Abstract
Selenium protects cells and inhibits many inflammatory cell mechanisms through antioxidant seleno-enzymes. Immunity improvement is illustrated by the study of Berger and colleagues, with reduction of nosocomial pneumonia in burnt patients under multi-trace-element supplementation. As seleno-compounds (especially sodium selenite) are pro-oxidant, however, administration above 800 μg/day may be dangerous in septic shock. Paradoxically, direct reversible pro-oxidative effects of seleno-compounds may also be beneficial for reduction of inflammation (genomic action, apoptosis), and may even be bactericidal or virucidal. These facts need to be further examined, as well as the possible dramatic drop of plasma selenoprotein P in septic shock and its role in endothelium protection.
Highlights
Biological and medical advances in the area of selenium provide interest in selenium for both its antioxidant properties through seleno-enzyme incorporation, as illustrated in the previous issue of Critical Care [1], and its direct pro-oxidant toxic effect through seleno-compounds
We know that selenium plays a crucial role in antioxidant defense, as one selenium atom is absolutely required at the active site of all selenoenzymes in the form of the 21-amino-acid selenocystein [6,7]
The authors show a significant reduction of nosocomial pneumonia by intravenous multitrace-element supplements
Summary
The importance of selenium to human health. In Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium and carotenoids. Edited by Panel on Dietary Antioxidants and Related Compounds, Interpretation and Uses of Dietary Reference Intakes, Institute of Medicine. 8. Forceville X, Vitoux D: Selenium et sepsis. 9. Forceville X, Vitoux D, Gauzit R, Combes A, Lahilaire P, Chappuis P: Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients [see comments]. Forceville X, Moster V, Vitoux D, Plouvier E, Lahilaire P, Combes A: Early marked selenoprotein P decrease in severe inflammatory and septic patients. In 1st International FESTEM Congress on Trace Elements and Minerals in Medicine and Biology; May 2001.
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