Selenium and Autoimmune Diseases: A Review Article

Abstract

Background: Selenium is an essential trace element with fundamental effects on human biology. Trace elements deficiency is not an uncommon finding in autoimmune diseases. This deficiency may be a consequence of autoimmune diseases or may contribute to their etiology. With regard to evidence showing the association between selenium deficiency and generation of reactive oxygen species and subsequent inflammation, reviewing the role of selenium in collagen vascular diseases could help researchers to devise strategies for managing these diseases. Objective: The present study aimed to evaluate the role of selenium and autoimmune rheumatic diseases. Data Sources: PubMed, Scopus, Science Direct, and Google Scholar. Study Eligibility Criteria: All the studies on the use of selenium without any limitations in terms of the preparation method, administration route, or formulation process were included in the study. The exclusion criteria were: 1) Articles published in languages other than English, 2) Administration of chemical and hormonal drugs rather than selenium, 3) Investigation of the effects of selenium on the autoimmune problems in animal models, and 4) Insufficiency of the presented data or poor description of the applied methods. Furthermore, review articles, meta-analyses, expert opinions, editorial letters, case reports, consensus statements, and qualitative studies were excluded from the study. Data Extraction: In this systematic review, articles were evaluated through searching following keywords in combination with selenium: "autoimmune rheumatic diseases "or "scleroderma" or "systemic sclerosis" or "Behcet's disease" or "Sjögren syndrome" or "systemic lupus erythematosus" or "musculoskeletal diseases" or "rheumatoid arthritis" or "vasculitis" or "seronegative arthritis" or "antiphospholipid antibody syndrome". Results: Of 312 articles, 280 were excluded and 32 articles were entered in this study. Based on the majority of studies assessing selenium level in patients with collagen vascular diseases, lower selenium levels were observed in these patients. Moreover, the majority of articles showed an improvement in clinical symptoms of collagen vascular diseases compared to controls after the treatment of patients with different dosages of L-selenomethionine. Conclusion: A decrease in the serum level of selenium was noted in patients with autoimmune diseases, which may be a risk factor for inflammation and initiation of autoimmunity in these patients. A sufficient quantity of selenium has been shown to contribute to the management of complications of autoimmune diseases and even improved survival in patients with autoimmune diseases, which may be due to the anti-inflammatory effects of selenium. Since this issue is of clinical importance, it can be considered in potential nutrition interventions and have beneficial effects on some autoimmune diseases.

The Relevance of Selenium Status in Rheumatoid Arthritis

“…These types of enzymes participate in the regulation of the oxidative and inflammatory state, and it has previously been considered as a factor that affects the disease activity. Nevertheless, it is unclear whether Se deficiency is a cause or consequence of autoimmune diseases [ 84 ]. In RA, it has been stipulated with more consistency among the studies addressed in this review, that this phenomenon is caused by inflammation [ 86 , 94 , 96 , 98 , 99 ]; however, other studies suggested that deficiency of this trace element in the diet could be the cause of low levels of Se in serum [ 55 , 92 , 100 ].…”

“…Previously, decreased serum concentration of trace elements has been described as a common occurrence in autoimmune diseases [ 81 , 82 , 83 ]. Nevertheless, although it has not been clarified whether Se deficiency is a cause or consequence of the development of these diseases, its deficiency could be a factor for the progression of RA, because it has been associated with the generation of ROS and the associated inflammatory state [ 84 ]. Several studies that evaluated the serum concentration of this trace element in patients with RA reported lower concentrations compared to that of apparently healthy individuals ( Table 3 ) [ 55 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ].…”

Selenium and selenoproteins in viral infection with potential relevance to COVID-19

“…In Kashin-Beck disease, increased levels of IL-6, IL-1β and TNF-α were found in selenium-depleted individuals [ 102 ]. In a systematic review of 32 studies of autoimmune diseases, such as rheumatoid arthritis and vasculitis, significantly lower serum selenium concentration was identified in cases than in controls [ 103 ], though the direction of causality was unclear.…”

CpG Methylation of the GPX3 Promoter in Patients with Kashin-Beck Disease Potentially Promotes Chondrocyte Apoptosis

“…Seleniun de ciency has been proposed for decades as the archetypal etiological theory of KBD [6][7][8].…”