There is a growing body of evidence to suggest that Se can alleviate conditions associated with high levels of oxidative stress or inflammation. These include asthma (Jahnova et al. 2002; Shaheen et al. 1999), arthritis (Peretz et al. 2001), muscular dystrophy (Kurihara et al. 2000), cystic fibrosis (Kauf et al. 1994), acute pancreatitis (De las Heras Castano et al. 2000; Vaona et al, 2005), osteoarthritis (Kurz et al. 2002), acute septicaemia [systemic inflammatory response syndrome] (Angstwurm et al. 1999) and kwashiorkor (Ashour et al. 1999). In addition, Schrauzer (1998) discusses the application of selenium therapy to viral haemorrhagic fever and lymphoedema. The association of Se with two of these conditions: asthma and acute septicaemia, are discussed below.
Asthma
Asthma is a condition with genetic, allergic, environmental, infectious, emotional and nutritional components. Its underlying pathophysiology is allergic airway inflammation. Oxidative stress contributes to the inflammatory component of asthma (Gazdik et al, 2004). Studies have shown an association between both low Se intake/status and low plasma/serum GPx activity, and increased asthma risk (Stone et al, 1989; Omland et al, 2002; Qujeq et al, 2003; Shaheen et al, 2004). Supplementation of Se in asthmatics inhibits the activity of pro-inflammatory adhesion molecules (Jahnova et al, 2002), substantially improves immunocompetence (Gazdik et al, 2002a), and enables a reduction in corticosteroid use (Gazdik et al, 2002b).
People with asthma tend to have increased oxidative activity, lowered Se status, and decreased GPx activity. Studies which examine Se deficiency and the preventive and clinical effects of Se supplementation on asthma, including its immunostimulatory effects, support the concept of Se supplementation of asthmatics (Gazdik et al, 2004).
Acute septicaemia
Clinical studies have shown that patients with systemic inflammatory response syndrome (SIRS) and sepsis exhibit decreased plasma Se and glutathione peroxidase activity. Moreover, the degree of Se deficiency correlates with the severity of the disease and the incidence of mortality. Patients with these conditions are under severe oxidative stress, while selenoenzymes have important roles in alleviating this, especially where lipid peroxidation is involved. Several studies have shown that Se supplementation improves outcomes for SIRS/sepsis patients (Forceville et al, 2001; Gartner et al, 2001). In a prospective randomised study, mortality was reduced from 40% to 15%, using a daily dose of 1000 µg sodium selenite over 28 days (Zimmermann et al, 1997), while Schrauzer (1998) reports the finding of another German study of a reduction in mortality from 70% to 30% in the most seriously ill septicaemia patients, who had also developed pneumonia. This study used daily selenite doses from 500 µg, decreasing by day 7 to 150 µg. Thus, although these studies are not large, the findings are promising. Adjuvant Se therapy for these conditions, which are characterised by such high fatality rates, may become standard practice, especially in view of widespread resistance to standard antibiotics.
Angstwurm MWA, Schottdorf J, Schopohl J Gartner R 1999. Selenium replacement in patients with severe systemic inflammatory response syndrome improves clinical outcome. Crit Care Med 27: 1807-1813.
De las Heras Castano G, Garcia de la Paz A, Fernandez MD, Fernandez, Forcelledo JL 2000. Use of antioxidants to treat pain in chronic pancreatitis. Revista Espanola de Enfermedades Digestivas 92(6): 375-385.
Jahnova E, Horvathova M, Gazdik F, Weissova S 2002. Effects of selenium supplementation on expression of adhesion molecules in corticoid-dependent asthmatics. Bratislav Lek Listy 103(1): 12-16.
Kurihara M, Kumagai K, Nakae Y, Nishino I, Nonaka I 2000. Two sibling patints with non-Fukuyama type congenital muscular dystrophy with low serum selenium levels - therapeutic effects of oral selenium supplementation. No To Hattatsu 32(4): 346-351.
Kurz B, Jost B, Schunke M 2002. Dietary vitamins and selenium diminish the development of mechanically induced osteoarthritis and increase the expression of antioxidative enzymes in the knee joint of STR/1N mice. Osteoarthritis-Cartilage 10(2): 119-126.
Peretz A, Siderova V, Neve J 2001. Selenium supplementation in rheumatoid arthritis investigated in a double blind, placebo-controlled trial. Scand J Rheumatol 30(4): 208-212.
Schrauzer GN 1998. Selenium: present and future applications in medicine. In STDA Sixth International Symposium, 10-12 May 1998, Scottsdale, USA. Grimbergen, Belgium: Selenium-Tellurium Development Association.
Shaheen SO, Sterne JAC, Thompson RL 1999. Dietary antioxidants and asthma in adults. Eur Respir J 14(Suppl. 30): 141S.
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