The rationale for selenium supplementation in inflammatory bowel disease: A mechanism-based point of view
Moein Ala Nutrition 14 January 2021,
Highlights
• Selenium deficiency is a common finding in IBD and increases with disease severity.
• Selenium contributes to effective function of antioxidant system and alleviates colitis.
• Selenium contributes to mucosal healing by modification of immune response.
• Selenium may improve gut protective microbiota which are decreased in IBD.
• Selenium may prevent colorectal cancer by modulation of several signaling pathways.
Management of IBD (inflammatory bowel disease) has always been a challenge for physicians. Current treatment protocols may cause numerous adverse effects. Selenium is known for its putative anti-inflammatory properties. Selenium is needed for the biosynthesis of enzymatically active selenoproteins, which contribute to antioxidative defence, and effective function of immune systems. Several studies showed that IBD patients have a lower selenium level compared to healthy subjects. Hence, experimental studies mimicking ulcerative colitis and Crohn's disease investigated the effect of selenium supplementation on IBD.
Previous studies indicated that: i) Selenoproteins can curb the inflammatory response and attenuate oxidative stress. This anti-inflammatory property caused remission in animal models of colitis. ii) Selenium supports protective gut microbiota which indirectly improves management of IBD. iii) Selenium may block some of the predominant tumorigenesis pathways proposed in colitis-associated colorectal cancer. iv) Selenium supplementation showed promising results in preliminary clinical studies particularly in patients with selenium deficiency.
While selenium supplementation seems to be beneficial for IBD, clinical studies remained too preliminary in this regard. Randomized clinical trials are needed to measure the short-term and long-term effects of selenium on both active and quiescent IBD particularly in IBD patients whom have documented selenium deficiency.