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01.01.2019 | Original Article

Supranutritional Sodium Selenate Supplementation Delivers Selenium to the Central Nervous System: Results from a Randomized Controlled Pilot Trial in Alzheimer’s Disease

verfasst von: Barbara R. Cardoso, Blaine R. Roberts, Charles B. Malpas, Lucy Vivash, Sila Genc, Michael M. Saling, Patricia Desmond, Christopher Steward, Rodney J. Hicks, Jason Callahan, Amy Brodtmann, Steven Collins, Stephen Macfarlane, Niall M Corcoran, Christopher M. Hovens, Dennis Velakoulis, Terence J. O’Brien, Dominic J. Hare, Ashley I. Bush

Erschienen in: Neurotherapeutics | Ausgabe 1/2019

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Abstract

Insufficient supply of selenium to antioxidant enzymes in the brain may contribute to Alzheimer’s disease (AD) pathophysiology; therefore, oral supplementation may potentially slow neurodegeneration. We examined selenium and selenoproteins in serum and cerebrospinal fluid (CSF) from a dual-dose 24-week randomized controlled trial of sodium selenate in AD patients, to assess tolerability, and efficacy of selenate in modulating selenium concentration in the central nervous system (CNS). A pilot study of 40 AD cases was randomized to placebo, nutritional (0.32 mg sodium selenate, 3 times daily), or supranutritional (10 mg, 3 times daily) groups. We measured total selenium, selenoproteins, and inorganic selenium levels, in serum and CSF, and compared against cognitive outcomes. Supranutritional selenium supplementation was well tolerated and yielded a significant (p < 0.001) but variable (95% CI = 13.4–24.8 μg/L) increase in CSF selenium, distributed across selenoproteins and inorganic species. Reclassifying subjects as either responsive or non-responsive based on elevation in CSF selenium concentrations revealed that responsive group did not deteriorate in Mini-Mental Status Examination (MMSE) as non-responsive group (p = 0.03). Pooled analysis of all samples revealed that CSF selenium could predict change in MMSE performance (Spearman’s rho = 0.403; p = 0.023). High-dose sodium selenate supplementation is well tolerated and can modulate CNS selenium concentration, although individual variation in selenium metabolism must be considered to optimize potential benefits in AD. The Vel002 study is listed on the Australian and New Zealand Clinical Trials Registry (http://www.anzctr.org.au/), ID: ACTRN12611001200976.

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Titel: Supranutritional Sodium Selenate Supplementation Delivers Selenium to the Central Nervous System: Results from a Randomized Controlled Pilot Trial in Alzheimer’s Disease
verfasst von: Barbara R. Cardoso
Blaine R. Roberts
Charles B. Malpas
Lucy Vivash
Sila Genc
Michael M. Saling
Patricia Desmond
Christopher Steward
Rodney J. Hicks
Jason Callahan
Amy Brodtmann
Steven Collins
Stephen Macfarlane
Niall M Corcoran
Christopher M. Hovens
Dennis Velakoulis
Terence J. O’Brien
Dominic J. Hare
Ashley I. Bush
Publikationsdatum: 01.01.2019
Verlag: Springer International Publishing
Erschienen in: Neurotherapeutics / Ausgabe 1/2019
Print ISSN: 1933-7213
Elektronische ISSN: 1878-7479
DOI: https://doi.org/10.1007/s13311-018-0662-z

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