Selenium: implications for outcomes in extremely preterm infants

Abstract

Extremely preterm infants are at high risk for morbidities including bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity likely related to their exposure to reactive oxygen and nitrogen species early in life. Selenium is a trace mineral contributes to the proper function of multiple systems including immunity, redox regulation, and inflammation via the "selenoenzymes" glutathione peroxidase, thioredoxin reductase, and selenoprotein P. Given that selenium accretion via the placenta occurs primarily during the third trimester, preterm neonates are born selenium deficient. While the role of selenium in animals and adults is better described, publications are lacking in the neonatal population regarding consequences of selenium deficiency or toxicity, accurate monitoring of levels, and proper enteral and parental dosages. This review highlights the role of selenium as it relates to the optimal function of antioxidant systems in extremely preterm infants in order to highlight the gaps in knowledge as it relates to the pathogenesis and prevention of morbidities in this population.

Selenium supplementation of lung epithelial cells enhances nuclear factor E2-related factor 2 (Nrf2) activation following thioredoxin reductase inhibition

“…Se contributes to the proper immune, redox, inflammatory, and thyroid function [2] . For an in depth review of the implications of perinatal Se deficiency on neonatal outcomes, the reader is referred to a recent publication by our group [5] . Perinatal Se deficiency is primarily driven by a lack of adequate placental transfer and insufficient postnatal Se supplementation.…”

“…Selenium (Se) is a trace element that is essential for proper redox signaling, antioxidant defense, and immune response in the critically ill patient [2] . During critical illness, low Se levels have been identified in neonatal, pediatric, and adult patients [3] , [4] and preterm infants are Se deficient at birth [5] . Low serum Se levels in patients with respiratory disease correlate with poor prognosis [6] .…”

Low Selenium Levels in Amniotic Fluid Correlate with Small-For-Gestational Age Newborns

“…The molecular mechanisms of exposure to hyperoxia and inflammation which increases ROS could impact the mechanisms leading to premature birth. However, regardless of year of intensive research, the roles of Se, GPx, and selenoproteins are poorly understood in prematurity as well as oxidant injury [ 21 ]. In order to clearly be able to claim the role of trace elements in pre-term birth, roles of heavy metals should additionally be evaluated such as cadmium (Cd), which was found to be positively associated with the risk of early pre-term birth [ 54 ].…”

“…Pregnancy represents a physiological state, which is considered to be a time of increased oxidative stress and in order to protect the fetus, the maternal antioxidants need to work against free radicals in utero [ 21 ]. During pregnancy, especially pre-eclamptic women, who often exhibit SGA newborns, have reduced placental GPx activity compared to control women [ 17 ].…”

Correlation between SEPS1 gene polymorphism and type 2 diabetes mellitus: A preliminary study

“…So far, many studies have reported the association between gene polymorphisms and T2DM risk. Selenium is an essential trace element in mammals, which contributes to the normal functioning of multiple systems, including immunity, redox regulation, and resistance to inflammation, through "selenide" glutathione peroxidase and thioredoxin reductase . Currently, it has been found that selenoprotein gene polymorphism is closely associated with inflammatory and immune diseases.…”