**3. Good beers and good ideas: the selenium hypothesis**

In 1996, we were introduced to Se effects in cardiopathies through contact with Belgian colleagues that worked with *Médicins sans Frontières* in China and who studied experimental CD with us during a postdoctoral stage [18]. Good Belgian beers composed the scene for this open and free discussion. These colleagues were testing the use of Se to improve the treatment of Kashin-Beck osteoarthropathy [19], and they


## **Figure 2.**

*Main landmarks of the STCC clinical trial. Starting from the first ideas in 1996, three decades will lead to evidence to support public policies. Financial supports are shown in blue and main publications are shown in red; yellow dots at left indicate the critical points that threatened or delayed the project. The orange gradient background indicates the three main phases of the translational roadmap—(a) ideas, conceptualization, and basic preclinical studies, from 1996 to 2015, including the three PhD thesis, (b) pretrial activities conditioning the start of recruitment phase, from 2004 to 2014, and (c) the first clinical trial (STCC) from 2013 to 2020, with results published in 2021. This first trial used a short follow-up and showed a significant effect only in patients of the B2 stage of chronic Chagas cardiopathy, leaving some questions that implicated the design of new clinical trials to elucidate points that remained open, thus opening a fourth phase (white background) that deserves planning, financial funding, and implementation.*

*The Saga of Selenium Treatment Investigation in Chagas Disease Cardiopathy: Translational… DOI: http://dx.doi.org/10.5772/intechopen.103772*

were aware of Se involvement in an endemic cardiopathy, the Keshan disease [20]. Later, Keshan disease was linked to Se scarcity in the soil of some Chinese regions. Important projects were also conducted testing Se in an experimental virus disease and the possibility of pathology reversion after Se treatment [21]. Se deficiency in food turns benign viral strains into more virulent and pathogenic ones. The original idea was planted (a good idea)—does Se have any relationship with Chagas' disease cardiomyopathy?

We then asked Prof. Alejandro Luquetti, from the Federal University of Goiás, to give us some serum samples from CD patients at different stages of cardiac disease and measured Se levels. In the five pilot samples tested, two from non-infected and three from CD-infected people, we found that those with the lowest level of Se were the ones with the more advanced cardiac disease. It would be worth persisting in testing the hypothesis, thus starting the timeline of this long project. **Figure 2** shows this 30-year timeline, writing in black the yearly landmarks, in blue the application and approval of financial support projects, and in red the main publications.
