硒与甲状腺疾病课件

硒与甲状腺疾病2011-10硒的作用1、抗氧化功能2、保护心血管3、抗辐射损伤能力4、解毒及抗癌5、其他功能（未知）硒在体内的存在形式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硒蛋白第二个发现的硒蛋白：PHG-Px磷脂过氧化谷胱甘肽过氧化物酶硒是其的必需成分活性部位与GSH-Px相同硒蛋白还有一些硒蛋白虽然全部功能未知，但它们的一些功能已被人们了解，包括细胞内信号的氧化还原调节、氧化还原稳态和甲状腺激素代谢。在病理上，硒蛋白表达降低与硒蛋白N（SEPN）相关肌病与因甲状腺激素代谢缺陷（由SBP2遗传缺陷引起的脱碘酶缺乏）引起的先天性肌病直接相关。硒化合物硒代半胱氨酸Sec

Sec与硒蛋白结合，参与到UGA密码子的解码。硒的摄入硒：Se足量摄入：人每日摄取硒180-280μg有明显的防癌作用过量：人每日摄取硒≥819μg，敏感的人会出现硒中毒症状硒与甲状腺疾病1、Seleniumstatusandover-expressionofinterleukin-15inceliacdiseaseandautoimmunethyroiddiseases.2010

甲状腺对硒缺乏特别敏感，因为含硒蛋白质（含硒代半胱氨酸）在甲状腺激素的生物合成和活动中起着重要的作用

硒与甲状腺疾病3、SeleniumandtheThyroid:AClose-KnitConnection.2010

Context:Therecentrecognitionthattheessentialtraceelementseleniumisincorporatedasselenocysteineinallthreedeiodinaseshasdecisivelyconfirmedtheclear-cutlinkbetweenseleniumandthyroidfunction.Ithasadditionallybeenestablishedthatthethyroidcontainsmoreseleniumthananyothertissueandthatseleniumdeficiencyaggravatesthemanifestationofendemicmyxedematouscretinismandautoimmunethyroiddisease.

硒与甲状腺疾病3、SeleniumandtheThyroid:AClose-KnitConnection.2010

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

Maintenanceof"selenostasis"viaoptimalintakenotonlyaidspreservationofgeneralhealthbutalsocontributessubstantiallytothepreventionofthyroiddisease.

硒与甲状腺疾病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.硒与甲状腺相关性眼病（TAO）1、Graves'ophthalmopathy,20102、Graves'Orbitopathy，2011在GO的中度至重度活动期疾病阶段，行抗炎治疗（主要是全身性类固醇的应用，眼眶照射），而且在威胁视力的严重阶段行眼眶减压手术。在轻度疾病中，对症处理和硒补充就可以。在疾病的非活动阶段，手术（眼眶减压，眼外肌手术，眼睑手术）可以改善外观和功能。吸烟会增加GO的患病率和严重性，并降低治疗的效果。甲状腺功能恢复正常可以改善约60％GO患者的症状。

硒与甲状腺相关性眼病（TAO）3、DoesseleniumsupplementationimproveGravesophthalmopathy?2011

有轻度Graves眼病（GO）的患者中，硒的补充可以起到改善软组织症状的作用。

硒与甲状腺相关性眼病（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.硒与甲状腺相关性眼病（TAO）4、Do