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This is a review article telling a 50-years old story about the studies on selenium deficiency and Keshan disease in China, an endemic heart disease with high case-fatality, as an example of translational research. Extensive cross-sectional epidemiological studies showed that low selenium concentrations in cereal grains and low selenium status of local residents were associated with the occurrence of Keshan disease. Several large populationbased intervention trials using oral administration of sodium selenite tablets showed significant reduction of Keshan disease incidence. Based on the above evidence, it was concluded that selenium deficiency is the major cause of Keshan disease, although other etiological factors could not be ruled out. The implications of the findings include: provided critical scientific evidence for selenium being an essential trace element for humans; as scientific basis for identifying minimum requirement and RDA/RNI for selenium; and as solid reference for the formulation of effective preventive measures for Keshan disease in China.
Key Words: selenium, Keshan disease, translational research, essential trace element
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INTRODUCTION
In the present scientific community, the term "translational science" has become more and more popular in any expertise and field. Although it is widely agreed that research outcomes would be much more valuable, if they could be translated into practical means that could benefit the society; in the real world, convincing cases and stories are rare. This overview article aims to tell an old story about selenium deficiency and Keshan disease research conducted in 1960-70 in China, as an example of translational nutritional research based on my personal experience.
A BRIEF DESCRIPTION ON KESHAN DISEASE (KD)1
Keshan disease was discovered in the winter of 1935 in northeast China when an outbreak of an unknown disease occurred with sudden onset of precardial oppression and pain, nausea and vomiting and fatal termination. The disease was named Keshan disease (KD), because the outbreak was first occurred in the Keshan county of Heilongjiang province and its cause was unknown. Later on, KD was discovered in other areas of northeast and also southwest China, including Sichuan and Yunnan provinces. It had a very high case fatality, which was greater than 80% in the 1940s and around 30% since. It was at first suspected to be an acute infectious...