摘要
·Thetherapeuticeffectofselenium(Se)hasalreadybeenproveninthyroiddiseaseandthyroidassociatedophthalmopathy(TAO).InspiteofclearscientificproofofitsbenefitsinTAO,thereappearstobenoclearagreementamongthecliniciansregardingitsoptimumdose,durationofthetreatment,efficacyandsafetytodate.Inthisreview,theauthorsummarisesthefindingsof135Englishlanguagearticlespublishedonthissubjectoverthepastfourdecadesfrom1973to2013.TheregulationandmetabolismofthyroidhormonesrequireasteadysupplyofSeandrecentstudieshaverevealedseveralpossiblemechanismsbywhichSeimprovestheseverityofthyroiddiseaseandTAO.Thesemechanismsinclude1)inhibitoryeffectofHLA-DRmoleculeexpressiononthyrocytes;2)profoundreductionsofthyroidstimulatinghormone(TSH)receptorantibodies(TSHR-Ab)andTPOantibodies(TPO-Ab);3)preventionofdysregulationofcell-mediatedimmunityandBcellfunction;4)neutralisingreactiveoxygenspecies(ROS)andinhibitionofredoxcontrolprocessesrequiredfortheactivation,differentiationandactionoflymphocytes,macrophages,neutrophils,naturalkillercellsinvolvedinbothacuteandchronicorbitalinflammationinTAO;5)inhibitionofexpressionofproinflammatorycytokinesand6)inhibitionofprostaglandinandleukotrienesynthesis.AnincreasedoxidativestresshasbeenobservedinbothacuteandchronicphasesofthyroiddiseasewithraisedtissueconcentrationsofROS.ThebenefitsofSesupplementationinindividualswithTAOappeartobeproportionatetothedegreeofsystemicactivityofthethyroiddisease.ThemaximalbenefitofSesupplementationisthereforeseeninthesubjectswhoarehyperthyroid.RestorationofeuthyroidismisoneofthemaingoalsinthemanagementofTAOandwhenanti-thyroiddrugsarecombinedwithSe,thepatientswithGraves’disease(GD)andautoimmunethyroiditis(AIT)achievedeuthyroidismfasterthanthosetreatedwithanti-thyroiddrugsalone.SestatusofnormaladulthumanscanvarywidelyandSe
出版日期
2014年02月12日（中国期刊网平台首次上网日期，不代表论文的发表时间）
