply. The review contains 393 references on key discoveries and recent progress.

Design, synthesis and antitumor activities of novel 7-arylseleno-7-deoxydaunomycinone derivatives

7-Arylseleno-7-deoxydaunomycinone derivatives 3a-e and 7-thiophenyl-7-deoxydaunomycinones (7 and 8) were synthesized and the antitumor activities of them were evaluated against human stomach cancer SGC-7901 and human leukaemia HL60. The cytotoxic assay show that seleno daunomycinone derivatives are much better inhibitory activity than thiodaunomycinone and the structure-activity relationship was discussed. 7-Deoxydaunomycinone 4 was obtained when selenophenols were used in excess and the possible mechanism was proposed.

Selenium intake, mood and other aspects of psychological functioning

Selenium is an essential trace element although the level of selenium in food items reflects the soil in which they were grown and thus varies markedly between different parts of the world. The metabolism of selenium by the brain differs from other organs in that at times of deficiency the brain retains selenium to a greater extent. The preferential retention of selenium in the brain suggests that it plays important functions. To date mood is the clearest example of an aspect of psychological functioning that is modified by selenium intake. Five studies have reported that a low selenium intake was associated with poorer mood. The underlying mechanism is unclear although a response to supplementation was found with doses greater than those needed to produce maximal activity of the selenoprotein glutathione peroxidase. Although the functions of many selenoproteins are unknown some play important roles in anti-oxidant mechanisms. As there are suggestions that oxidative injury plays a role in normal aging, schizophrenia, Parkinson's and Alzheimer's disease, the possible role of selenium is considered. Although there is evidence that supplementation with anti-oxidant vitamins shown some promise with Alzheimer's patients, and in preventing the development of tardive dyskinesia in schizophrenics taking neuroleptics, a role for selenium has been little considered.

Simultaneous monitoring of volatile selenium and sulfur species from se accumulating plants (wild type and genetically modified) by GC/MS and GC/ICPMS using solid-phase microextraction for sample introduction

A sensitive method for determining ultratrace volatile Se species produced from Brassica juncea seedlings is described. The use of a new commercially available GC/ ICPMS interface in conjunction with solid-phase micro-extraction is a promising way to perform these studies. The addition of optional gases (O2 and N2) to the argon discharge proved to increase the sensitivity for Se and S as well as for Xe, which as a trace contaminant gas, was used for ICPMS optimization studies. However, the optimization parameters differ when an optional gas is added. In the best conditions, limits of detection ranging from 1 to 10 ppt can be obtained depending on the Se compound and 30 to 300 ppt for the volatile S species. The use of GC/MS with similar sample introduction permits the characterization of several unknown species produced as artifacts from the standards. The method allows the virtually simultaneous monitoring of S and Se species from the headspace of several plants (e.g., onions, garlic, etc.) although the present work is focused on the B. juncea seedlings grown in closed vials and treated with Se. Dimethyl selenide and dimethyl diselenide were detected as the primary volatile Se components in the headspace. Sulfur species also were present as allyl (2-propenyl) isothiocyanate and 3-butenyl isothiocyanate as characterized by GC/MS.

Selenium and breast-feeding

The objective of the present review is to discuss Se nutrition during breast-feeding, encompassing environmental and maternal constitutional factors affecting breast-milk-Se metabolism and secretion. A literature search of Medline and Webofscience was used to retrieve and select papers dealing with Se and breast milk. Although Se in natural foods occurs only in organic form, breast milk responds to organic and inorganic Se in supplements. Inorganic Se (selenite, selenate), which is largely used in maternal supplements, is not detectable in breast milk. The mammary-gland regulating mechanism controls the synthesis and secretion of seleno-compounds throughout lactation, with a high total Se level in colostrum that decreases as lactation progresses. Se appears in breast milk as a component of specific seleno-proteins and seleno-amino-acids in milk proteins that are well tolerated by breast-fed infants even in high amounts. Se in breast milk occurs as glutathione peroxidase (4-32 % total Se) > selenocystamine > selenocystine > selenomethionine. The wide range of breast-milk Se concentrations depends on Se consumed in natural foods, which reflects the Se content of the soils where they are grown. Se prophylaxis, either through soil Se fertilization or maternal supplements, is effective in raising breast-milk Se concentration. In spite of wide variation, the median Se concentration from studies worldwide are 26, 18, 15, and 17 microg/l in colostrum (0-5 d), transitional milk (6-21 d), mature milk (1-3 months) and late lactation (>5 months) respectively. Se recommendations for infants are presently not achieved in 30 % of the reported breast-milk Se concentrations; nevertheless Se status is greater in breast-fed than in formula-fed infants.

Impact of a selenium chemoprevention clinical trial on hospital admissions of HIV-infected participants

PURPOSE

To evaluate the impact of selenium chemoprevention (200 microg/day) on hospitalizations in HIV-positive individuals.

METHOD

Data were obtained from 186 HIV+ men and women participating in a randomized, double-blind, placebo-controlled selenium clinical trial (1998-2000). Supplements were dispensed monthly, and clinical evaluations were conducted every 6 months. Inpatient hospitalizations, hospitalization costs, and rates of hospitalization were determined 2 years before and during the trial.

RESULTS

At enrollment, no significant differences in CD4 cell counts or viral burden were observed between the two study arms. Fewer placebo-treated participants were using antiretrovirals (p <.05). The total number of hospitalizations declined from 157 before the trial to 103 during the 2 year study. A marked decrease in total admission rates (RR = 0.38; p =.002) and percent of hospitalizations due to infection/100 patients for those receiving selenium was observed (p =.01). As a result, the cost for hospitalization decreased 58% in the selenium group, compared to a 30% decrease in the placebo group (p =.001). In the final analyses, selenium therapy continued to be a significant independent factor associated with lower risk of hospitalization (p =.001).

CONCLUSION

Selenium supplementation appears to be a beneficial adjuvant treatment to decrease hospitalizations as well as the cost of caring for HIV-1-infected patients.

Malnutrition and gastrointestinal disease

The recognition of several disease processes that cause or are associated with gastrointestinal malabsorption has led to extensive investigation into their pathogenesis, diagnosis, and treatment. This review of selected articles covers a range of subjects related to some of the more common malabsorptive disease. Selected topics including celiac disease, disaccharidase deficiencies, short bowel syndrome, and Crohn disease are discussed.

Intracellular trafficking of micronutrients: from gene regulation to nutrient requirements

The intracellular distribution of micronutrients, as well as their uptake, is important for cell function. In some cases the distribution of micronutrients or their related proteins is determined by gene expression mechanisms. The 3' untranslated region (3'UTR) of metallothionein-1 mRNA determines localisation of the mRNA, and in turn intracellular trafficking of the protein product. Using transfected cells we have evidence for the trafficking of metallothionein-1 into the nucleus and for its involvement in protection from oxidative stress and DNA damage. When nutritional supply of Se is limited, selenoprotein expression is altered, but not all selenoproteins are affected equally; the available Se is prioritised for synthesis of particular selenoproteins. The prioritisation involves differences in mRNA translation and stability due to 3'UTR sequences. Potentially, genetic variation in these regulatory mechanisms may affect nutrient requirements. Genetic polymorphisms in the 3'UTR from two selenoprotein genes have been observed; one polymorphism affects selenoprotein synthesis. These examples illustrate how molecular approaches can contribute at several levels to an increased understanding of nutrient metabolism and requirements. First, they provide the tools to investigate regulatory features in genes and their products. Second, understanding these processes can provide model systems to investigate nutrient metabolism at the cellular level. Third, once key features have been identified, the availability of human genome sequence information and single nucleotide polymorphism databases present possibilities to define the extent of genetic variation in genes of nutritional relevance. Ultimately, the functionality of any variations can be defined and subgroups of the population with subtly different nutrient requirements identified.

Selenium as a 'nutraceutical': how to conciliate physiological and supra-nutritional effects for an essential trace element

PURPOSE OF REVIEW

To review how selenium has been appreciated in nutrition and therapeutics for the last few decades.

RECENT FINDINGS

Selenium is a powerful micronutrient constituting the active centre of about 20 eukaryotic proteins highly relevant in biochemistry, mostly for redox state-regulating properties. This element is now better recognized as a biologically important nutrient. Insufficient dietary intake for satisfying biological requirements in several physiological or pathological conditions has been demonstrated, and it is now established that inadequate intake has adverse consequences for disease susceptibility and the maintenance of optimal health. The 'recommended dietary allowances' for selenium actually seem inadequately defined considering not only the recent evolutions of selenium biochemistry, but also the way in which selenium requirements are estimated. Indeed, the element also seems active at supra-nutritional levels of dietary intake, mostly in the field of cancer prevention, and maybe also at pharmacological levels as an adjuvant treatment of some cancers.

SUMMARY

Selenium perfectly illustrates the concept of 'nutraceutical' and the need for changing paradigms in nutrition. Indeed, intakes for satisfying physiological needs as reflected by classical selenium-dependent biochemical functions (mostly glutathione peroxidase activity) only explain a part of selenium biological potency. Other beneficial effects can be obtained at higher nutritional intakes, which in turn implies specified chemical forms and doses. Studies are under way to document these effects in a more complete and convincing manner.

Onions--a global benefit to health

Onion (Allium cepa L.) is botanically included in the Liliaceae and species are found across a wide range of latitudes and altitudes in Europe, Asia, N. America and Africa. World onion production has increased by at least 25% over the past 10 years with current production being around 44 million tonnes making it the second most important horticultural crop after tomatoes. Because of their storage characteristics and durability for shipping, onions have always been traded more widely than most vegetables. Onions are versatile and are often used as an ingredient in many dishes and are accepted by almost all traditions and cultures. Onion consumption is increasing significantly, particularly in the USA and this is partly because of heavy promotion that links flavour and health. Onions are rich in two chemical groups that have perceived benefits to human health. These are the flavonoids and the alk(en)yl cysteine sulphoxides (ACSOs). Two flavonoid subgroups are found in onion, the anthocyanins, which impart a red/purple colour to some varieties and flavanols such as quercetin and its derivatives responsible for the yellow and brown skins of many other varieties. The ACSOs are the flavour precursors, which, when cleaved by the enzyme alliinase, generate the characteristic odour and taste of onion. The downstream products are a complex mixture of compounds which include thiosulphinates, thiosulphonates, mono-, di- and tri-sulphides. Compounds from onion have been reported to have a range of health benefits which include anticarcinogenic properties, antiplatelet activity, antithrombotic activity, antiasthmatic and antibiotic effects. Here we review the agronomy of the onion crop, the biochemistry of the health compounds and report on recent clinical data obtained using extracts from this species. Where appropriate we have compared the data with that obtained from garlic (Allium sativum L.) for which more information is widely available.

Mutations of the selenoprotein N gene, which is implicated in rigid spine muscular dystrophy, cause the classical phenotype of multiminicore disease: reassessing the nosology of early-onset myopathies

Multiminicore disease (MmD) is an autosomal recessive congenital myopathy characterized by the presence of multiple, short core lesions (known as "minicores") in most muscle fibers. MmD is a clinically heterogeneous condition, in which four subgroups have been distinguished. Homozygous RYR1 mutations have been recently identified in the moderate form of MmD with hand involvement. The genes responsible for the three other forms (including the most prevalent phenotype, termed the "classical" phenotype) remained, so far, unknown. To further characterize the genetic basis of MmD, we analyzed a series of 62 patients through a combined positional/candidate-gene approach. On the basis of clinical and morphological data, we suspected a relationship between classical MmD and the selenoprotein N gene (SEPN1), which is located on chromosome 1p36 (RSMD1 locus) and is responsible for the congenital muscular dystrophy with rigid spine syndrome (RSMD). A genomewide screening, followed by the analysis of 1p36 microsatellite markers in 27 informative families with MmD, demonstrated linkage to RSMD1 in eight families. All showed an axial myopathy with scoliosis and respiratory failure, consistent with the most severe end of the classical MmD spectrum; spinal rigidity was evident in some, but not all, patients. We excluded linkage to RSMD1 in 19 families with MmD, including 9 with classical MmD. Screening of SEPN1 in the 8 families that showed linkage and in 14 patients with classical sporadic disease disclosed 9 mutations affecting 17 patients (12 families); 6 were novel mutations, and 3 had been described in patients with RSMD. Analysis of three deltoid biopsy specimens from patients with typical RSMD revealed a wide myopathological variability, ranging from a dystrophic to a congenital myopathy pattern. A variable proportion of minicores was found in all the samples. The present study represents the first identification of a gene responsible for classical MmD, demonstrates its genetic heterogeneity, and reassesses the nosological boundaries between MmD and RSMD.

Multiorgan sensitivity to anticarcinogenesis by the organoselenium 1,4-phenylenebis(methylene)selenocyanate

The data in this report clearly indicate that the form (structure) in which selenium is used is the most critical determinant of success in future clinical trials. Synthetic organoselenium compounds can be tailored to achieve greater chemopreventive efficacy with minimal toxic side effects by structural modifications. We demonstrated that 1,4-phenylenebis(methylene)selenocyanate is a powerful chemopreventive agent against the development of experimental colon, mammary, lung, and oral carcinogenesis. On the basis of metabolism studies of organoselenium compounds and those reported in the literature, our working hypothesis is that aromatic selenol intermediates are important entities in cancer chemoprevention. In addition, we suggest that 1,4-phenylenebis(methylene)selenocyanate not only serves as a chemopreventive agent, but it may be valuable in preventing metastatic diseases in future studies in the clinic.

Selenium status and associated factors in a British National Diet and Nutrition Survey: young people aged 4-18 y

OBJECTIVE

Assessment of selenium status to provide normative reference values, and investigation of associated socio-demographic factors, in a national sample of British young people aged 4-18 y.

SETTING

National Diet and Nutrition Survey-a nationwide cross-sectional sample of young people aged 4-18 y living in mainland Britain in 1997.

METHODS

Selenium status was measured, mainly in fasting blood samples, by plasma selenium concentration in 1127 participants, by red blood cell (RBC) selenium concentration in 1112, and by whole-blood glutathione peroxidase (GPx) activity in 658.

RESULTS

No evidence of severe selenium deficiency or toxicity was observed. Plasma selenium concentration was directly correlated with RBC selenium concentration, and both were associated directly, although less strongly, with GPx activity. Plasma and RBC selenium concentrations increased significantly with age, with RBC concentrations significantly higher in older girls than boys. Region of domicile exhibited a significant relationship. Associations also occurred with parental occupational social class, selenium concentrations being higher in more socially advantaged children. Black and Indian children had considerably higher concentrations than Caucasian children. Concentrations, especially of plasma selenium, were significantly lower in children either (or both) of whose parents were smokers, although, unexpectedly, there was no evidence that children who themselves smoked had lower levels.

CONCLUSIONS

The observed associations between selenium status indices and age, gender, social class, parental smoking and ethnic group indicate a complex network of biological factors which determine selenium concentrations in blood components, and which thus need to be controlled for when using these indices to assess selenium status in young people.

SPONSORSHIP

The survey was commissioned jointly by the Department of Health and the Ministry of Agriculture, Fisheries and Food, whose responsibility has since been transferred to the Food Standards Agency. Support for the further analysis presented in this paper was provided by the Department of Health.

A novel single nucleotide polymorphism in the 3' untranslated region of human glutathione peroxidase 4 influences lipoxygenase metabolism

Selenium (Se) is an essential micronutrient for human health. The biological roles of the essential micronutrient Se are attributed to its presence in a range of 20-30 selenoproteins including the cytosolic and phospholipid hydroperoxide glutathione peroxidases (GPX1 and GPX4). It has been suggested that GPX4 may play a role in regulation of leukotriene biosynthesis and thus inflammation. In eukaryotes Se is incorporated into selenoproteins as the amino acid selenocysteine in a process requiring a stem-loop within the 3' untranslated region (3'UTR) of the mRNA. In this study the region of the GPX4 gene corresponding to the 3'UTR was scanned for mutations in a group of 66 volunteers. The data show a T/C variant at position 718. The distribution of this SNP in our population was 34% CC, 25% TT and 41% TC; i.e., it is in Hardy-Weinberg equilibrium. Individuals of different genotypes exhibited significant differences in the levels of lymphocyte 5-lipoxygenase total products, with C718 showing increased levels of those products compared to T718 and T/C718 (36% and 44% increases, respectively). The data suggest that the SNP718 that we have identified has functional effects and support the hypothesis that GPX4 plays a regulatory role in leukotriene biosynthesis.

Role of selenium depletion in the etiopathogenesis of depression in patients with alcoholism [corrected]

Chronic heavy alcohol consumption adversely affects both macronutrients and micronutrients. Alcohol use affects selenium status. Considerable evidence suggests that selenium status may modify mental function. The author suggests that the effects of alcohol intake on mood, behavior, and cognition may be partly mediated by biological changes related to selenium deficiency. It has been observed that there is a trend towards the normalization of selenium levels in patients with alcoholism after a relatively short period of abstinence from alcohol. It has also been observed that when depression develops in persons with alcoholism, they are likely to improve fairly rapidly after a relatively short period of abstinence from alcohol without therapy aimed at the depressive symptoms. The author suggests that improvement in depressed patients after a period of abstinence from alcohol might be in part related to the normalization of selenium status. Treatment and prevention of comorbid alcoholism and mood disorders require more attention by research workers, practicing physicians, and the general public. Future studies of the etiology and pathogenesis of mood disorders in patients with alcoholism are merited.