A study of serum zinc levels in children admitted with pneumonia in a tertiary care hospital in India

Background: Worldwide, pneumonia is a leading cause of morbidity and mortality in children under 5 years of age; especially, in developing countries. Objectives: The objective of the study is to investigate whether zinc deficiency and other nutritional factors are related to pneumonia in children between 6 months and 5 years old. Methodology: In this casecontrol study, a valid written consent was obtained from mothers of enrolled children. The cases included 75 children fulfilling the World Health Organization criteria for pneumonia, between the age group of 6 months and 5 years. They were interrogated for potential nutritional risk factors as per a predesigned proforma followed by a measurement of serum zinc levels. In the control group, 75 children of the same age group who were siblings of admitted children were included along with other children of the same age group admitted for non-respiratory complaints. A detailed case history was obtained and physical examination was done according to a predesigned proforma to elicit various potential risk factors. A semi-auto analyzer was used to measure the serum zinc levels through colorimetric methods using 5-bromo-PAS. Results: Significant nutritional risk factors identified were low serum zinc level, malnutrition, and anemia. Conclusion: The present study has identified various nutritional risk factors for pneumonia which can be tackled through effective education of the community and appropriate initiatives.

Regulatory Role of Zinc in Allergic Rhinitis through the IL-33/ST2 Pathway

Objective. We aimed to investigate the expression of serum zinc and cytokines interleukin- (IL-) 13 and IL-33 in patients with allergic rhinitis (AR) and observe the effects of zinc on cytokines and pathway proteins in P815 mast cells stimulated by Artemisia annua allergen (Art.) in the IL-33/suppression of the tumorigenicity 2 (ST2) pathway. We also aimed to explore the possible regulatory role of zinc in AR and provide new ideas to determine the etiology and treatment of AR. Methods. AR patients treated from March to September in 2018 were selected as the research participants, and 50 healthy people in the same period were selected as the control group. Serum samples of all patients were collected, and those of AR patients were tested for the presence of allergens. The expression of IL-13 and IL-33 was detected by performing an enzyme-linked immunosorbent assay, while the serum zinc level was detected by conducting an inductively coupled plasma mass spectrometry. The cell counting kit (CCK-8) was used to detect the proliferation of P815 mast cells, and western blot was used to detect the expression of ST2, p38, and p65 proteins. Results. A total of 92 AR patients were included in the study; of them, 52 had mild AR, while 40 had moderate AR. The primary allergen found in AR patients was Artemisia, and the positivity rate was 53.26%. The serum zinc ion level of AR patients decreased, and the expression of IL-13 and IL-33 increased. After Art. was used to treat P815 mast cells, the expression of IL-33 in the cell supernatant increased in a concentration-dependent manner, the expression of receptor ST2 increased, and the expression of downstream p38 and p65 proteins increased. However, after treatment with ZnSO4, the expression of IL-33 in the cell supernatant decreased, and the expression of ST2, p38, and p65 protein decreased. Conclusion. The serum zinc level of AR patients decreased. In the IL-33/ST2 pathway, ZnSO4 can reduce the hypersensitivity of mast cells induced by Art.

The Effects and Mechanisms of Action of TC-G 1008, GPR39 Agonist, in Animal Models of Seizures and Epilepsy

Background and purpose: The G-protein coupled receptor 39 (GPR39) may be activated by zinc ions. Activation of GPR39 was suggested as a novel pharmacological strategy for treating seizures. Experimental approach: We utilized a specific agonist of GPR39, TC-G 1008, and the nonspecific agonist, zinc chloride and a variety of models of acute seizures or a chronic model of epilepsy which were induced in non-genetically modified mice, GPR39 knockout mice or in zebrafish larvae. We examined total serum zinc (by Inductively Coupled Plasma Optical Emission Spectrometry) as well as intracellular zinc ([Zn2+]I) (by Zinpyr-1 staining) concentrations and the expression of selected proteins (by Western blot) which are associated with GPR39 signaling in the hippocampus. Key results: Liquid chromatography tandem mass spectrometry analysis showed that TC-G 1008 is brain penetrant. TC-G 1008 decreased the seizure threshold in the maximal electroshock seizure (MES) threshold test, but it increased the seizure threshold in the 6-Hz induced seizure threshold test. The behavioral effects of TC-G 1008 and MES or 6-Hz seizure were accompanied by alterations in hippocampal [Zn2+]I. TC-G 1008 increased the mean duration of EEG discharges in response to pentylenetetrazole (PTZ) in zebrafish larvae and facilitated the development of PTZ kindling in mice. Using GPR39 knockout mouse line, generated by the CRISPR-Cas-9 method, we showed that GPR39 is a target for TC-G 1008 regarding PTZ-induced epileptogenesis. Conclusion and implications: Our in vivo data obtained using TC-G 1008 generally argue against GPR39 activation as a therapeutic strategy for alleviating seizures/epilepsy.

Hypozincemia in COVID-19 Patients Correlates With Stronger Antibody Response

Zinc ion as an enzyme cofactor exhibits antiviral and anti-inflammatory activity during infection, but circulating zinc ion level during Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is unclear. This study aimed to evaluate serum zinc ion level in Coronavirus Disease 2019 (COVID-19) patients and healthy subjects, as well as its correlation with antibodies against SARS-CoV-2. 114 COVID-19 patients and 48 healthy subjects (38 healthy volunteers and 10 close contacts of patients with COVID-19) were included. Zinc ion concentration and levels of antibodies against SARS-CoV-2 Spike 1 + Spike 2 proteins, nucleocapsid protein, and receptor-binding domain in serum were measured. Results showed that the concentration of zinc ion in serum from COVID-19 patients [median: 6.4 nmol/mL (IQR 1.5 – 12.0 nmol/mL)] were significantly lower than that from the healthy subjects [median: 15.0 nmol/mL (IQR 11.9 – 18.8 nmol/mL)] (p < 0.001) and the difference remained significant after age stratification (p < 0.001) or when the patients were at the recovery stage (p < 0.001). Furthermore, COVID-19 patients with more severe hypozincemia showed higher levels of IgG against the receptor-binding domain of SARS-CoV-2 spike protein. Further studies to confirm the effect of zinc supplementation on improving the outcomes of COVID-19, including antibody response against SARS-CoV-2, are warranted.

Prevalensi dan Faktor Risiko Anemia pada Anak di Negara Maju

Background: Anemia is a global public health problem that occurs in developed countries or in developing countries. The prevalence of anemia in children aged 1-5 years in the United States is 3.9% and iron anemia is 1.1%. This review discussed prevalence and the risk factors and anemia in children in developed countries. Method: The method used is a literature review, the data source in the form of research articles is obtained from online databases, namely Google Scholar and Science Direct. The articles reviewed were 10 articles that met the inclusion criteria. Result: Based on several studies, iron deficiency or deficiency is the most common cause in children in developed countries. 8% of children under five in the United States have iron deficiency, and 2-3% of them are iron deficiency anemia. Risk factors for anemia include lack of serum zinc, low levels of 25 (OH) D, exclusive breastfeeding without iron fortification, Low Birth Weight (LBW), food intake factors, history of asthma and eczema, and maternal education. Iron deficiency anemia in childhood has been shown to have a negative effect on cognitive and psychomotor development. Prevention of anemia that can be done include giving iron supplements and food recommendations. Conclusion: Risk factors for anemia include lack of serum zinc, low 25 (OH) D levels, exclusive breastfeeding without iron fortification, Low Birth Weight (LBW), food intake factors, history of asthma and eczema, and maternal education.

Study of serum ghrelin and resistin levels and their correlation with zinc and magnesium in men with type 2 diabetes

Introduction: The objectives of our work were to compare the serum concentrations of lipid parameters,insulin, resistin, ghrelin, zinc and magnesium between two groups of men with obese type 2 diabetes and a control group and to study possible correlations between these differentparameters. Material and methods: This was a monocentric case-control study during the period 19 October 2015 to 18 November 2015. It included biological parameters from two separate samples: a group of 41 male, obese, type 2 diabetic patients and a group of 34 diabetes-free controls. Results: Mean plasma ghrelin concentrations were significantly lower in patients with type 2 diabetes compared to those in the control group: (14.05 ± 2.35 pg/mL) versus (45.45 ± 13.59 pg/mL). Mean resistance was significantly higher in diabetics (10.09 ± 2.63 ng/mL) compared to healthy subjects (2.22 ± 0.58 ng/mL). In multivariate analysis, body mass index (BMI) and insulin levels were factors that could influence zincemia variability, while BMI and ghrelinaemia appeared to be predictors of magnesium variability. Discussion: Most correlation studies are based on serum zinc concentration. The different possible correlations between resistin, zinc, magnesium and ghrelin require an increase in the size of the study population, as well as an increase in nutritional surveys during the different stages of type 2 diabetes and obesity. Conclusion: It would be interesting to evaluate, according to the stages of obesity, serum levels of magnesium and ghrelin, on the one hand, and serum levels of zinc and insulin, on the other hand.

Effect of some toxic metals in drinking water on male reproductive hormones

Objective: Drinking water contaminated with toxic metals can be a leading cause of infertility in males. The aim of this study was to determine the levels of some toxic metals and trace elements in drinking water and reproductive hormone levels in males who drink water from these sources in Sabongida-Ora , Edo State, Nigeria. Material and Methods: A total of 90 subjects consisting of 30 subjects who drink borehole water, 30 subjects who drink water from hand-dug well, and 30 subjects who drink table water, aged between 18 and 45 years, were recruited for this study. Serum reproductive hormones were analyzed using ELISA method. Blood lead, cadmium, serum zinc, and copper were analyzed using atomic absorption spectroscopy (AAS). The data obtained were analyzed using SPSS version 23.0. Results: Blood Cd and Pb levels were significantly higher (P<0.05) in hand-dug, borehole and treated water consumers while serum Zn level was significantly lower P<0.05) in hand-dug well and borehole water consumers than treated table water consumers. The serum Cu level was not significantly different between the groups. The reproductive hormones were significantly lower among hand-dug well and borehole water consumers than treated table water consumers (p<0.05), while PROL(P<0.05) was significantly higher among hand-dug well, borehole water consumers than treated water consumers. Serum PROL correlated positively with Pb (r=0.443; P<0.05) and negatively with serum Zn (r=-0.404; P<0.05) while T correlated positively (r=0.542; P<0.005) with Zn. Similarly, FSH correlated negatively with Pb (r=-0.398; P<0.05) and positively with Zn (r=0.422;P<0.05), while LH correlated inversely with Cd (r=-0.622;P<0.05) and positively with Zn (r=0.745; P<0.05). Expectedly, Cd and Pb were higher while Cu and Zn were lower in hand-dug well water consumers than borehole water consumers. Conclusion: Water consumption from hand-dug wells may have adverse reproductive sequelae among consumers.

Association of Serum Zinc Level with Febrile Seizures in Children

Introduction: Febrile seizure (FS), previously known as febrile convulsion, is the most common seizure in children. FS usually occurs between six months and five years of age. Aims and objectives: The main objective of the study is to find the association of serum zinc level with febrile seizures in children of Pakistan. Material and methods: This cross sectional study was conducted at Mayo Hospital, Lahore during June 2020 to January 2021. The data was collected from 164 patients of both genders. Results: The data was collected from 164 patients. In the case group, 46 children were male (53.3%), and 36 children (46.7%) were female. In the control group 44 children were male (43.3%) and 38 children were female (56.7%). The age of all participants was between one months and six years. Conclusion: It is concluded that low serum zinc levels are fairly un-sufficient to support the hypothesis that Zinc deficiency could not be a potential risk factor for febrile seizure in children.

Randomized clinical trial: does using zinc and zinc ionophore EGCG as supplements improve outcome of active pulmonary tuberculosis

Tuberculosis is a big health challenge especially during the Covid-19 pandemic because of the similarity of symptoms between the two diseases, active pulmonary T.B is associated with malnutrition. Tuberculosis is still a global disease burden worldwide especially at low-income countries affecting families and health authorities because of the cost of medicine and health costs. There are growing numbers of multidrug resistants’ T.B patients. Epigallocatechin-3-gallate (EGCG) as antioxidant and inhibition of mycobacterium life in macrophages increase the potency of rifampicin oral anti-tuberculous drug. EGCG is an iron chelator which can be useful in T.B patients (1). Zinc is the most abundant trace element in the human body, Dabbagh-Bazarbachi et al. (2014) have demonstrated that EGCG can act as an ionophore that helps transport zinc to across cell membrane and exert cytotoxicity effect. EGCG can enhance the cytotoxicity of zinc ions to cancer. It is possible that the zinc(ii)-EGCG complex reduces the pH inside organelles, and might bind effectively to DNA in the nucleus. At our study use of EGCG and zinc as adjuvant therapy to national protocol may help at malnutrition and accelerate of sputum conversion to negative and faster improvement and less risk for infection transmission and lower the inflammatory cytokines like il-6 and increase weight of patients. Methodology: The objective of our study is to evaluate oral zinc administration as zinc sulfate 50 mg and zinc ionophore EGCG 200 mg in new smear positive active pulmonary tuberculosis patients above 18 year old for one month in an open labeled randomized controlled clinical trial (RCT) in line with directly observed treatment short course (DOTS) strategy recommended by WHO. We will do sputum tests at 0 and 2 weeks and 1 month for evaluation of conversion of positive to negative samples and also measure the serum zinc levels before the start of treatment, and serum interleukin 6 as cytokine marker. We are conducting this study at cat I patients as WHO classification of tuberculosis having active lung tuberculosis to see efficacy and change in immunological parameters. Place of study: Saudia Arabia – Ministry of health, public health department, First health cluster, Riyadh, Tuberculosis clinics of Mobile team tuberculosis program.Informed Consent will be taken from patients before the start the study.The clinical trial registration number for this trial is NCT05116098.