Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study

Abstract

IntroductionSelenoenzymes can modulate the extent of oxidative stress, which is recognized as a key feature of septic shock. The pathophysiologic role of erythrocyte selenium concentration in patients with septic shock remains unknown. Therefore, the objective of this study was to evaluate the association of erythrocyte selenium concentration with glutathione peroxidase (GPx1) activity, GPx1 polymorphisms and with ICU and hospital mortality in septic shock patients.MethodsThis prospective study included all patients older than 18 years with septic shock on admission or during their ICU stay, admitted to one of the three ICUs of our institution, from January to August 2012. At the time of the patients’ enrollment, demographic information was recorded. Blood samples were taken within the first 72 hours of the patients’ admission or within 72 hours of the septic shock diagnosis for determination of selenium status, protein carbonyl concentration, GPx1 activity and GPx1 Pro198Leu polymorphism (rs 1050450) genotyping.ResultsA total of 110 consecutive patients were evaluated. The mean age was 57.6 ± 15.9 years, 63.6% were male. Regarding selenium status, only erythrocyte selenium concentration was lower in patients who died in the ICU. The frequencies for GPx1 Pro198Leu polymorphism were 55%, 38% and 7% for Pro/Pro, Pro/Leu and Leu/Leu, respectively. In the logistic regression models, erythrocyte selenium concentration was associated with ICU and hospital mortality in patients with septic shock even after adjustment for protein carbonyl concentration and acute physiology and chronic health evaluation II score (APACHE II) or sequential organ failure assessment (SOFA).ConclusionsErythrocyte selenium concentration was a predictor of ICU and hospital mortality in patients with septic shock. However, this effect was not due to GPx1 activity or Pro198Leu polymorphism.

Erythrocyte SOD1 activity, but not SOD1 polymorphisms, is associated with ICU mortality in patients with septic shock

“…In the present study, 66% of patients with septic shock progressed to death. Although this is a very high mortality rate, it is in accordance with the septic shock mortality observed in other studies in Latin America [22,23].…”

Erythrocyte superoxide dismutase as a biomarker of septic acute kidney injury

“…A barrier to uncovering new biomarkers for this scenario is a lack of understanding of the pathophysiology of sepsis-induced AKI [ 12 , 13 ]. However, oxidative stress is a key feature of sepsis and could be a common pathophysiological pathway between septic shock and AKI [ 31 ].…”

Serum selenium levels in patients with respiratory diseases: a prospective observational study

“…Selenium undertakes its role as a cofactor of glutathione peroxidases, which is a selenium-containing converts the reactive oxygen species into H 2 O depending on the disease conditions just like other enzymatic antioxidants such as superoxide dismutase (35). It is contained in selenoprotein and thereby plays a role in protecting cells from oxidation and suppressing the metabolism of inflammatory cells by lowering the degree of peroxidation of intracellular water content (5,34,(36)(37)(38). Increased oxidative stress is associated with a poor prognosis of ICU patients.…”