Erythrocyte antioxidant activity and trace element levels in Behçet's disease

Selenium and Autoimmune Diseases: A Review Article

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.

Cristobalite and Hematite Particles in Human Brain

Foreign substances get into the internal environment of living bodies and accumulate in various organs. Cristobalite and hematite particles in the glial cells of pons cerebri of human brain with diagnosis of Behhet disease with scanning electron microscopy (SEM), energy-dispersive microanalysis (EDX), and transmission electron microscopy (TEM) with diffraction were identified. SEM with EDX revealed the matter of irregular micrometer-sized particles sometimes forming polyhedrons with fibrilar or stratified structure. It was found in some particles Ti, Fe, and Zn. Some particles contained Cu. TEM and electron diffraction showed particles of cristobalite and hematite. The presence of the particles can be a result of environmental effect, disruption of normal metabolism, and transformation of physiologically iron-ferrihydrite into more stable form-hematite. From the size of particles can be drawn the long-term accumulation of elements in glial cells.

Study of the correlation of serum selenium level with Behcet's disease

BACKGROUND

Selenium, like other trace elements and antioxidant enzymes, is known as an antioxidant and immunomodulator trace element. Due to recent evidence for selenium deficiency in Behcet's syndrome, this study is to evaluate the correlation of serum selenium level with Behcet's disease (BD).

MATERIALS

This case-control study was conducted on 46 BD patients and 46 healthy controls in a rheumatology research centre. The case and control groups were both age- and race-matched. Serum selenium level was then measured by atomic absorption spectrometry Shimadzu AA-680. Average serum levels of both groups were then compared and analyzed using t-test.

RESULTS

Mean serum selenium levels of patients appeared to be 66.4 ± 15.38 μg/L which was significantly lower than that in the healthy controls (86.87 ± 17.18 μg/L) (P < 0.005). Taking physician global assessment of disease activity into account, significant difference was detected between the patients with active disease (66.57 ± 15.21 μg/L) and those in the inactive state (65.83 ± .75 μg/L). Regardless of the findings mentioned above, serum selenium level was meaningfully elevated among the patients with ocular involvement (P < 0.001).

CONCLUSIONS

These findings demonstrated that selenium serum level among BD patients was lower than that in healthy controls, whereas among the patients with ocular involvement it was higher than those not involved.

Nitric oxide, lipid peroxidation and antioxidant defence system in patients with active or inactive Behçet's disease

BACKGROUND

One of the prominent features of Behçet's disease (BD) is vasculitis and thrombosis as a result of endothelial dysfunction. Nitric oxide (NO) is responsible for endothelial vasorelaxation and inhibition of platelet adhesion.

OBJECTIVES

To assess serum total NO, erythrocyte superoxide dismutase (SOD), whole blood glutathione peroxidase (GSH-Px), plasma total antioxidant status (TAS) and plasma malondialdehyde (MDA) in patients with BD and to correlate their levels with disease activity.

METHODS

The study group consisted of 49 patients with BD and 26 healthy control subjects. None of the subjects was given a standardized diet. Patients with any systemic disease were excluded. Patients with BD were randomized to two groups according to their disease activity (active/inactive, 26/23). We measured serum total NO levels using the enzyme-linked immunosorbent assay method, and SOD, GSH-Px, TAS and MDA levels by spectrophotometric methods.

RESULTS

In patients with active disease (n = 26), serum total NO levels were found to be significantly decreased when compared with the inactive (n = 23) and control (n = 26) groups. Levels were also significantly lower in patients with inactive disease and in total BD patients (n = 49) than in the controls. GSH-Px activities and TAS levels were significantly lower in total BD patients than those in the controls. Patients with active disease and total BD patients exhibited markedly higher MDA levels than the control subjects. MDA levels in the patients with active disease were also found to be elevated compared with the patients with inactive disease.

CONCLUSIONS

We conclude that changes in parameters associated with oxidative stress such as NO-related processes, activities of antioxidant enzymes in the bloodstream and erythrocytes and total plasma antioxidant capacity are involved in the aetiopathogenesis of the vasculitis seen in BD.

Evaluation of nitrosative and oxidative stress in Behcet disease

Plasma nitrotyrosine and nitrite/nitrate levels as markers of nitrosative stress and plasma malondialdehyde (MDA) and protein carbonyl as markers of oxidative stress were determined in patients with Behcet disease (BD). To evaluate the balance between oxidant and antioxidant systems in these patients, we measured erythrocyte lysate CuZn superoxide dismutase (CuZn SOD) activity, plasma sulfhydryl (SH) values and total antioxidant activity. We also determined levels of plasma C-reactive protein (CRP), a key marker of inflammation, and compared them with those of healthy subjects. We found plasma nitrotyrosine levels of BD patients to be increased, indicating that nitrosative stress may occur in these patients. Plasma MDA and CRP levels in BD patients were found to be significantly higher than those in control group. However, plasma SH levels were decreased. No changes were observed in the other measured parameters of the patient group compared with the controls. These data suggest the possible involvement of nitric oxide (NO) together with reactive oxygen substances (ROS) in the pathogenesis of BD.

Erythrocyte superoxide dismutase, catalase activities and plasma nitrite and nitrate levels in patients with Behcet disease and recurrent aphthous stomatitis

Behçet disease (BD) and recurrent aphthous stomatitis (RAS) are two distinct diseases of unknown aetiology which are both characterized by oral aphthae. The aim of this study was to determine the possible association of both diseases with antioxidant status and nitric oxide levels. Twenty-six patients (17 female, nine male) with RAS, 28 patients (17 female, 11 male) with BD and 31 (22 female, nine male) healthy control subjects were included in the study. Blood samples were studied for erythrocyte superoxide dismutase (SOD) and catalase (CAT) activities and plasma nitric oxide (NO) levels. Erythrocyte SOD activity in BD patients was significantly higher than in RAS patients and controls. Although SOD activity in RAS patients was higher than in controls, the difference was not statistically significant. No significant differences in CAT activities or NO levels were found between the three groups. In conclusion, changes in SOD activity may be important in the inflammatory reactions observed in BD and RAS, but NO does not seem to play a primary role in the aetiopathogenesis.

Effects of vitamin E supplementation on blood antioxidants levels in patients with Behçet's disease

Behçet's disease (BD) is known for many years, yet its etiology remains unknown. In BD, the increased production of reactive oxygen species from activated neutrophils may reduce concentrations of antioxidant vitamins and enzymes in plasma and red blood cells (RBC). Vitamin E is an important fat soluble antioxidant and its role on antioxidant parameters of BD is unclear. The study was undertaken to evaluate the role of vitamin E on lipid peroxidation (MDA) levels, antioxidant vitamin and enzyme concentrations in plasma and RBC in patients with BD. There were three groups i.e., control, patient and treatment groups with twenty-five subjects in each. Nonsmoking patients with BD, patient group, was compared with an equal number of healthy control subjects (control group). Blood samples were taken from both control and patient groups and then oral vitamin E was daily supplemented to the patients with BD for six weeks (treated group). At the end of six weeks, blood was taken from the treated group once more. RBC and plasma MDA levels, serum neopterin, complement system (C(3) and C(4)), ASO, CRP, rheumatoid factor, plasma lipoprotein (a), total cholesterol concentrations and erythrocyte sedimentation rate were higher in the patient group than in the control group, but they were lower in the treatment group than in the patient group. While vitamins A, E and beta-carotene concentrations in plasma, catalase, glutathione peroxidase activities and reduced glutathione levels in RBC and plasma were lower in patient group than in the controls, they were found to be higher in the treatment group than in the patient group. These results provide some evidence for a potential role of increased lipid peroxidation and decreased enzymatic and non enzymatic antioxidants in BD by its inflammatory character and vitamin E which may strengthen the antioxidant defense system, and may contribute to the treatment of BD.

Superoxide dismutase activity and glutathione system in erythrocytes of men with Behchet's disease

In order to clarify whether erythrocyte superoxide dismutase (SOD) activity and glutathione system including reduced glutathione (GSH), glutathione peroxidase (G-Px), glutathione reductase (G-Red), glutathione S-transferase (GST) are impaired in men with Behchet's disease (BD) at the first diagnosed time, erythrocyte SOD activity, GSH level, activities of G-Px, G-Red and GST were determined in men with new diagnosed BD. Erythrocyte GSH level, G-Px and G-Red activities were found to be lower, SOD activity was found to be higher in the patients as compared the controls. There was no significant difference between patients and controls for GST activity. Significant positive correlations between GSH and G-Px, GSH and G-Red; significant negative correlations between GSH and SOD, G-Px and SOD, G-Red and SOD were determined. It was concluded that erythrocyte SOD activity and glutathione system are altered in men with new diagnosed BD. It was concluded that these alterations may be a contributory factor for tissue damage associated with BD.

Lipid peroxidation and erythrocyte antioxidant enzymes in patients with Behçet's disease

In spite of unknown etiology, it is now accepted that reactive oxygen species (ROS) produced by neutrophils may be related to the pathogenesis of Behçet's Disease (BD). The objective was to investigate whether increased production of ROS may affect erythrocyte oxidant/antioxidant system in patients with BD. The levels of malondialdehyde (MDA), one of the end products of lipid peroxidation, in plasma and erythrocyte, and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), antioxidant enzymes, in erythrocyte, also C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured in 22 patients in active stage of the disease and also in 30 healthy controls. Increased CRP, ESR, and MDA levels in plasma and erythrocyte and increased SOD but decreased GSH-Px activities in erythrocytes were observed in the patients, when compared to the controls. In addition, significantly positive correlations between plasma and erythrocyte MDA levels, and erythrocyte MDA-CRP, MDA-ESR, MDA-SOD, SOD-ESR and SOD-CRP levels, but negative correlation between plasma MDA and erythrocyte GSH-Px, were found in BD patients. It may be suggested that increased production of ROS in BD, as reflected by higher plasma and erythrocyte MDA levels, may impair erythrocyte membrane integrity and also may lead to the alterations in the erythrocyte antioxidant defense system, as reflected by higher SOD and lower GSH-Px activities in erythrocytes.