Selen bei malignen hämatologischen Erkrankungen: von der Zytoprotektion bis zur Apoptoseinduktion

Zusammenfassung

Selen ist ein essenzielles Spurenelement. Es wird spezifisch über einen sehr komplexen Vorgang in Selenoproteine eingebaut. Eine defizitäre Versorgung von Patienten mit Krebserkrankungen wurde mehrfach beschrieben [17]. Der Selenbedarf von onkologischen Patienten nimmt in therapeutischer Belastungssituation erheblich zu, so z. B. während Strahlentherapie, Chemotherapie und in der perioperativen Situation [19]. Neben immer wieder kontrovers diskutierten Untersuchungen, mit teilweise widersprüchlichen Ergebnissen, zur Primärprävention von malignen Erkrankungen, insbesondere des Prostatakarzinoms [7], [20], gibt es zahlreiche internationale Publikationen zum interventionellen Einsatz von Selen, begleitend zur konventionellen Tumortherapie, sowie Untersuchungen aus der Präklinik zum Mechanismus der Wirkungsweise von Selen und verschiedenen Selenmetaboliten bei Tumorerkrankungen. Dabei werden überwiegend therapeutisch synergistische, selektiv zytoprotektive Effekte auf gesunde Zellen und pro-apoptotische Effekte auf maligne Zellen beschreiben. In diesem Beitrag wird der Fokus auf eine aktuelle Übersicht zum Einsatz von Selen bei malignen hämatologischen Erkrankungen gerichtet.

Summary

Selenium is an essential trace element. It is integrated into specific selenoproteins in a sophisticated manner. In several publications a deficiant supply was indicated [17]. The demand for selenium is enhanced in stressfull treatment situations, such as durind radiotherapy, chemotherapy and in peri-operative situations [19]. Besides intensely discussed results of studies, mostly with prostate cancer in the situation of primarily prevention [7], [20] with different forms of selenium, there are numerous international publications in preclinical and clinical setting, examining the mode of action and the effects of selenium and its various metabolites on malignant diseases. Predominantly synergistic therapeutic and selective cytoprotective effects were described. This report is focusing on the application of selenium as sodium selenite with hematologic malignant diseases.

Schlüsselwörter

Selen - Natriumselenit - hämatologische maligne Erkrankungen - Selenmangel - Zytoprotektion - Mukositis - Apoptose - NFkappaB - Lymphom - Leukämie

Keywords

Selenium - sodium selenite - hematologic malignancies - selenium deficiency - zytoprotetction - mucositis - apoptosis - NFkappaB - lymphoma - leukemia

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