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Endothelial dysfunction and selenium status in children with acute systemic inflammatory response

Grant number: 13/25801-6
Support type:Regular Research Grants
Duration: July 01, 2014 - June 30, 2016
Field of knowledge:Health Sciences - Medicine - Maternal and Child Health
Principal researcher:Heitor Pons Leite
Grantee:Heitor Pons Leite
Home Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil
Assoc. researchers: Emilio Lopes Junior ; Tulio Konstantyner


Oxidative stress occurs during shock as a result of granulocytes and endothelial cell activation. Higher intensity of endothelial activation is associated with unfavorable outcomes. Selenium is an essential trace element that plays a key role in the antioxidant defenses and whose plasma concentrations have been low in critically ill patients. There are no clinical studies, especially in pediatric patients, that consider the roles of selenium and nutritional status in the modulation of endothelial adaptive response during the inflammatory response secondary to shock. We hypothesize that selenium deficiency is associated with changes in biological markers of endothelial dysfunction and that these changes, in turn, are associated with worse clinical prognosis. Objectives: 1) to investigate the association between selenium status and the endothelial activation in children during acute systemic inflammatory response, and 2) to investigate whether the intensity of endothelial activation can predict the clinical outcome in children with systemic inflammatory response. Methodology: prospective, observational study in children admitted to an intensive care unit (ICU) with systemic inflammatory response. Patients will be classified into two groups according to the mean arterial pressure level in the first 24 hours of admission. The groups will be compared using anthropometric measures, plasma and erythrocyte selenium concentrations, GPx activity, selenoprotein P, intensity of endothelial activation, organ dysfunction, infectious complications and mortality. Biomarkers of endothelial activation (sE-selectin, sICAM-1 and sVCAM-1) will be assessed at three different time points: upon admission and on days 3 and 5 of ICU stay. Expected results: if the study hypotheses are correct, they may justify the analysis of biomarkers of endothelial activation in medical practice and in future studies assessing the benefits of selenium supplementation in critical illness. (AU)

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