Abstract
The essential trace element selenium (Se), in the form of selenoproteins, plays a
pivotal role in the antioxidant defense system of the cell. There is evidence that
Se may confer benefits in patients with inflammatory disease and even infectious diseases
like HIV. Furthermore, in patients with severe sepsis, characterized by an increase
in reactive oxygen species and low endogenous anti-oxidative capacity, as well as
in patients with systemic inflammatory response syndrome, Se supplementation may reduce
mortality and improve the clinical outcome, respectively. The nuclear factor kappa-B
(NF-κB) signaling pathway has been associated with enhanced inflammatory response
and its activation has been significantly correlated with interleukin-6 and TNF-α
production. Selenium may inhibit the activation of NF-κB by modulating selenoprotein
genes expression. Moreover, Se supplementation in chronic inflammation restores the
depleted hepatic and serum Se levels by increasing selenoprotein biosynthesis leading
to suppressed CRP production thereby attenuating the inflammatory process. Se increases
shedding of L-selectin from monocytes while decreasing soluble L-selectin, which has
been reported to be associated with high mortality in patients with sepsis. These
mechanisms are likely to contribute to the modulatory effects of an increased Se status
on the inflammatory response. This review evaluates some apparently key mechanisms
of the anti-inflammatory action of selenium and advocates Se supplementation as a
modulator of inflammatory response in infectious and autoimmune disease. Prospective,
randomized, controlled studies must be performed to provide a greater degree of certainty.
Key words
selenium - inflammation - selenoproteins - NF-κB - CRP
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Correspondence
L. H. DuntasMD
Professor of Endocrinology
Endocrine Unit
Evgenidion Hospital
University of Athens
20 Papadiamantopoulou St.
115 28 Athens
Greece
Phone: +30/2106/74 88 78
Fax: +30/2106/75 67 18
Email: ledunt@otenet.gr