STATUS OF SELENIUM AND ANTIOXIDANTS IN VA RIOUS CLINICAL PICTURES

All healthy memmalian organisms are characterized by an equilibrium be tween the occurrence of highly reactive oxygen species and their destr uction by antioxidants. Numerous diseases go hand in hand with a distu rbance of the homoeostatis. In order to avoid or minimize the destruct ive effect of the oxidant stress on biological structures, therapies u tilizing drugs weith anti-oxidant effects are increasingly being appli ed. Preconditions for these therapies are a characterisation and a fol low-up of the anti-oxidant status in the diseased organism. In the cou rse of the present study selenium, glutathione peroxidase and malondia ldehyde were determined in patients with various clinical pictures (te rminal renal insufficiency, septic shock, high-risk gravidieties, arte riosclerosis, pulmonary carcinoma, acute myocardial infarction, test p atients taking the contraceptive pill). Patients with terminal renal i nsufficiency and those suffering from septic shock syndromes clearly s how a selenium decrease in serum and whole blood as well as a drop in the GSH-Px-activity, and increased malondialdehyde concentrations in t he serum. Both are a reflection of an increased lipid peroxidation. Fi rst results of a selenium therapy are available for patients with ther minal renal insuficiency and post-traumatically induced renal failure. The interpretation of the findings in the categories ''high-risk grav idity'' and ''women on the contraceptive pill'', which show a normal G SH-Px-activity and significantly increased malondialdehyde concentrati ons, seems problematic. The organism counteracts an increased lipid pe roxidation with a normal plasma-GSH-Px-activity, clearly a sign of a s till normal anti-oxidant potential.