Changes in the Concentrations of Plasma Selenium and Selenoproteins After Minor Elective Surgery: Further Evidence for a Negative Acute Phase Response?(Technical Briefs‪)‬

The acute phase plasma protein response is part of the complex series of physiological, hematological, and biochemical events that constitute the inflammatory response after tissue injury or infection. The magnitude and duration of the response are related to the nature and severity of the injury and the presence of sepsis (1). We have previously related alterations in plasma iron, transferrin, zinc, albumin, copper, and ceruloplasmin concentrations after major surgery to a marked rise in plasma C-reactive protein (CRP) concentration (2). In both acute (3, 4) and chronic (5) illnesses, the plasma concentration of selenium also decreases in proportion to the magnitude of the inflammatory response. There is concern about the decline in dietary intake of selenium in some areas of the world (6), because the antioxidant activities of several selenoproteins may be important in preventing free radical damage (7). If plasma selenium concentrations decrease during an inflammatory response, independently of dietary intake, then this would have important implications for the interpretation of the plasma selenium values reported in a wide range of illnesses. In this study, total plasma selenium concentration and changes in plasma selenoproteins after minor elective surgery (inguinal hernia repair) were determined and related to the accompanying alterations in plasma CRP. Ten male patients (mean age, 51 years; range, 18-90 years) requiring inguinal hernia repair were recruited to the study. All patients were healthy before surgery, and none were taking any relevant medication. Samples of head hair and toe nails (80-100 mg) were obtained 24 h before surgery as a measure of long-term selenium nutritional status, along with venous blood collected into plain (10 mL) and lithium heparin tubes (20 mL). Blood samples were taken on the mornings of day 1 and day 6 after surgery. None of the patients received intravenous fluids or blood products postsurgery, and all had uncomplicated clinical courses. Routine ward diet was resumed the day after surgery. The study was approved by the local Ethics Committee, and all subjects gave their informed consent. Plasma and serum were separated as soon as possible and stored in plastic tubes at -20 [degrees]C.