scholarly journals P619 Efficacy of zinc acetate hydrate administration for zinc deficiency in patients with inflammatory bowel disease: a multi-centre retrospective study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S514-S515
Author(s):  
K Sakurai ◽  
T Katsurada ◽  
S Otagiri ◽  
K Yamanashi ◽  
K Nagashima ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Zinc Deficiency ◽  
Bowel Disease ◽  
Zinc Acetate ◽  
Zinc Concentration ◽  
Serum Zinc ◽  
Serum Zinc Concentration ◽  
Inflammatory Bowel ◽  
Acetate Hydrate ◽  
Observation Period

Abstract Background Zinc deficiency is common in patients with inflammatory bowel disease (IBD), and the frequency is about 42.1% in Crohn’s disease (CD) and 38.5% in ulcerative colitis (UC). Patients with IBD with serum zinc deficiency are more likely to have adverse disease-specific outcomes. However, there are few studies about the effect of administering zinc preparations in IBD patients with zinc deficiency. The purpose of this study was to investigate the efficacy of zinc acetate hydrate (Nobelzin®︎) preparation for patients with IBD with zinc deficiency. Methods 56 IBD patients who were treated with Nobelzin®︎ for zinc deficiency from March 2017 to November 2019 were analyzed. We conducted a multicenter retrospective observational study to investigate changes in serum zinc concentration or changes in disease activity before and after administration and their contributing factors. Results Among 56 cases, 4 cases were excluded due to self-interruption of internal use, and 52 cases (39 cases of CD, 13 cases of UC) were included. The median observation period was 27.5 (13–47) weeks, the median serum zinc concentration before administration was 58.5 (50.8–65.3) μg/dl, and the average of starting dose of Nobelzin®︎ was 67.8±31.1 mg/day. Nobelzin®︎ administration normalised serum zinc concentration(Zn ≥80 μg/dl) in 94.2 % (49/52) of patients. The median administration period required for normalisation of serum zinc concentration was 5 (3–8) weeks. In the group of CD patients who achieved zinc normalisation, the median CDAI score significantly improved after the normalisation from 171.5 to 129.5 (p < 0.001). Similarly, the partial Mayo score in the same group of UC significantly improved after the normalisation (p = 0.035). There were 77.6 % patients who did not have additional treatment without Nobelzin®︎ administration until zinc was normalised. In CD patients of this group, the median CDAI score significantly improved after the normalisation from 152 to 120 (p = 0.029). All 3 cases in which zinc normalisation was not achieved within the observation period were CD cases, and they had a history of multiple surgeries, changes in biologics, or a long medical history. In one patient, side effects of Nobelzin®︎ administration were observed and these were abdominal discomfort and nausea. During the observation period, serum copper concentration was measured in 27 patients after administration of Nobelzin®︎, and one patient presented with copper deficiency. Conclusion Our findings show that administration of zinc acetate hydrate preparations may be effective in improving zinc deficiency and contribute to improve disease activity in IBD patients with zinc deficiency.

scholarly journals Increase in Epithelial Permeability and Cell Metabolism by High Mobility Group Box 1, Inflammatory Cytokines and TPEN in Caco-2 Cells as a Novel Model of Inflammatory Bowel Disease

2020 ◽  
Vol 21 (22) ◽  
pp. 8434
Author(s):  
Maki Miyakawa ◽  
Takumi Konno ◽  
Takayuki Kohno ◽  
Shin Kikuchi ◽  
Hiroki Tanaka ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Growth Factor ◽  
Inflammatory Cytokines ◽  
Zinc Deficiency ◽  
Bowel Disease ◽  
Kinase Inhibitor ◽  
Cell Metabolism ◽  
High Mobility ◽  
Epithelial Barrier ◽  
Inflammatory Bowel

High mobility group box 1 protein (HMGB1) is involved in the pathogenesis of inflammatory bowel disease (IBD). Patients with IBD develop zinc deficiency. However, the detailed roles of HMGB1 and zinc deficiency in the intestinal epithelial barrier and cellular metabolism of IBD remain unknown. In the present study, Caco-2 cells in 2D culture and 2.5D Matrigel culture were pretreated with transforming growth factor-β (TGF-β) type 1 receptor kinase inhibitor EW-7197, epidermal growth factor receptor (EGFR) kinase inhibitor AG-1478 and a TNFα antibody before treatment with HMGB1 and inflammatory cytokines (TNFα and IFNγ). EW-7197, AG-1478 and the TNFα antibody prevented hyperpermeability induced by HMGB1 and inflammatory cytokines in 2.5D culture. HMGB1 affected cilia formation in 2.5D culture. EW-7197, AG-1478 and the TNFα antibody prevented the increase in cell metabolism induced by HMGB1 and inflammatory cytokines in 2D culture. Furthermore, ZnSO4 prevented the hyperpermeability induced by zinc chelator TPEN in 2.5D culture. ZnSO4 and TPEN induced cellular metabolism in 2D culture. The disruption of the epithelial barrier induced by HMGB1 and inflammatory cytokines contributed to TGF-β/EGF signaling in Caco-2 cells. The TNFα antibody and ZnSO4 as well as EW-7197 and AG-1478 may have potential for use in therapy for IBD.

Zinc Deficiency in Inflammatory Bowel Disease

2009 ◽  
Vol 46 (12) ◽  
pp. 401-408 ◽  
Author(s):  
Kristy M. Hendricks ◽  
W. Allan Walker
Keyword(s):  
Inflammatory Bowel Disease ◽  
Zinc Deficiency ◽  
Bowel Disease ◽  
Inflammatory Bowel

scholarly journals Zinc Deficiency is Associated with Poor Clinical Outcomes in Patients with Inflammatory Bowel Disease

2017 ◽  
Vol 23 (1) ◽  
pp. 152-157 ◽  
Author(s):  
Shivi Siva ◽  
David T. Rubin ◽  
George Gulotta ◽  
Kristin Wroblewski ◽  
Joel Pekow
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Outcomes ◽  
Zinc Deficiency ◽  
Bowel Disease ◽  
Inflammatory Bowel

scholarly journals Ferric maltol Real-world Effectiveness Study in Hospital practice (FRESH): clinical characteristics and outcomes of patients with inflammatory bowel disease receiving ferric maltol for iron-deficiency anaemia in the UK

2021 ◽  
Vol 8 (1) ◽  
pp. e000530
Author(s):  
JR Fraser Cummings ◽  
Aileen Fraser ◽  
Catherine Stansfield ◽  
Ian Beales ◽  
Shaji Sebastian ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Iron Deficiency ◽  
Adverse Events ◽  
Serum Ferritin ◽  
Real World ◽  
Bowel Disease ◽  
Iron Deficiency Anaemia ◽  
Deficiency Anaemia ◽  
Inflammatory Bowel ◽  
Observation Period

ObjectiveTo assess outcomes in patients with iron-deficient inflammatory bowel disease (IBD) treated with ferric maltol in UK real-world practice.Design/MethodThis observational, multicentre, retrospective cohort study included adults with IBD and iron-deficiency anaemia (IDA; haemoglobin ≥95 to <120 g/L (women) or ≥95 to <130 g/L (men) plus serum ferritin <30 µg/L or transferrin saturation <20%) who received ferric maltol. Data were extracted from patient records. The primary analysis was the proportion of patients with normalised haemoglobin (≥120 g/L (women); ≥130 g/L (men)) over 12 weeks. Iron indices and safety were assessed.ResultsThirty of 59 patients had data for the primary outcome, 19 of whom (63%) achieved haemoglobin normalisation at week 12. Mean±SD haemoglobin was 127±16 g/L at week 12 (increase of 14±17 g/L from baseline). Overall, 27 patients achieved haemoglobin normalisation by the end of the observation period; mean±SD time to normalisation was 49.5±25.6 days. Nine of 17 patients had normalised serum ferritin (30–300 µg/L) at week 12, and 16 patients had normalised ferritin at the end of the observation period; mean±SD time to normalisation was 71.3±27.6 days. Twenty-four adverse events occurred in 19 patients (32%); most frequent adverse events were abdominal pain or discomfort (n=9) and constipation (n=3).ConclusionFerric maltol increases haemoglobin and iron indices and is generally well tolerated in patients with IBD and IDA treated in clinical practice. These real-world data support findings from randomised controlled trials.

scholarly journals High Prevalence of Zinc Deficiency in Rural Nigerian Preschool Children: A Community-Based Cross-Sectional Study

2017 ◽  
Vol 24 (1) ◽  
pp. 31-39
Author(s):  
Amarabia N.E. Ibeawuchi ◽  
Alphonsus N. Onyiriuka ◽  
Philip O. Abiodun
Keyword(s):  
Zinc Deficiency ◽  
Rural Community ◽  
Zinc Concentration ◽  
Serum Zinc ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Serum Zinc Concentration ◽  
High Prevalence ◽  
Zinc Concentrations

AbstractBackground and Aims: In Nigeria, community-based epidemiological data related to the prevalence of zinc deficiency in preschool children are scarce. We assessed the prevalence of zinc deficiency and the associated socio-demographic variables in children aged between 6 and 60 months, living in a Nigerian rural community.Materials and Methods: In this cross-sectional study, the serum zinc concentrations of 252 children aged between 6 and 60 months in a rural community in Nigeria were assessed, using atomic absorption spectrophotometry. The study population was selected by multistage random sampling and at least two children were selected from every household which had children in the study age group. The socio-demographic characteristics of the subjects were obtained, using an interviewer-administered questionnaire.Results: A total of 252 children were studied, 134 (53.2%) males and 118 (46.8%) females. The mean age was 32.7±17.0 months, similar for both sexes. Overall, 220 (87.3%) had low serum zinc concentrations (less than 7.65µmol/L). According to age, the highest mean serum zinc concentration was 5.43±3.52µmol/L in children aged between 6 and 12 months. Correlation between serum zinc concentration and family size or socio-economic status (SES) showed that the smaller the family size and the higher the SES, the higher the serum zinc concentration.Conclusions: The high prevalence of low serum zinc concentration indicates that zinc deficiency is a public health problem in our rural communities, requiring public health intervention.

Serum zinc status in thalassemic adolescents attending Yangon Children Hospital, Myanmar

2020 ◽  
Author(s):  
Win-Yu Aung ◽  
Thae-Nu Htwe ◽  
Myat Thandar ◽  
Ohn Mar
Keyword(s):  
Zinc Deficiency ◽  
Day Care ◽  
Zinc Concentration ◽  
Zinc Supplementation ◽  
Care Center ◽  
Serum Zinc ◽  
Delayed Puberty ◽  
Zinc Status ◽  
Day Care Center ◽  
Serum Zinc Concentration

Background: Thalassemia constitutes a major public health problem causing a significant burden on children and their families. Zinc deficiency plays an important role in many thalassemia-related complications like growth retardation, hypogonadism and delayed puberty which are frequently noted in adolescent age. Although zinc is supplemented to thalassemic patients visiting Day Care Center, Yangon Children Hospital (YCH), Myanmar, a report concerning serum zinc level of these patients is still lacking. This study, therefore, aimed to assess serum zinc status in thalassemic adolescents attending Day Care Center, YCH. Materials and Methods: This hospital-based cross-sectional study was conducted on 99 thalassemic adolescents. Mean age of diagnosis was 5.1±2.1 years. Non-fasting serum zinc concentration was determined by atomic absorption spectrophotometry. According to National Health and Nutrition Examination Survey data, zinc deficiency was defined as serum zinc concentration < 66 μg/dL (female) and < 70 μg/dL (male). Results: Serum zinc concentration (μg/dL) was 57.35 (47.30-80.14) (median, interquartile range) with maximum, 195.05 and minimum, 28.83. Zinc deficiency was observed in 69.7% (69 out of 99; 35 males and 34 females) of the patients. The associations of zinc deficiency with gender, phenotype and the use of chelator were non-significant (P>0.05). Conclusion: In spite of zinc supplementation, nearly 70% of the thalassemic adolescents showed zinc deficiency. Zinc deficiency in these adolescents might not be related to gender, phenotypes or the use of chelator. Poor compliance to take zinc supplementation and/or irregular blood transfusion could partly be attributable to zinc deficiency in these adolescents. Providing health education on the importance of regular intake of adequate zinc is advisable and periodic evaluation of zinc levels is recommended for thalassemic adolescents.

scholarly journals Efficacy and Safety of Polaprezinc (Zinc Compound) on Zinc Deficiency: A Systematic Review and Dose–Response Meta-Analysis of Randomized Clinical Trials Using Individual Patient Data

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1128 ◽  
Author(s):  
Kei Furihata ◽  
Masaru Tsuchikawa ◽  
Takaki Miwa ◽  
Yuji Naito ◽  
Koji Oba ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Dose Response ◽  
Randomized Clinical Trials ◽  
Zinc Concentration ◽  
Individual Patient Data ◽  
Serum Zinc ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Baseline Serum ◽  
Serum Zinc Concentration

Zinc intake is recommended for zinc deficiency. In clinical practice, polaprezinc has been used as a zinc replacement therapy for zinc deficiency. However, the efficacy of polaprezinc has not been established. To confirm the efficacy on zinc deficiency of polaprezinc and provide additional information on an appropriate regimen, we conducted a systematic review using individual patient data (IPD). We searched PubMed, the Japanese database Ichushi, and the database owned by the marketing authorization holder of polaprezinc. Randomized placebo-controlled trials that reported the serum zinc concentration were eligible. The mean difference of the change from baseline in serum zinc concentration was estimated using a fixed-effects model. The linear dose–response relationship and the subgroup effects were also assessed. Out of 54 unique randomized clinical trials (RCTs), four studies met the eligibility criteria, and we could access IPD for all of them. All three doses of polaprezinc (75 mg, 150 mg, and 300 mg) and the placebo group were examined. The dose-combined overall polaprezinc increased the change from baseline by a mean of 9.08 µg/dL (95% confidence interval: 5.46, 12.70; heterogeneity: I 2 = 0.61%) compared to the placebo. A significant dose–response relationship was confirmed (p < 0.001). Baseline serum zinc concentration was considered an effect modifier in polaprezinc 300 mg. All doses of polaprezinc were tolerable, but a dose–response relationship with adverse events (AEs) was observed in gastrointestinal disorders. The dose of 300 mg may be useful among patients with baseline serum zinc concentration of less than 70 µg/dL, and 150 mg for 70 µg/dL or more.

scholarly journals Administration of zinc to preterm infants with hypozincemia does not reduce serum copper concentrations in most cases: a single-center retrospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Toshikazu Ito ◽  
Kazuya Uenoyama ◽  
Kazuhiro Kobayashi ◽  
Mikio Kakumoto ◽  
Hiroshi Mizumoto ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Zinc Acetate ◽  
Zinc Concentration ◽  
Zinc Acetate Dihydrate ◽  
Serum Zinc ◽  
Serum Copper ◽  
Acetate Dihydrate ◽  
Serum Zinc Concentration ◽  
Postmenstrual Age ◽  
Zinc Concentrations

Abstract Background Zinc is an essential trace element involved in various physiological functions. In Japan, zinc acetate dihydrate is administered to neonates and infants with hypozincemia. Since serum copper concentrations are reduced by the administration of zinc, we retrospectively investigated changes in serum zinc and copper concentrations in preterm infants with hypozincemia receiving zinc acetate dihydrate. Methods Sixty-three preterm infants were included in the present study. Serum zinc and copper concentrations, doses, and other clinical characteristics were retrieved from electronic medical records. Results The medians and interquartile ranges of the dosage and duration of zinc acetate dihydrate were 2.1 (1.8–2.5) mg/kg/day and 12.0 (10.0–13.0) days, respectively. Its administration increased serum zinc concentrations in 39 patients (61.9%) and to more than 70 μg/dL in 16 patients (25.4%). The group with a serum zinc concentration of 70 μg/dL or higher after administration had a significantly higher zinc dose of 2.5 mg/kg/day than the group with a serum zinc concentration of less than 70 μg/dL. Serum copper concentrations did not decrease in 44 patients (69.8%). In the group with a decreased serum copper concentration, postmenstrual age and body weight were significantly lower, while serum zinc concentrations were significantly higher at the start of administration. Conclusion The present results showed that when zinc acetate dihydrate was administered to preterm infants with hypozincemia, it was possible to increase serum zinc concentrations without decreasing serum copper concentrations in many cases. However, caution may be required when administering zinc to preterm infants with a lower postmenstrual age or milder hypozincemia because serum copper concentrations may decrease.

scholarly journals Incidence trends of pediatric onset inflammatory bowel disease in the years 2000–2009 in Saxony, Germany–first results of the Saxon Pediatric IBD Registry

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243774
Author(s):  
Ivana Kern ◽  
Olaf Schoffer ◽  
Wieland Kiess ◽  
Jobst Henker ◽  
Martin W. Laaß ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Children And Adolescents ◽  
Bowel Disease ◽  
Incidence Rates ◽  
Federal States ◽  
Incidence Trends ◽  
European Standard Population ◽  
Inflammatory Bowel ◽  
Pediatric Ibd ◽  
Observation Period

Aims In developed countries, the incidence of inflammatory bowel disease (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC) is increasing. Therefore, we aimed to investigate the incidence rates and trends over time in the population of children and adolescents in one of the federal states of Germany, in Saxony. Methods Over the 10-year period 2000–2009 all 31 children’s hospitals and pediatric gastroenterologists, respectively in Saxony reported all IBD patients up to 15 years of age to the Saxon Pediatric IBD Registry. The completeness of the registry was estimated as 96.7% by independent surveys in the years 2005–2009. Incidence rates were presented as age-standardized incidence rates (ASR) regarding New European Standard Population 1990 per 100,000 person-years (PY) with 95% confidence intervals [CI]. Joinpoint and linear regression was used for trend analyses. Results 344 patients with confirmed IBD between 2000–2009 were included in the epidemiological evaluation: 212 (61.6%) patients with CD, 122 (35.6%) with UC and 10 (2.9%) with unclassified IBD (IBD-U). The ASR per 100,000 PY over the whole observation period was 7.2 [6.4–7.9] for IBD, 4.4 [3.8–5.0] for CD, 2.6 [2.1–3.0] for UC and 0.2 [0.1–0.3] for IBD-U. For IBD, the ASR per 100,000 PY increased from 4.6 [2.8–6.3] in 2000 to 10.5 [7.5–13.6] in 2009. The incidence trend analysis of ASRs using the joinpoint regression confirmed a significant increase of IBD as well as UC. The mean age at first diagnosis decreased significantly during the observation period from 11.5 (11.0–13.4) in 2000 to 9.6 (5.1–13.5) years in 2009. The median of the diagnostic latency among IBD patients was 3 months. Conclusion The incidence of IBD in children and adolescents in Saxony was slightly higher than the average of other countries in the same time period and followed the trend towards a general increase of IBD. The age at diagnosis was subject to a very unfavorable downward trend.

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