A study conducted by researchers at Fundação Oswaldo Cruz (Fiocruz) revealed benefits for heart function in patients with Chagas Disease from the use of a selenium-based supplement.
The substance, which acts as an antioxidant, was able to reduce cardiac damage related to the chronic phase of the disease in patients in a clinical study.
The trial results were published in the scientific journal EClinicalMedicine. The study involved patients with chronic Chagas disease with mild to moderate heart problems, which are classified as stage B.
The research confirmed the safety of the use of selenium, with no record of adverse reactions. In the subgroup of patients with moderate heart disease, classified as stage B2, the analyzes showed improvements with the reduction of the severity of the heart problems.
One of the causes of heart disease at this stage of the disease is oxidative damage, characterized by the action of oxygen in the body that affects body cells from the generation of free radicals. The selenium-based supplement works precisely to prevent oxidative damage that accelerates the wear and tear of the heart.
The authors of the research evaluate the result as positive and indicate that further studies will be carried out.
“We generated the first evidence, obtained in a randomized clinical trial, on the benefit of selenium for patients with stage B2 chronic heart disease in Chagas disease. It was a statistically significant result, but in a small sample”, says project coordinator Tania Cremonini de Araujo-Jorge, a researcher at the Oswaldo Cruz Institute (IOC/Fiocruz).
According to her, further studies will be conducted to confirm the findings from the evaluation for a longer period of patients at different stages of the disease.
“This was the first randomized clinical trial that tested the use of selenium to prevent worsening of the contractile function of the heart in Chagas’ heart disease. The trial showed that there is a subgroup of patients in which the treatment was beneficial, which excited us a lot and generated questions for further research”, adds cardiologist Marcelo Holanda, researcher at the National Institute of Infectious Diseases (INI/Fiocruz).
How the tests were performed
To assess the effects of selenium supplementation, Fiocruz researchers recruited 66 patients seen at Fiocruz’s Chagas disease outpatient clinic.
The volunteers were divided into two groups, while half received daily supplementation with selenium capsules, the other part received the so-called placebo, a substance without any kind of effect for the body. The patients were followed up for one year, from clinical consultations, laboratory and heart tests.
The research followed a protocol called technically double-blind randomized, which means that volunteers were randomly assigned to the groups and, throughout follow-up, both patients and evaluators were unaware of who was receiving selenium and who was taking it. placebo.
This type of analysis means that both groups have patients with similar profiles in relation to factors that may influence the outcome of the study. In addition, it avoids the predisposition to recognize signs of improvement in those who used the medication or worsening in those who did not.
At the end of the trial, the researchers compared the clinical course of the patients. The most relevant result was observed among those who initially had a moderate loss of heart contraction force (stage B2 heart disease).
After one year of follow-up, volunteers who received selenium supplementation maintained or improved cardiac function. On the other hand, the group that did not take the medication maintained the same condition or presented clinical worsening.
Among patients who had mildly altered cardiac function at baseline (stage B1 heart disease), no statistically significant difference was observed between the treated group and placebo after one year.
However, data indicate that there may be a benefit from the treatment for these patients, and that longer follow-up would be indicated to answer this question. On average, disease progression was slightly less marked among selenium-treated volunteers.
“Depending on the results of the clinical trial, we can signal that selenium replacement could be a adjuvant treatment to delay the progression of the disease. Now, it is necessary to increase the follow-up time from one to five years and verify if this positive trend towards less progress is maintained”, said Fiocruz researcher Alejandro Hasslocher.
The next steps of the research include expanding the number of patients followed up and the follow-up time, investigating the increase in the dose of selenium and combining it with another supplement, called coenzyme Q10, which may potentiate the effect of the therapy.
About Chagas disease
Heart problems occur in about 30% of patients with chronic Chagas disease, affecting approximately 400,000 to 900,000 people in Brazil alone. About 4,500 Brazilians die from Chagas disease each year. Most deaths are caused by cardiac disorders such as arrhythmia, heart failure, thromboembolism and sudden death.
According to the World Health Organization (WHO), between six and seven million people have chronic Chagas disease worldwide. In Brazil, the Ministry of Health points out that there are from one to four million people affected, and many cases are not diagnosed.
Two factors contribute to heart problems in Chagas disease. The parasite that causes the disease, Trypanosoma cruzi, lodges in the heart and attacks the heart muscle. In an attempt to fight the parasite, the body triggers an inflammatory reaction that, when exacerbated, can further aggravate the damage to the organ.
The disease progresses silently and for many years, forming a kind of scar on the heart muscle, which impairs the ability to pump blood and normally carry out electrical activity.
About 30 years after infection, patients begin to show symptoms of Chagas’ heart disease, usually with changes in the electrocardiogram, which are the first sign of the cardiac form of Chagas’ disease.
The treatment options currently available are the same used by patients who have heart disease from other causes, such as infarction. These are drugs that can improve the function of the heart, but do not attack the causes of the problem itself, and cannot prevent Chagas heart disease from progressively worsening.
(With information from Fiocruz News Agency)
Source: CNN Brasil
