Selenium is a trace element essential for regulating immune function, inflammatory balance, and antioxidant defense—all of which are critical in the perioperative period. Selenium supports both innate and adaptive immune responses by promoting cytokine regulation, enhancing immune cell signaling, and protecting tissues from damage caused by reactive oxygen species. Its interaction with antioxidant enzymes and immunoregulatory proteins underscores its value in maintaining immune homeostasis during periods of physiological stress, including surgery and infection.

Mechanisms of Action and Benefits

Immune Cell Activation and Cytokine Modulation
Selenium promotes immune regulation by enhancing the production of interferon-gamma (IFN-γ) and interleukin-10 (IL-10). These cytokines are critical for antiviral responses, helping the body defend against pathogens while reducing the risk of exaggerated inflammatory reactions [1,2].

Neutrophil Chemotaxis and Immune Surveillance
Selenium enhances the chemotactic activity of neutrophils, guiding immune cells to infection sites for rapid pathogen clearance. It also supports immune cell degranulation control, preventing excessive tissue damage that can occur during heightened immune activation [2].

Humoral Immunity and Immunoglobulin Stability
This mineral plays a role in maintaining IgM and IgG levels, reinforcing adaptive immune memory and antibody-mediated responses. By stabilizing immunoglobulin function, selenium contributes to long-term immune competence, particularly important in patients with surgical stress or infection risk [1].

Antioxidant Protection and Lipid Peroxidation Control
Selenium is a cofactor for glutathione peroxidases, enzymes that protect lipids, proteins, and DNA from oxidative damage. It inhibits lipid peroxidation, preserves cell membrane integrity, and works synergistically with vitamin E to support cellular stability [1].

Viral Defense and Genetic Stability
Selenium has been shown to reduce viral mutation rates and support viral clearance by preserving the redox environment and stabilizing immune signaling. This function may be particularly valuable in managing perioperative infections and preventing viral complications [1].

References

1. Bermano G,Méplan C, Mercer DK, Hesketh JE. Selenium and viral infection: are there
   lessons for COVID-19? British Journal of Nutrition. 2021;125(6):618-627.
   
2. Lacy, P. Mechanisms of Degranulation in Neutrophils. All Asth Clin Immun 2,
   98 (2006).