Selen in der Intensivmedizin

Abstract

Since selenium was discovered as an essential trace element being widely distributed, and since glutathione peroxidase is known as a selenoenzyme, associations with several severe diseases were established (Keshan disease, Kaschin-Beck syndrome). Despite these known selenium deficiency diseases a related human therapy is still not established so far. In veterinary medicine, however, substitution of selenium is already a standard therapy. Our laboratory investigates the role of selenium since 1990. This includes investigations about the effects of selenium in acute inflammatory diseases in intensive care, in the reperfusion phenomenon following vascular surgery, and in oncology. In acute pancreatitis and sepsis, adjuvant therapy using sodium selenite seems to have positive effects on the overall outcome of patients (a multicenter, double-blind, randomized trial on sepsis is being prepared). New findings concerning the influence of selenium on transcription factors in inflammatory processes will permit a scientifically sound interpretation of clinical results. With further investigations in molecular biology the trace element selenium will become, in the next decade, one of the most interesting topics in intensive care and oncology.