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.

Perbedaan Kadar Zink ASI pada Ibu Postpartum dengan Anemia dan Tidak Anemia

Zinc is one of the substances needed in breast milk for baby growth. Zinc deficiency is a common health problem that affects the development of children and contributes to diseases such as diarrhea, pneumonia, and malaria. The purpose of this study was to determine the difference in zinc levels in the first week postpartum mothers with anemia compared to postpartum mothers who were not anemic. The research design used observational analytic with a cross-sectional approach, with purposive sampling. Examination of zinc levels in breast milk using spectrophotometry. Data analysis used an unpaired t-test. The test results obtained that the average zinc level in the first week postpartum mothers who were not anemic was 0.40±0.350 mg/L while the average zinc level in the first week postpartum mothers with anemia was 0.42±0.439 mg/L with p-value=0.92 (p>0.05). There was no difference between zinc levels in the first week postpartum mothers with anemia and not anemia. The zinc concentration in breast milk is highest during colostrum, while the lowest value is between 7-12 months of lactation and increases during weaning.

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.

Retrospective observational study evaluating zinc plasma level in patients undergoing thoracoabdominal aortic aneurysm repair and its correlation with outcome

Thoracoabdominal aortic aneurysm (TAAA) repair is related to a relevant morbidity and in-hospital mortality rate. In this retrospective observational single-center study including serum zinc levels of 33 patients we investigated the relationship between zinc and patients’ outcome following TAAA repair. Six patients died during the hospital stay (18%). These patients showed significantly decreased zinc levels before the intervention (zinc levels before intervention: 60.09 µg/dl [survivors] vs. 45.92 µg/dl [non-survivors]). The post-interventional intensive care SOFA-score (Sepsis-related organ failure assessment) (at day 2) as well as the SAPS (Simplified Acute Physiology Score) (at day 2) showed higher score points in case of low pre-interventional zinc levels. No significant correlation between patient comorbidities and zinc level before intervention, except for peripheral arterial disease (PAD), which was significantly correlated to reduced baseline zinc levels, was observed. Septic shock, pneumonia and urinary tract infections were not associated to reduced zinc levels preoperatively as well as during therapy. Patients with adverse outcome after TAAA repair showed reduced pre-interventional zinc levels. We speculate that decreased zinc levels before intervention may be related to a poorer outcome because of poorer physical status as well as negatively altered perioperative inflammatory response.

HGCSG1902 Multicenter, Prospective, Observational Study of Chemotherapy-induced Dysgeusia in Gastrointestinal Cancer

PurposeDysgeusia is an adverse event caused by chemotherapy. Although retrospective studies have shown zinc administration improves dysgeusia, there have been no prospective studies. The present study examined effects of zinc therapy on dysgeusia in patients with gastrointestinal cancer.MethodsThis multicenter, prospective, observational study enrolled patients with dysgeusia during chemotherapy treatment. Patients received treatment of no intervention (control), polaprezinc p.o., or zinc acetate hydrate p.o. and serum zinc levels were measured at 0 (baseline), 6, and 12 weeks. Dysgeusia was assessed using CTCAE v5.0 and Subjective Total Taste Acuity (STTA) criteria using questionnaires at baseline and 12 weeks.ResultsFrom February 2020 to June 2021, 180 patients were enrolled from 17 institutes. There were no differences in mean serum zinc levels in each group at baseline (67.3, 66.6, and 67.5 μg/dL in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. P = 0.846) and the mean changes in serum zinc level in the three groups from baseline to after 12 weeks were −3.8, +14.3, and +46.6 μg/dl, respectively. The efficiency rates of dysgeusia were 33.3%, 36.8%, and 34.6% using CTCAE and 33.3%, 52.6%, 32.7% using STTA in the no intervention, polaprezinc, and zinc acetate hydrate groups, respectively. The polaprezinc group showed a significantly improved STTA score compared with the no intervention group (P = 0.045).ConclusionThere was no significant correlation between the degree of serum zinc elevation and improvement in dysgeusia, suggesting that polaprezinc, but not zinc acetate hydrate, is effective in improving chemotherapy-induced dysgeusia.Trial registration number UMIN000039653. Date of registration, March 2, 2020.

Evaluation of serum zinc level and IL-18 mRNA expression in children with pneumonia

Pneumonia is currently one of the leading causes of death in children. Increased susceptibility to pneumonia may be due to their decreased immunity. One of the reasons for the decrease in immunity is zinc deficiency. In children with pneumonia, on the other hand, some cytokines are secreted, resulting in inflammation that spreads, persists, and makes treatment difficult for specialists. In this study, we investigated the serum zinc level in children with pneumonia and healthy children. Also, we tried to find its relationship with IL-18 mRNA expression as an inflammatory cytokine. For this purpose, serum zinc levels and IL-18 mRNA expression were evaluated in 120 children aged 3-60 months with pneumonia and 120 healthy children. After taking 2ml of blood from children and measuring serum zinc level, the level of the IL-18 mRNA was measured by real-time PCR. Total RNA was extracted by bioZOL™-G RNA Isolation Reagent kit. The primary cDNA was amplified by the extracted RNA, and in the next step, 2µl of cDNA were amplified by specific primers to measure IL-18 mRNA. The Beta-actin gene was also used as internal control and housekeeping gene. Results showed that the level of zinc in the patient group was 412.625±28.87?M and in the control group was 514.40±49.67?M. This difference was statistically significant (P=0.0053). Also, the expression of the IL-18 gene was increased in children with pneumonia, significantly (P=0.0015). Therefore, from the results, it can be deduced that children with zinc deficiency were at higher risk for a lung infection. Inflammatory cytokines such as IL-18 also were increased in these children. Hence, it can be concluded that zinc levels can reduce the expression of IL-18 mRNA and play an important role in the prevention and treatment of children with pneumonia.

Serum zinc levels and in vivo beta-amyloid deposition in the human brain

Background Despite the known associations between zinc levels and Alzheimer’s disease (AD) dementia and related cognitive impairment, the underlying neuropathological links remain poorly understood. We tested the hypothesis that serum zinc level is associated with cerebral beta-amyloid protein (Aβ) deposition. Additionally, we explored associations between serum zinc levels and other AD pathologies [i.e., tau deposition and AD-signature cerebral glucose metabolism (AD-CM)] and white matter hyperintensities (WMHs), which are measures of cerebrovascular injury. Methods A total of 241 cognitively normal older adults between 55 and 90 years of age were enrolled. All the participants underwent comprehensive clinical assessments, serum zinc level measurement, and multimodal brain imaging, including Pittsburgh compound B-positron emission tomography (PET), AV-1451 PET, fluorodeoxyglucose (FDG)-PET, and magnetic resonance imaging. Zinc levels were stratified into three categories: < 80 μg/dL (low), 80 to 90 μg/dL (medium), and > 90 μg/dL (high). Results A low serum zinc level was significantly associated with increased Aβ retention. In addition, apolipoprotein E ε4 allele (APOE4) status moderated the association: the relationship between low zinc level and Aβ retention was significant only in APOE4 carriers. Although a low zinc level appeared to reduce AD-CM, the relationship became insignificant on sensitivity analysis including only individuals with no nutritional deficiency. The serum zinc level was associated with neither tau deposition nor the WMH volume. Conclusions Our findings suggest that decreased serum zinc levels are associated with elevation of brain amyloid deposition. In terms of AD prevention, more attention needs to be paid to the role of zinc.

The role of zinc in the pathogenesis and treatment of COVID-19: A review

Destructive outcomes of coronavirus pandemic call for medical research which can report all of the influential agents not only for the treatment of the disease but also preventing its severe impacts on the societal health in the most efficient manner. Zinc plays an integral role in the function of cellular enzymes and transcription factors. Owing to its anti-inflammatory and cellular immunity regulation activity, zinc is regarded to be effective on strengthening the immune system. Its crucial antiviral effects have long been established as well. Studies suggest that low serum zinc level predisposes the patient to severe COVID-19 infection, which makes patient’s zinc profile a potential determinant of prognosis and severity of this disease. Furthermore, zinc supplementation has indicated promising outcomes of coronavirus infection management. Zinc modulates cell-mediated immunity and participates in the killing of microorganisms in cytotoxic immune cells. Zn2 + has anti-inflammatory effects by inhibiting IL-6 production. Although there is still not enough evidence, it seems that zinc could be a promising supplementary treatment for COVID-19 especially in zinc-deficient patients. The aim of this review is to clarify the role of zinc in pathogenesis and therapy of COVID-19 in detail.

Dysgeusia Due to Zinc Deficiency After Pancreaticoduodenectomy Requiring Continuous Intravenous Zinc Supplementation: a Case Report and Literature Review

Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.