Selenium-related nutritional status in patients with common variable immunodeficiency: association with oxidative stress and atherosclerosis risk

Abstract

Background Common variable immunodeficiency (CVID) is an inborn errors of immunity, that leads to recurrent chronic infections and autoimmune/ inflammatory diseases and neoplasms. It is considered that these condition is related to persistent this immune-inflammatory stimulation and increased oxidative stress. A positive impact on the survival of patients with an inborn error of immunity was observed with advanced clinical care protocols, thus raising concerns about the risk of developing other associated chronic diseases, such as atherosclerosis. Studies suggest that selenium (Se) is a protective trace element against damage caused by oxidative stress. Thus, it is postulated that adequate consumption reduces the risk of some chronic diseases. Results Se median levels (ug/L) [45.6 (37.3–56.2) vs. 57.8 (46.0–66.0); p = 0.004] and GPX activity (U/L) [7682 (6548–8446) vs. 9284(8440–10,720); p = 0,002) were significantly lower in patients compared to controls. Inadequacy of Se levels was observed in 50% of the patients. There was a higher percentage of high values of C-reactive protein in the group of CVID patients compared to controls [8 (36.4%) vs. 2 (11.1%); p = 0.082]. Higher concentrations of oxidized LDL (45.3 mg/dL vs. 33.3 mg/dL; p = 0.016) and lower concentrations of Apo A-1 (98.5 mg/dL) vs. 117.0 mg/dL; p = 0.008) were observed in the CVID group compared to the control. There was a significant and positive correlation between Se plasma levels and apolipoprotein A-1 concentrations in CVID group (rho = 0.577; p = 0.001). Se values less than 46 μg / L (OR = 3.590; 95% CI 1.103 to 11.687; p = 0.034) and GPX activity below the 4th quartile (OR = 21.703; 95% CI 2.534 to 185.914; p = 0.005) were independently associated, after adjustment for age, overweight and dyslipidemia, with the CVID group (Table 5). Conclusion This study showed an higher percentage of high us-CRP, lower values of plasma Se and GPX activity, higher concentrations of LDLox and lower levels of Apo A-1 in CVID patients in comparison to controls, suggesting oxidative stress and cardiovascular risk.These data point to the importance of assessing the Se status and cardiovascular risk in these patients.

The mechanism of selenium regulating the permeability of vascular endothelial cells through selenoprotein O

“…Among them, the role of selenium deficiency in the occurrence of cardiovascular diseases has received the most extensive attention [ 48 ]. Se deficiency has been identified as a common cause of vascular disease, with significantly reduced blood Se content observed in patients with chronic vascular diseases compared to healthy individuals [ 49 ].The reduced production of GSH-PX and SOD mediated by Se deficiency, as well as a significant decrease in enzyme activity, leads to intense lipid peroxidation, which impairs cell membrane fluidity and repair and mediates vascular endothelial cell damage [ 50 ]. However, dietary intake is the only way for the body to absorb Se, so Se content can regulate Sel expression in the body [ 51 ].…”

Disturbed lipid profile in common variable immunodeficiency – a pathogenic loop of inflammation and metabolic disturbances

“…More recently, Andrade et al. reported decreased levels of ApoA-I associated with increased oxidative stress in 32 CVID patients ( 39 ). MacPherson et al.…”

The Impact of Oxidative Stress on Pediatrics Syndromes

“…Other evidence of increased oxidative stress in CVID comes from the study of Aukrust et al, where a significantly higher level of reduced homocysteine was found in CVID patients compared to the control group [ 237 ]. A recent study showed how selenium median levels and glutathione peroxidase (GPX) activity were significantly lower in CVID patients compared to controls [ 238 ]. Furthermore, there was a higher percentage of high values of C-reactive protein, higher concentrations of oxidized LDL, and lower concentrations of Apolipoprotein A in the group of CVID patients compared to the control group [ 238 ].…”

“…A recent study showed how selenium median levels and glutathione peroxidase (GPX) activity were significantly lower in CVID patients compared to controls [ 238 ]. Furthermore, there was a higher percentage of high values of C-reactive protein, higher concentrations of oxidized LDL, and lower concentrations of Apolipoprotein A in the group of CVID patients compared to the control group [ 238 ]. All these data suggest increased oxidative stress and cardiovascular risk in these patients [ 238 , 239 ].…”

“…No studies are available for the therapeutical use of antioxidants in this disease. However, due to the importance of Selenium as an antioxidant defense mediated by the glutathione peroxidase (GPX) family protein against dyslipidemia and cardiovascular disease, and due to the Se reduced level in CVDI patients, a diet integration could be useful [ 238 ]. Nevertheless, further studies are needed.…”