Extracted from “Medicine World”, P34-35, issue 10, 2004
Prevention and Control of Hepatopathy with Selenium: Study State in China
Chinese University of Science and Technology

This paper has discussed the results of studies on selenium and hepatopathy carried out in China in resent years. It has been found that hepatopath lack selenium in general, and the more serious the illness, the more significant the lack of selenium is; proper supplement of selenium can improve the immune and antioxidant function of hepatopath and enhance the effect of medicine treatment; with selenium we have built three defense lines; animal test shows that supplement of selenium at proper dosage can restrain liver fibrosis and damage; both animal and human tests show that selenium can prevent liver cancer.

In 1950s, during his study on hepatonecrosis, Schwarz, an American dietitian, found that sulfur-containing amino acid (factor 1) and vitamin E (factor 2) were able to protect the liver, and there was another factor 3 having a still better effect, but its contents not known. When he was trying to identify the factor 3, a kind of pungent swell like that of garlic appeared in his laboratory. A colleague of his reminded him the swell was very like that breathed out by the oxen that eaten high selenium fodder in South Dakota State, and suggested to him to measure the selenium in the factor 3. As expected, selenium was found in the factor 3, and thus the concept that lack of selenium would lead to hepatonecrosis was established. Liver is the organ that contains richer selenium in human body. The number of hepatopath is quite large in our country, and so the study on the prevention of hepatopathy with selenium is rather deeper. This paper has combined the study results in this aspect and it can be seen that hepatopathy is the phenomenon of lacking selenium, and taking selenium at proper dosage 200 ug)can prevent liver cancer and assist in the treatment of many kinds of hepatopathy.

It is a universal phenomenon that hepatopath are lacking selenium and the more serious the ill, the lower the level of selenium is in blood. In 1994, "Railway Medical Science" reported that the selenium content in the blood of patients with liver cancer and cirrhosis is lower than that of healthy people; In 1995, "The Third Chinese PLA Medical College Journal" reported that the selenium contents in the blood in human body are arranged: liver cancer ? cirrhossis ? severe hepatitis ? chronic active hepatitis ? hepatitis virus carriers without symptoms ? healthy people; In 1995, "Henan Medical Science University Journal" reported that the selenium contents in the blood of patients with hepatitis B are lower than that of healthy people; In 1996, "Xi'an Medical Science University Journal" reported that the selenium contents in the blood of patients with chronic hepatitis are lower than that of healthy people, and supplemented with selenium 200 ug a day for 8 weeks, can be restored to normal level; In 1997, "New Digestive System Disease Journal" reported that the selenium contents in the blood of patients with hepatitis B are lower than that of healthy people; In 1999, "The Chinese Health Examination Journal" reported that the selenium contents in the blood of hepatitis B virus carriers, whether or not suffering from hepatitis, are lower than that of healthy people, and will be further lowered after hepatitis B having transferred to liver cancer; In 2000, "Guangdong Trace Element Science" reported that the selenium contents in the blood of human body are arranged: liver cancer ? cirrhossis ? hepatitis B ? healthy people, and that alpha fetoprotein belongs to carcinoembryonic protein, and the content of selenium varies oppositely with the alpha fetoprotein; In 2002, "Foreign Medical Science, Geographic Part" reported that the selenium contents in the blood of human body are arranged: cirrhossis ? liver function degeneration, holding that the lack of selenium will be more distinguished when liver is injured; In 2003, "Foreign Medical Science, Geographic Part" reported that the selenium contents in the blood of patients with cirrhossis are lower than that of healthy people; In 2003, "Chinese Coal Industry Medical Science" reported that the selenium contents in the blood of human body are arranged: cirrhossis ? hepatitis ? hepatitis virus carriers without symptoms ? healthy people.

Adequate supplement of selenium can improve the hepatopath"s immune and antioxidant function. In 1995, "Chinese Lemology Journal" reported that for the patients with hepatitis B taking selenium 200 ug a day for two months, the selenium contents and selenium enzymes in the blood can be restored significantly; In 1996, "Guangdong Trace Element Science" reported that for the patients with hepatitis B taking selenium 200 ug a day for three months, the contents of selenium and enzymes in the blood can be increased and the aminopherase decreased; In 1999, "Pharmacology Practice" reported that for the patients with hepatitis B taking selenium 100 ug a day for one months, the course of diseases can be shortened and the curative ratio improved; In 2000, "Heilongjiang Medical Science" reported that for the patients with hepatitis B taking selenium 200 ug a day for one months, the state of illness such as anorexia, fatigue, abdominal distention and discomfort in liver area, as well as transaminase and bilirubin has been restored well; In 2003, "Guangdong Trace Element Science" reported that for the patients with hepatitis and hepatomegaly, taking selenium 300 ug a day for 5-10 days will have significant curative effect; In 2003, "Xi'an Communication University Journal" reported that for the patients with chronic hepatitis taking selenium 200-300 ug a day for three months, the baijiesu-2 and baijiesu-2 accepter in an individual nuclear cell in the peripheral blood have significantly increased, film fluidity strengthened and the fatty peroxide in the blood reduced, playing an important role in the improvement of immune function disorder and antioxidation decline; In 2003, "Chinese Hospital Pharmacology" reported that by combination of interferon and selenium o treat hepatitis B, transaminase can be restored and the transformation-to-Yin and complete response are superior to that of separate application. Interferon can induce NF-KB, which can reduce the curative effect of the interferon, whereas the selenium can restrain NF-KB, so as to improve the curative effect of interferon.

Selenium can build up three defense lines for antiviruses. In China , the patients with hepatitis B are estimated to be 28 million, with hepatitis virus carriers without symptoms exceeding 120 million, 20% of them will be transferred finally to various kinds of chronic hepatitis. The viruses inflict damage on human body through three fundamental processes. First, avoid immune defense and invade into the body; second, destroy the antioxidant defense in human body and inflict damage; third, vary during their reproduction in human body, and in some cases become new viruses with stronger attack capacity in the variance. Selenium plays a restraining role on hepatitis viruses, CVs, influenza virus, AIDS viruses, etc. on the three defense lines. On the first defense line (immune defense), sufficient selenium is essential to keep the immune system normal, and selenium can also adjust the body fluid immune, cell immune and phagocytic functions. And through the adjustment, selenium can prevent virus invasion. Study shows that after invasion, the viruses will disturb the organism's immune system, leading to the decline of baijiesu-2 and baijiesu-2 accepter, whereas selenium supplement can restore the baijiesu-2 and baijiesu-2 accepter to patients with hepatitis B. On the second defense line (antioxidant defense), when the viruses invade into the organism, the immune system in the body will release a large number of free radicals to kill the viruses, and form a immune storm. However, these free radicals will also do damage to the immune cells and the histiocytes, which can be reduced by antioxidase. There are two kinds of antioxidases (glutathion peroxidase and antioxidase thioredoxin), and both are selenium-containing enzymes, the activity of them will be low when in short of selenium. Morbigenous viruses, when run into an organism with sufficient selenium, only cause slight tissue damage because of high activity of selenium-containing enzymes. On the contrary, if the viruses encounter an organism in short of selenium, they will inflict heavy damage on the tissue due to the low activity of selenium-containing enzymes. Study has found that the intrusion of hepatitis B viruses will lower the antioxidant activity of the blood, so as make the fatty peroxides increasing. Supplement of selenium can increase the glutathion peroxidases and decrease the fatty peroxidases for the patients with hepatitis B. On the third defense line (block off virus mutation), the viruses are blocked. The pathogeny of keshan disease is CVs, but some CVs themselves do not give rise to disease, and are called innocent viruses. However, when the organism lacks selenium, the CVs, owing to their genes not being stable and mutation having happened but not repaired, will become vicious viruses with a strong pathogenicity. Supplement of selenium can inhibit the mutation of CVs. Influenza viruses are also likely to change suddenly in the organism deficient in selenium. The study results on the relationship between selenium and the mutation of hepatitis viruses are not available at present, but a number of study conducted in our country have found that the patients with viral hepatitis always lack selenium, and the supplement of selenium can relieve hepatitis symptoms, strengthen the curative effect of liver protection medicines and impede the development of hepatitis towards liver cancer, manifesting the function of selenium in the control of hepatitis mutation.

Experience on animals also shows adequate dosage of selenium can inhibit liver fibrosis and hepatic injury. Hepatitis and fatty liver, if not controlled, have the risk of developing into liver fibrosis. Because the cycle of fibrosis is rather long and selenium is not a medicine, and the study on the functions of selenium in prevention and control of liver fibrosis is difficult, we have not seen any report in this aspect. However, the study on the functions of selenium in the treatment of fibrosis by applying liver fibrosis model of animals has achieved a series of results proving that proper selenium can restrain the formation of liver fibrosis. In 1994, "Trace element and health" reported that by application of carbon tetrachloride to induce liver fibrosis in rats, it was found the selenium and selenium-containing enzymes in the blood and liver were reduced; In 1994, "Xi'an Medical Science University Journal" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with selenium, it was able to lower the transaminase in the blood, increase the albumin, selenium and selenium-containing enzymes in the liver and improve the pathological change; In 1995, "Health Toxicology" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with selenium, it was able to keep stable the glutathion in the liver, lower the transaminase and improve the pathological change; in 1998, "Chinese digest" reported that with albumin to induce liver fibrosis in rats and then supplemented with selenium, it was possible to lower the severity of fibrosis; In 1999, "Xi'an Medical Science University Journal" reported that after application of carbon tetrachloride to induce liver fibrosis in rats followed by supplemented with selenium, it was able to lower liver proline and decrease collagen fibril ; In 2000, "Radioactive immunology" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with selenium, it was possible to restore to normal level the selenium and tumor necrosin in the blood; In 2000, "gastroenterology" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with proper selenium, it was able to lower the fibrosis pathology, with tissue metal protease depressor mRNA in the sternzellen lowered, but supplement too much seeing no significant result; In 2002, "Hebei Medical University Journal" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with selenium, it was possible to increase albumin, lower globulin, transaminase, hexadecenoic acid and small collagen. Meanwhile, the application of selenium together with Chinese medicine would have a better effect; In 2003, "Clinical Alimentary Canal Diseases" reported that after application of carbon tetrachloride to induce liver fibrosis in rats and then supplemented with selenium, it was possible to lower globulin, transaminase and hexadecenoic acid. Meanwhile, the application of selenium together with vitamin E would have a better effect.

Apart from hepatitis, fibrosis and liver cancer, hepatic diseases also include fatty liver, alcohol liver and others. The relationship between selenium and these hepatic diseases has also been studied. In 1998, "Chinese clinical protein" reported that for the fatty liver in rats induced by high fat fodder, supplement of selenium can relieve the symptoms of fatty liver; In 1998, "Anhui Medical Science University Journal" reported that selenium can significantly hinder the ever-increasing trend of transaminase, gross bilirubin and direct bilirubin in rats with obstructive jaundice, increase the livability of animals and relieve the damage of ultrastructure of liver cells; In 1999, "Protein inside and outside of intestines" reported that selenium can significantly reduce the glutamate pyruvate transaminase, gross bilirubin and direct bilirubin in the serum of rats with obstructive jaundice and relieve the damage of the ultrastructure of liver cells; In 2002, "Chinese Professional Medical Science" reported that feeding rats with alcohol for 3 months, the content of fatty peroxidein in the liver tissue of the rats will be increased with the activity of antioxidase distinctively reduced, but after supplement of selenium, the change can be reversed..

Both animal experience and human experience have show that the selenium can be used to prevent liver cancer, and this is an outstanding function of selenium. The prevention of liver cancer with selenium in our country has attracted great attention in the world. In 1987, "Chinese prevention medical science" reported that the outbreak rate of liver cancer induced by aftatoxin in rats was 65%, which was reduced to 24% by supplement of selenium; In 1988, "Chinese Medical Science Academy Journal" reported that the outbreak rate of liver cancer induced by aftatoxin in ducks was 26%, which was reduced to 6% by supplement of selenium; In 1997, "The Third PLA Medical University Journal" reported that for the liver cancer induced by diethyl nitrosamine in rats, 3ppm selenium fodder can significantly reduce the node area of liver cancer; In 1992, " Chinese prevention medical science" reported that the outbreak rate of liver cancer for the carrier of hepatitis viruses who have taken selenium for 4 years was zero, whereas for those who had not taken selenium was 1573/100,000; the outbreak rate of liver cancer for the first-grade relatives of liver cancer high-outbreak family who have taken selenium for 2 years was 219/100,000, whereas for those who had not taken selenium was 5533/100,000; In 1993, "Cancer" reported that in Qidong County, 21,000 people had taken selenium for 6 years and the outbreak of liver cancer decreased from 54% to 33%. As comparison, 28,000 people had not taken selenium, and the outbreak of liver cancer increased from 54% to 64%. In the high-outbreak period, the outbreak rate of liver cancer for those who had taken selenium was 4.6%, but for those who had not taken selenium was 7-14%; In 2000, "Chinese prevention medical science" reported about the functions of selenium in the prevention of the primary liver cancer. 2065 hepatitis virus carriers were divided into a selenium supplement group (1112 people) and a control group (953 people). In the selenium group, selenium was taken 228 ?g/day each person, and in the control group, placebo was taken. After observation for 3 years, it was found that in the selenium supplement group, the selenium in the blood significantly increased along with the corresponding increase of glutathion peroxidase. On the contrary, the detectable rate of lymphocyte micronucleus in the peripheral blood was 3059.55/100,000 for the selenium supplement group and 5981.11/100,00 for the control group, decreasing nearly 50%. These studies have made it clear that in the highly dangerous crowd in the high-outbreak areas, especially in the low selenium areas, supplement of selenium can prevent liver cancer.

Abstracted from "Medicine World", P43-44, issue 10, 2004

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