Association between serum selenium level and conversion of bacteriological tests during antituberculosis treatment

Abstract

Objective: To determine whether serum selenium levels are associated with the conversion of bacteriological tests in patients diagnosed with active pulmonary tuberculosis after eight weeks of standard treatment. Methods: We evaluated 35 healthy male controls and 35 male patients with pulmonary tuberculosis, the latter being evaluated at baseline, as well as at 30 and 60 days of antituberculosis treatment. For all participants, we measured anthropometric indices, as well as determining serum levels of albumin, C-reactive protein (CRP) and selenium. Because there are no reference values for the Brazilian population, we used the median of the serum selenium level of the controls as the cut-off point. At 30 and 60 days of antituberculosis treatment, we repeated the biochemical tests, as well as collecting sputum for smear microscopy and culture from the patients. Results: The mean age of the patients was 38.4 ± 11.4 years. Of the 35 patients, 25 (71%) described themselves as alcoholic; 20 (57.0%) were smokers; and 21 (60.0%) and 32 (91.4%) presented with muscle mass depletion as determined by measuring the triceps skinfold thickness and arm muscle area, respectively. Of 24 patients, 12 (39.2%) were classified as moderately or severely emaciated, and 15 (62.5%) had lost > 10% of their body weight by six months before diagnosis. At baseline, the tuberculosis group had lower serum selenium levels than did the control group. The conversion of bacteriological tests was associated with the CRP/albumin ratio and serum selenium levels 60 days after treatment initiation. Conclusions: Higher serum selenium levels after 60 days of treatment were associated with the conversion of bacteriological tests in pulmonary tuberculosis patients.

A Study of Selenium in Leprosy

“…Moraes et al, do a study about the association between selenium levels with bacteriological test conversion during anti-tuberculosis treatment. It was found that high selenium levels after 60 days treatment with anti-tuberculosis medication was associated with bacteriological test conversion in patients with lung tuberculosis [ 14 ]. Another study also showed that vitamin E and selenium administration might lower oxidative stress and heighten antioxidant capacity in patients with lung tuberculosis [ 15 ].…”

Proteínas de Fase Aguda: Ferramentas Antigas para Melhorar o Diagnóstico da Tuberculose

“…Outros autores demonstraram níveis de ALB aumentados significativamente em pacientes com TB no final do tratamento antituberculose, independente do status bacteriológico. Estes resultados estão possivelmente associados à melhora da inflamação, do sistema imunológico e ao status de ativação do sistema complemento, sugerindo potencial da ALB como biomarcador para acompanhamento do tratamento e avaliação de cura [15][16][17] .…”

“…Quando estratificamos os valores da razão PCR/ALB para avaliar o risco de complicações do estresse inflamatório, verificamos que o risco diminui conforme o tempo de tratamento. Estes resultados estão de acordo com estudo que relatou baixos níveis da razão PCR/ALB associados à negativação da cultura micobacteriana ao final do sexto mês do tratamento antituberculose, sugerindo que a razão PCR/ALB possa ser utilizada como biomarcador da resposta terapêutica na tuberculose pulmonar 15 .…”

“…Desta forma, o estudo de marcadores de fase aguda pode ser útil para identificar bons marcadores de diagnóstico e acompanhamento do tratamento antituberculose, principalmente em casos de baciloscopia e/ou cultura negativa, contribuindo para o fechamento do diagnóstico presuntivo da TB em associação com o histórico clínico-radiológico. Alguns estudos já evidenciaram o papel da PCR e ALB como marcadores, entretanto poucos avaliaram o potencial da razão PCR/ALB neste papel 5,15,16 .…”

Macrophage Selenoproteins Restrict Intracellular Replication of Francisella tularensis and Are Essential for Host Immunity

“…While selenoproteins promote normal growth, immunity, and reproductive health in humans (11), the ability of Sesupplementation and therefore, selenoproteins of the host to limit infectious disease severity has also been demonstrated in nutritional intervention studies (12)(13)(14)(15)(16)(17)(18)(19)(20). Se deficiency is associated with chronic infections caused by HIV/AIDS, hepatitis C virus, and Mycobacterium tuberculosis (12)(13)(14)(15); nutritional interventions that contain Se have benefitted patients (16)(17)(18)(19)(20). However, many of these studies did not test the change in expression of selenoproteins following intervention.…”