Low Serum Levels of Selenium, Zinc, Iron, and Zinc/Copper Ratio in an Endemic Region of Cutaneous Leishmaniasis in Southwest Iran.

Leishmaniasis is a widespread tropical infection; cutaneous leishmaniasis (CL) is the most common form of this disease known to cause significant morbidity. Trace metals, including selenium, zinc, iron, and copper, are required for the activity of several enzymes involved in immune system responses. The aim of this research was to measure the serum levels of selenium (Se), zinc (Zn), copper (Cu), iron (Fe), and Zn/Cu ratio in patients with CL. In this case-control study, 80 patients with CL and 80 healthy volunteers (not exposed to CL) from a CL endemic region in southwest Iran agreed to participate. Both clinical and parasitological verifications were made to include each subject as a CL-positive case. A questionnaire was completed for each participant which included the following criteria: age (year), height (cm), weight (kg), body mass index (kg/m2), and duration of disease (day). The biochemical assays were performed according to the standard protocols, and the values of Zn, Cu, Se, and Fe were expressed in micrograms per deciliter (μg/dl). All results were expressed as mean ± standard deviation (SD), and the statistical significance level was defined to be less than 0.05 (P < 0.05). There were no statistically significant differences in terms of mean values of age, body weight, height, and body mass index between CL patients and the control group (P > 0.05). The mean ± SD concentrations of Zn, Fe, and Se in the control group were found to be 118.87 ± 6.35 μg/dl, 123.00 ± 8.40 μg/dl, and 11.26 ± 1.88 μg/dl, respectively. These trace elements (TEs) were statistically lower (P < 0.001) in patients with CL (case group) with values of 83.05 ± 7.32 μg/dl for Zn, 86.51 ± 10.09 μg/dl for Fe, and 3.83 ± 1.20 μg/dl for Se. We have also observed that serum levels of Cu in CL-positive group were significantly higher than in the controls (P < 0.001). Furthermore, CL patients had significantly lower Zn/Cu ratio than controls (0.63 ± 0.05 μg/dl vs. 1.11 ± 0.10; P < 0.001). The alternation in serum levels of TEs may be a part of the defense strategy of the organism. Based on these results, it can be suggested that serum levels of these TEs can be a useful marker to estimate the prognosis of CL infection.