Preventative role of Selenium in Keshan Disease: A Review
Keywords:Selenium, Keshan disease, Cardiomyopathy, Selenium supplementation.
Mineral deficiencies have caused severe health consequences in developing countries. Among many other minerals, selenium is also an essential nutritional trace mineral element that is critical to the normal physiology of humans. In 1817, Swedish chemist and physician Jons Jacob Berzelius discovered this element. The US Department of Agriculture has an RDA of 55 μg/day for adults. Regional dietary deficiency of selenium caused Keshan and Kashin-Beck diseases. Keshan disease is endemic congestive cardiomyopathy, characterized by cardiac insufficiency, heart enlargement, arrhythmia, and electrocardiographic modifications. First identified in 1935 in Keshan County, Heilongjiang Province, northeast China. This disease is clinically divided into four categories: acute, subacute, chronic, and latent. However, selenium supplementations to the residents of Keshan disease endemic areas significantly reduced the incidence of KD. Thus, the government decided to apply sodium selenite to growing crops, and the incidence of the disease decreased dramatically.
Albuquerque, R.G., Hirotsu, C., Tufik, S. and Andersen, M.L., (2017). Why Should We Care About Selenium in Obstructive Sleep Apnea? Journal of Clinical Sleep Medicine, 13(7), 931-932.
Avery, J.C. and Hoffmann, P.R., (2018). Selenium, selenoproteins, and immunity. Nutrients, 10(9), 1203.
Becker, D.J., Reul, B., Ozcelikay, A.T., Buchet, J.P., Henquin, J.C. and Brichard, S.M., (1996). Oral selenate improves glucose homeostasis and partly reverses abnormal expression of liver glycolytic and gluconeogenic enzymes in diabetic rats. Diabetologia, 39(1), 3-11.
Bergqvist, A.C., Chee, C.M., Lutchka, L., Rychik, J. and Stallings, V.A., (2003). Selenium deficiency associated with cardiomyopathy: a complication of the ketogenic diet. Epilepsia, 44(4), 618-620.
Bevis, L.E., (2015). Soil-to-human mineral transmission with an emphasis on zinc, selenium, and iodine. Springer Science Reviews, 3(1), 77-96.
Bolog, M.I., (2019). Coenzyme Q10 and Selenium in Heart Failure–A New Perspective. Internal Medicine, 16(5), 41-51.
Boosalis, M.G., (2008). The role of selenium in chronic disease. Nutrition in Clinical Practice, 23(2), 152-160.
Burk, R.F. and Hill, K.E., (2015). Regulation of selenium metabolism and transport. Annual review of nutrition, 35(1), 109-134.
Cheng, W.H. and Prabhu, K.S., (2019). Special issue of “Optimal selenium status and selenoproteins in health”. Biological trace element research, 192(1), 1-2.
Cheng, Y.Y. and Qian, P.C., (1990). The effect of selenium-fortified table salt in the prevention of Keshan disease on a population of 1.05 million. Biomedical and environmental sciences: BES, 3(4), 422-428.
Coppinger, R.J. and Diamond, A.M., (2001). Selenium deficiency and human disease. In Selenium, Springer, Boston, MA, 219-233.
Dos-Reis, A.R., El-Ramady, H., Santos, E.F., Gratão, P.L. and Schomburg, L., (2017). Overview of selenium deficiency and toxicity worldwide: affected areas, selenium-related health issues, and case studies. In Selenium in plants, Springer, 11(1), 209-230.
Duntas, L.H. and Benvenga, S., (2015). Selenium: an element for life. Endocrine, 48(3), 756-775.
Fleming, C.R., Lie, J.T., McCall, J.T., O'brien, J.F., Baillie, E.E. and Thistle, J.L., (1982). Selenium deficiency and fatal cardiomyopathy in a patient on home parenteral nutrition. Gastroenterology, 83(3), 689-693.
Guan, B., Yan, R., Li, R. and Zhang, X., (2018). Selenium as a pleiotropic agent for medical discovery and drug delivery. International journal of nanomedicine, 13, 7473–7490.
Guang-qi, Y., Tai-an, Y.I.N. and Sheng-jie, L.I.U., (1982). Approaches to the supplemenation of selenium in the prevention of keshan disease. ActaNutrimentaSinica, 1.
Jia, C., Chen, X., Li, X., Li, M., Miao, C., Sun, B., Fan, Z. and Ren, L., (2011). The effect of DHEA treatment on the oxidative stress and myocardial fibrosis induced by Keshan disease pathogenic factors. Journal of Trace elements in medicine and biology, 25(3),154-159.
Koller, L.D. and Exon, J.H., (1986). The two faces of selenium-deficiency and toxicity--are similar in animals and man. Canadian Journal of Veterinary Research, 50(3),297–306. PMID: 3527390
Kuruppu, D., Hendrie, H.C., Yang, L. and Gao, S., (2014). Selenium levels and hypertension: a systematic review of the literature. Public health nutrition, 17(6), 1342-1352.
Lei, C., Niu, X., Ma, X. and Wei, J., (2011). Is selenium deficiency really the cause of Keshandisease? Environmental geochemistry and health, 33(2),183-188.
Li, G., Wang, F., Kang, D. and Li, C., (1985). Keshan disease: an endemic cardiomyopathy in China. Human pathology, 16(6), 602-609.
Li, Q., Liu, M., Hou, J., Jiang, C., Li, S. and Wang, T., (2013). The prevalence of Keshan disease in China. International journal of cardiology, 168(2),1121-1126.
Li, S., Wang, T., Ye, C., Li, Q., Guo, Z., Wu, H., Liu, H., Gao, X., Zhou, H., Pang, H. and Deng, J., (2016). An approach to assessment of Keshan disease elimination at the township level. International Health, 8(6), 398–404,
Liu, H., Yu, F., Shao, W., Ding, D., Yu, Z., Chen, F., Geng, D., Tan, X., Lammi, M.J. and Guo, X., (2018). Associations between selenium content in hair and Kashin-Beck disease/Keshan disease in children in northwestern China: a prospective cohort study. Biological trace element research, 184(1), 16-23.
Liu, X., Yang, G., Wang, L.X., Wei, J., Tan, W.H. and Zhu, Y.H., (2016). Progressive risks of latent Keshan disease: a long term follow-up study. Sichuan da xuexuebao. Yi xue ban= Journal of Sichuan University. Medical science edition, 47(3), 398-424.
Liu, Y., Chiba, M., Inaba, Y. and Kondo, M., (2002). Keshan disease-a review from the aspect of history and etiology. Nippon EiseigakuZasshi (Japanese Journal of Hygiene), 56(4), 641-648.
Loscalzo, J., (2014). Keshan disease, selenium deficiency, and the selenoproteome. New England Journal of Medicine, 370(18), 1756-1760.
Mujaji, W.B., (1983). Advances in nutritional research, edited by Harold H Draper, Plenum Press, New York & London, 4(2), 344-349.
Mukherjee, B., Anbazhagan, S., Roy, A., Ghosh, R. and Chatterjee, M., (1998). Novel implications of the potential role of selenium on antioxidant status in streptozotocin-induced diabetic mice. Biomedicine & pharmacotherapy, 52(2), 89-95.
Munguti, C.M., Al Rifai, M. and Shaheen, W., (2017). A rare cause of cardiomyopathy: A case of selenium deficiency causing severe cardiomyopathy that improved on supplementation. Cureus, 9(8): e1627.
Naziroglu, M. and Çay, M., (2001). Protective role of intraperitoneally administered vitamin E and selenium on the antioxidative defense mechanisms in rats with diabetes induced by streptozotocin. Biological trace element research, 79(2),149-159.
Neve, J., (1996). Selenium as a risk factor for cardiovascular diseases. European Journal of Cardiovascular Prevention & Rehabilitation, 3(1),42-47.
Nezelof, C., Bouvier, R. and Dijoud, F., (2002). Multifocal myocardial necrosis: a distinctive cardiac lesion in cystic fibrosis, lipomatous pancreatic atrophy, and Keshan disease. Pediatric pathology & molecular medicine, 21(3), 343-352.
Oldfield, J.E., (2006). Selenium: A historical perspective. In Selenium: Its molecular biology and role in human health, Springer, Boston, MA, 1-6.
Oster, O. and Prellwitz, W., (1990). Selenium and cardiovascular disease. Biological trace element research, 24(2), 91-103.
Ozturk, N., Olgar, Y. and Ozdemir, S., (2013). Trace elements in diabetic cardiomyopathy: An electrophysiological overview. World journal of diabetes, 4(4), 92-95.
Prince, K., Khan, M.S., Ijaz, M., Anjum, A.A., Ali, M.A., Khan, J.A., Nisar, A., Rais, A., Mushtaq, A., Umar, S. and Yung-Fu, C., (2018). Dynamics of Selenium Deficiency in Bovines in District Kasur, Punjab, Pakistan. Pakistan Journal of Zoology, 50(2), 611-617.
Quercia, R.A., Korn, S., O'Neill, D., Dougherty, J.E., Ludwig, M., Schweizer, R. and Sigman, R., (1984). Selenium deficiency and fatal cardiomyopathy in a patient receiving long-term home parenteral nutrition. Clinical pharmacy, 3(5), 531-535.
Rai, A., Singh, N., Rani, R., Kanse, S. And Shingh, S., (2019). Selenium in Food, its Detection Methods and Human Health: A Review, Trends in Biosciences,12(12), 849-854.
Rees, K., Hartley, L., Day, C., Flowers, N., Clarke, A. and Stranges, S., (2013). Selenium supplementation for the primary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews, (1).
Reeves, M.A. and Hoffmann, P.R., (2009). The human selenoproteome: recent insights into functions and regulation. Cellular and Molecular Life Sciences, 66(15),2457-2478.
Reeves, W.C., Marcuard, S.P., Willis, S.E. and Movahed, A., (1989). Reversible cardiomyopathy due to selenium deficiency. Journal of Parenteral and Enteral Nutrition, 13(6), 663-665.
Reich, H.J. and Hondal, R.J., (2016). Why nature chose selenium. ACS chemical biology, 11(4), 821-841.
Smith, A.M. and Temple, K., (1997). Selenium metabolism and renal disease. Journal of Renal Nutrition, 7(2), 69-72.
Stoffaneller, R. and Morse, N.L., (2015). A review of dietary selenium intake and selenium status in Europe and the Middle East. Nutrients, 7(3),1494-1537.
Sun, S., Tao, J.I. and Zhang, J., (2018). A brief history and revelation of etiological studies on Keshan disease. Chinese Journal of Endemiology, 37(5), 345-350.
Sun, Y., Gao, C., Wang, X. and Liu, Y., (2017). Preliminary quantitative proteomics analysis in chronic and latent Keshan disease by iTRAQ labeling approach. Oncotarget, 8(62),105761–105774.
Tinkov, A.A., Ajsuvakova, O.P., Filippini, T., Zhou, J.C., Lei, X.G., Gatiatulina, E.R., Michalke, B., Skalnaya, M.G., Vinceti, M., Aschner, M. and Skalny, A.V., (2020). Selenium and selenoproteins in adipose tissue physiology and obesity. Biomolecules, 10(4),658-672.
Vinceti, M., Filippini, T. and Wise, L.A., (2018). Environmental selenium and human health: an update. Current environmental health reports, 5(4),464-485.
Vinceti, M., Filippini, T., Del Giovane, C., Dennert, G., Zwahlen, M., Brinkman, M., Zeegers, M.P., Horneber, M., D'Amico, R. and Crespi, C.M., (2018). Selenium for preventing cancer. Cochrane database of systematic reviews, 1(1), 1-8.
Wang, C., Li, S., Wang, H. and Fu, J., (2016). Selenium minerals and the recovery of selenium from copper refinery anode slimes. Journal of the Southern African Institute of Mining and Metallurgy, 116(6), 593-600.
Wang, S., Lv, Y., Wang, Y., Du, P., Tan, W., Lammi, M.J. and Guo, X., (2018). Network analysis of Se-and Zn-related proteins in the serum proteomics expression profile of the endemic dilated cardiomyopathy Keshan disease. Biological trace element research, 183(1), 40-48.
Wang, S., Yan, R., Wang, B., Du, P., Tan, W., Lammi, M.J. and Guo, X.,(2018). Prediction of co-expression genes and integrative analysis of gene microarray and proteomics profile of Keshan disease. Scientific reports, 8(1), 231-236.
Wang, Y., Wang, X., Liu, Z., Chong, G., Wang, J. and Wang, M., (2016). Life quality of Chinese patients with chronic Keshan disease and its influencing factors. Chinese Journal of Endemiology, 35(9), 650-654.
Winther, K.H., Rayman, M.P., Bonnema, S.J. and Hegedüs, L., (2020). Selenium in thyroid disorders—essential knowledge for clinicians. Nature Reviews Endocrinology, 16(3),165-176.
Xu, G.L., Wang, S.C., Gu, B.Q., Yang, Y.X., Song, H.B., Xue, W.L., Liang, W.S. and Zhang, P.Y., (1997). Further investigation on the role of selenium deficiency in the aetiology and pathogenesis of Keshan disease. Biomedical and environmental sciences: BES, 10(3), 316-326. PMID: 9315325
Yan, C., Luo, R., Li, F., Liu, M., Li, J., Hua, W. and Li, X., (2021). The epidemiological status, environmental and genetic factors in the etiology of Keshan disease. Cardiovascular Endocrinology & Metabolism, 10(1),14-16.
Yang, G., Ge, K., Chen, J. and Chen, X., (1988). Selenium-related endemic diseases and the daily selenium requirement of humans. World review of nutrition and dietetics, 55(1),98-100.
Yuanyuan, W.F. and Zhao, X.X., (2020). Evaluation of Late Gadolinium Enhancement and Cardiac Cine-MRI Based on Artificial Intelligence in a Patient with Selenium Deficiency Cardiomyopathy (Keshan Disease): A Case Report. Iranian Journal of Radiology, 17(2), e91941.
Yusuf, S.W., Rehman, Q. and Casscells, W., (2002). Cardiomyopathy in association with selenium deficiency: a case report. Journal of Parenteral and Enteral Nutrition, 26(1), 63-66.
Zhou, B., He, S., Wang, X.I., Zhen, X., Su, X. and Tan, W., (2016). Metabolism of arachidonic acid by the cytochrome P450 enzyme in patients with chronic Keshan disease and dilated cardiomyopathy. Biomedical reports, 4(2), 251-255
Zhou, H., Wang, T., Li, Q. and Li, D., (2018). Prevention of Keshan disease by selenium supplementation: a systematic review and meta-analysis. Biological trace element research, 186(1), 98-105.
Zhou, J., Huang, K. and Lei, X.G., (2013). Selenium and diabetes—evidence from animal studies. Free Radical Biology and Medicine, 65(1), 1548-1556.
Zhu, Y.H., Wang, X.F., Yang, G., Wei, J., Tan, W.H., Wang, L.X., Guo, X., Lammi, M.J. and Xu, J.H., (2019). Efficacy of long-term selenium supplementation in the treatment of chronic Keshan disease with congestive heart failure. Current medical science, 39(2), 237-242.
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