Sodium Selenite Alleviates Breast Cancer-Related Lymphedema Independent of Antioxidant Defense System
Sodium Selenite Alleviates Breast Cancer-Related Lymphedema Independent of Antioxidant Defense System
复制标题
亚硒酸钠可在不依赖抗氧化防御系统的情况下缓解乳腺癌相关淋巴水肿
DOI：
10.3390/nu11051021
复制
发表时间：
2019-05-01
期刊：
影响因子：
5.9
通讯作者：
Lee, Seung-Min
中科院分区：
文献类型：
--
作者：
Han, Hye Won;Yang, Eun Joo;Lee, Seung-Min
长期监测是必要的，以确定患者在乳腺癌手术后发生继发性淋巴水肿的风险。我们评估了补充亚硒酸钠如何影响与抗氧化作用相关的乳腺癌相关淋巴水肿（BCRL）症状和参数。一项随机、双盲、对照试验对26名临床II至III期BCRL患者进行了研究。对照组（CTRL, n = 12）和硒组（SE, n = 14）在2周内分别给予0.9%生理盐水和500 g亚硒酸钠(Selenase（(R)）静脉注射5次。所有患者都接受了推荐行为和自我手动淋巴引流的教育。临床诊断淋巴水肿的医生，生物阻抗数据，血液中氧化标志物的水平，包括谷胱甘肽（GSH），谷胱甘肽二硫（GSSG），丙二醛（MDA），谷胱甘肽过氧化物酶活性（GSH- px）和血清氧自由基吸收能力（ORAC）水平，在基线，2周和随访的时间线进行调查。亚硒酸钠使SE组全血硒浓度升高。与基线相比，在2周时，75.0%的临床期参与者表现出改善，而CTRL组没有变化。随访时，83.3%的SE和10.0%的CTRL从III期变为II期（p = 0.002）。细胞外水（ECW）比率在2周和随访时显著降低，仅在SE组。补充硒后，血液GSH、GSSG、GSH/GSSG比值、MDA和ORAC水平没有变化。亚硒酸钠改善了BCRL的诊断阶段，并提高了ECW比率，但其有益作用可能与其抗氧化活性无关。亚硒酸盐对淋巴水肿的影响可能与非抗氧化特性有关，如抗炎症和免疫功能。需要在更大的人群中进行进一步的机制研究。
Long-term surveillance is necessary to identify patients at risk of developing secondary lymphedema after breast cancer surgery. We assessed how sodium selenite supplementation would affect breast cancer-related lymphedema (BCRL) symptoms and parameters in association with antioxidant effects. A randomized, double-blind, controlled trial was conducted on 26 participants with clinical stage II to III BCRL. The control group (CTRL, n = 12) and selenium group (SE, n = 14) underwent five sessions of 0.9% saline and 500 g sodium selenite (Selenase((R))) IV injections, respectively, within 2 weeks. All patients were educated on recommended behavior and self-administered manual lymphatic drainage. Clinical diagnosis on lymphedema by physicians, bioimpedance data, blood levels of oxidative markers, including glutathione (GSH), glutathione disulfide (GSSG), malondialdehyde (MDA), glutathione peroxidase activity (GSH-Px), and serum oxygen radical absorbance capacity (ORAC) levels, were investigated at timelines defined as baseline, 2-week, and follow-up. Sodium selenite increased whole blood selenium concentration in the SE group. Compared to the baseline, at 2 weeks, 75.0% of participants in clinical stage showed improvement, while there was no change in the CTRL group. At follow-up, 83.3% and 10.0% of the SE and CTRL, respectively, showed stage changes from III to II (p = 0.002). Extracellular water (ECW) ratios were significantly reduced at 2 weeks and follow-up, only in the SE group. Blood GSH, GSSG, GSH/GSSG ratio, MDA, and ORAC levels did not change by selenium supplementation. Sodium selenite improved diagnostic stages of BCRL along with ECW ratios, although the beneficial effect might not be related to its antioxidant activity. Selenite's effect on lymphedema may be associated with non-antioxidant properties, such as anti-inflammation and immune function. Further mechanistic research using a larger population is needed.