硒與甲狀腺疾病課件

硒與甲狀腺疾病2011-10硒的作用1、抗氧化功能2、保護(hù)心血管3、抗輻射損傷能力4、解毒及抗癌5、其他功能（未知）硒在體內(nèi)的存在形式1、低分子量的硒化合物2、硒蛋白的形式：GSH-PxPHG-Px3、硒代半胱氨酸SeC硒蛋白第二個(gè)發(fā)現(xiàn)的硒蛋白：PHG-Px磷脂過(guò)氧化谷胱甘肽過(guò)氧化物酶硒是其的必需成分活性部位與GSH-Px相同硒蛋白還有一些硒蛋白雖然全部功能未知，但它們的一些功能已被人們了解，包括細(xì)胞內(nèi)信號(hào)的氧化還原調(diào)節(jié)、氧化還原穩(wěn)態(tài)和甲狀腺激素代謝。在病理上，硒蛋白表達(dá)降低與硒蛋白N（SEPN）相關(guān)肌病與因甲狀腺激素代謝缺陷（由SBP2遺傳缺陷引起的脫碘酶缺乏）引起的先天性肌病直接相關(guān)。硒化合物硒代半胱氨酸Sec

Sec與硒蛋白結(jié)合，參與到UGA密碼子的解碼。硒的攝入硒：Se足量攝入：人每日攝取硒180-280μg有明顯的防癌作用過(guò)量：人每日攝取硒≥819μg，敏感的人會(huì)出現(xiàn)硒中毒癥狀硒與甲狀腺疾病1、Seleniumstatusandover-expressionofinterleukin-15inceliacdiseaseandautoimmunethyroiddiseases.2010

甲狀腺對(duì)硒缺乏特別敏感，因?yàn)楹鞍踪|(zhì)（含硒代半胱氨酸）在甲狀腺激素的生物合成和活動(dòng)中起著重要的作用

硒與甲狀腺疾病3、SeleniumandtheThyroid:AClose-KnitConnection.2010

Context:Therecentrecognitionthattheessentialtraceelementseleniumisincorporatedasselenocysteineinallthreedeiodinaseshasdecisivelyconfirmedtheclear-cutlinkbetweenseleniumandthyroidfunction.Ithasadditionallybeenestablishedthatthethyroidcontainsmoreseleniumthananyothertissueandthatseleniumdeficiencyaggravatesthemanifestationofendemicmyxedematouscretinismandautoimmunethyroiddisease.

硒與甲狀腺疾病3、SeleniumandtheThyroid:AClose-KnitConnection.2010

EvidenceSynthesis:Evidenceinsupportofseleniumsupplementationinthyroidautoimmunediseaseisevaluated,theresultshereinpresenteddemonstratingthepotentialeffectivenessofseleniuminreducingtheantithyroidperoxidasetiterandimprovingtheechostructureintheultrasoundexamination.However,considerablediscordremainsastowhoshouldcomprisetargetgroupsforseleniumtreatment,whowillmostbenefitfromsuchtreatment,thepreciseimpactofthebasalantithyroidperoxidaselevel,andtheeffectofdiseasedurationonthetreatmentoutcome.Clearly,furtherin-depthstudiesandevaluationarerequiredconcerningthemechanismofactionofseleniumaswellasthechoiceofsupplementsordietaryintake.Conclusions:

Maintenanceof"selenostasis"viaoptimalintakenotonlyaidspreservationofgeneralhealthbutalsocontributessubstantiallytothepreventionofthyroiddisease.

硒與甲狀腺疾病4、Ontheimportanceofseleniumandiodinemetabolismforthyroidhormonebiosynthesisandhumanhealth.2008

Thetraceelementsiodineandselenium(Se)areessentialforthyroidglandfunctioningandthyroidhormonebiosynthesisandmetabolism.Whileiodineisneededastheeponymousconstituentofthetwomajorthyroidhormonestriiodo-L-thyronine(T3),andtetraiodo-L-thyronine(T4),Seisessentialforthebiosynthesisandfunctionofasmallnumberofselenocysteine(Sec)-containingselenoproteinsimplicatedinthyroidhormonemetabolismandglandfunction.TheSe-dependentiodothyroninedeiodinasescontrolthyroidhormoneturnover,whilebothintracellularandsecretedSe-dependentglutathioneperoxidasesareimplicatedinglandprotection.Recently,anumberofclinicalsupplementationtrialshaveindicatedpositiveeffectsofincreasingtheSestatusoftheparticipantsinavarietyofpathologies.ThesefindingsenforcethenotionthatmanypeoplemightprofitfromimprovingtheirSestatus,bothasameanstoreducetheindividualhealthriskaswellastobalanceaSedeficiencywhichoftendevelopsduringthecourseofillness.Eventhoughtheunderlyingmechanismsarestilllargelyuncharacterised,theeffectsofSeappeartobeexertedviamultipledifferentmechanismsthatimpactmostpronouncedontheendocrineandtheimmunesystems.硒與甲狀腺相關(guān)性眼病（TAO）1、Graves'ophthalmopathy,20102、Graves'Orbitopathy，2011在GO的中度至重度活動(dòng)期疾病階段，行抗炎治療（主要是全身性類固醇的應(yīng)用，眼眶照射），而且在威脅視力的嚴(yán)重階段行眼眶減壓手術(shù)。在輕度疾病中，對(duì)癥處理和硒補(bǔ)充就可以。在疾病的非活動(dòng)階段，手術(shù)（眼眶減壓，眼外肌手術(shù)，眼瞼手術(shù)）可以改善外觀和功能。吸煙會(huì)增加GO的患病率和嚴(yán)重性，并降低治療的效果。甲狀腺功能恢復(fù)正?？梢愿纳萍s60％GO患者的癥狀。

硒與甲狀腺相關(guān)性眼?。═AO）3、DoesseleniumsupplementationimproveGravesophthalmopathy?2011

有輕度Graves眼?。℅O）的患者中，硒的補(bǔ)充可以起到改善軟組織癥狀的作用。

硒與甲狀腺相關(guān)性眼病（TAO）4、DoesseleniumsupplementationimproveGravesophthalmopathy?2011

BackgroundOxygenfreeradicalsandcytokinesplayapathogenicroleinGraves'orbitopathy.MethodsWecarriedoutarandomized,double-blind,placebo-controlledtrialtodeterminetheeffectofselenium(anantioxidantagent)orpentoxifylline(anantiinflammatoryagent)in159patientswithmildGraves'orbitopathy.Thepatientsweregivenselenium(100mugtwicedaily),pentoxifylline(600mgtwicedaily),orplacebo(twicedaily)orallyfor6monthsandwerethenfollowedfor6monthsaftertreatmentwaswithdrawn.Primaryoutcomesat6monthswereevaluatedbymeansofanoverallophthalmicassessment,conductedbyanophthalmologistwhowasunawareofthetreatmentassignments,andaGraves'orbitopathy-specificquality-of-lifequestionnaire,completedbythepatient.SecondaryoutcomeswereevaluatedwiththeuseofaClinicalActivityScoreandadiplopiascore.硒與甲狀腺相關(guān)性眼?。═AO）4、Do