Zinc and Liver Disease

Nutrition in Clinical Practice - Tập 27 Số 1 - Trang 8-20 - 2012
Mohammad K. Mohammad1, Mohammad K Mohommad, Zhanxiang Zhou, Matthew C. Cave, Ashutosh Barve, Craig J. McClain
1University of Louisville, Louisville, Ky., USA

Tóm tắt

Zinc is an essential trace element required for normal cell growth, development, and differentiation. It is involved in DNA synthesis, RNA transcription, and cell division and activation. It is a critical component in many zinc protein/enzymes, including critical zinc transcription factors. Zinc deficiency/altered metabolism is observed in many types of liver disease, including alcoholic liver disease (ALD) and viral liver disease. Some of the mechanisms for zinc deficiency/altered metabolism include decreased dietary intake, increased urinary excretion, activation of certain zinc transporters, and induction of hepatic metallothionein. Zinc deficiency may manifest itself in many ways in liver disease, including skin lesions, poor wound healing/liver regeneration, altered mental status, or altered immune function. Zinc supplementation has been documented to block/attenuate experimental ALD through multiple processes, including stabilization of gut‐barrier function, decreasing endotoxemia, decreasing proinflammatory cytokine production, decreasing oxidative stress, and attenuating apoptotic hepatocyte death. Clinical trials in human liver disease are limited in size and quality, but it is clear that zinc supplementation reverses clinical signs of zinc deficiency in patients with liver disease. Some studies suggest improvement in liver function in both ALD and hepatitis C following zinc supplementation, and 1 study suggested improved fibrosis markers in hepatitis C patients. The dose of zinc used for treatment of liver disease is usually 50 mg of elemental zinc taken with a meal to decrease the potential side effect of nausea.

Từ khóa


Tài liệu tham khảo

10.1056/NEJM195608302550901

Vallee BL, 1956, Zinc metabolism in hepatic dysfunction, II: correlation of metabolic patterns with biochemical findings, N Engl J Med, 257, 1056

10.1093/ajcp/44.4.426

10.1093/ajcn/23.2.170

10.1136/gut.14.12.943

10.3109/00365528009181484

10.1111/j.1530-0277.1983.tb05402.x

10.1016/j.mam.2005.07.002

Wang J, 1975, Distribution of zinc in skeletal muscle and liver tissue in normal and dietary controlled alcoholic rats, J Lab Clin Med, 85, 50

10.1136/gut.8.5.454

Kahn AM, 1967, Liver and serum zinc abnormalities in rats with cirrhosis, Gastroenterology, 53, 193, 10.1016/S0016-5085(19)34226-X

10.1111/j.1530-0277.1986.tb05149.x

10.1152/ajpendo.1997.272.6.E952

McClain CJ, 1993, Zinc and the stress response, Scand J Work Environ Health, 19, 132

10.1080/09546630600791434

Moynahan EJ, 1973, Acrodermatitis enteropathica: a lethal inherited human zinc deficiency disorder, Lancet, 2, 399

10.1111/j.1755-3768.1962.tb07832.x

Anonymous, 1975, Acrodermatitis enteropathica: hereditary zinc deficiency, Nutr Rev, 33, 327

10.3346/jkms.2010.25.12.1818

10.1097/00004836-198006000-00004

10.1177/0148607181005005424

Ecker RI, 1978, Acrodermatitis and acquired zinc deficiency, Arch Dermatol, 114, 937, 10.1001/archderm.1978.01640180071017

10.1111/j.1365-4362.1976.tb00176.x

Weismann K, 1980, Acquired zinc deficiency in alcoholic liver cirrhosis: report of two cases, Acta Dermat Venereal (Stockh), 60, 447, 10.2340/0001555560447449

10.1111/j.1365-4632.2008.03586.x

10.1007/s10620-010-1273-7

Patel U, 2010, Necrolytic acral erythema, Dermatol Online J, 16, 15, 10.5070/D36W99Z5QX

10.1001/archneur.1975.00490530067006

McClain CJ, Problems in Liver Disease, 162

10.1097/MEG.0b013e3283417567

Butterworth RF, 2000, Complications of cirrhosis, III: hepatic encephalopathy, J Hepatol, 32, 171, 10.1016/S0168-8278(00)80424-9

Grngreiff K, 1988, Clinical studies on zinc in chronic liver diseases, Z Gastroenterol, 26, 409

Rahelicć D, 2006, Serum concentration of zinc, copper, manganese and magnesium in patients with liver cirrhosis, Coll Antropol, 30, 523

Rabbani P, 1978, Plasma ammonia and liver ornithine transcarbamoylase activity in zinc‐deficient rats, Am J Physiol, 235, E203

10.1016/S0168-8278(05)80305-8

Görg B, 2011, Oxidative stress markers in the brain of patients with cirrhosis and hepatic encephalopathy, Hepatology, 54, 204

10.1111/j.1365-2036.2010.04448.x

10.1016/0016-5085(91)90290-2

10.1172/JCI101075

10.1136/bjo.2009.179176

10.1007/BF00152766

10.1111/j.1530-0277.1979.tb05287.x

10.1093/ajcn/31.2.276

Leure‐DuPree AE, 1982, The effect of severe zinc deficiency on the morphology of the rat retinal pigment epithelium, Invest Ophthalmol Vis Sci, 23, 425

10.1097/00006982-198202040-00015

10.1136/bjo.70.9.662

Essatara MB, 1984, Zinc deficiency and anorexia in rats: normal feeding patterns and stress induced feeding, Pharmacol Biochem Behav, 32, 469

10.7326/0003-4819-71-4-791

Reeves PG, 1981, Short‐term zinc deficiency in the rat and self‐selection of dietary protein level, J Nutr, 111, 375, 10.1093/jn/111.2.375

Essatara MB, 1984, Zinc deficiency and anorexia in rats: effect of central administration of norepinephrine, muscimol and bromergocryptine, Pharmacol Biochem Bheav, 32, 479

10.1016/0024-3205(81)90374-X

10.1016/0002-9343(84)90776-9

Antonow DR, Alcohol and the Brain, 81

Burch RE, 1978, Decreased taste and smell acuity in cirrhosis, Arch Int Med, 138, 743, 10.1001/archinte.1978.03630290047017

Smith FR, 1976, Disordered gustatory acuity in liver disease, Gastroenterology, 70, 568, 10.1016/S0016-5085(76)80497-0

10.1080/07315724.2009.10719780

10.1055/s-2008-1041756

McClain CJ, 1984, Hypogonadism in the zinc‐deficient rat: localization of the functional abnormalities, J Lab Clin Med, 104, 1007

10.7326/0003-4819-85-5-601

10.1016/S0899-9007(96)80058-X

10.1016/j.jtemb.2010.11.002

10.3945/jn.110.131318

Pories WJ, 1967, Acceleration of healing with zinc sulfate, Ann Surg, 167, 432

10.1016/S0140-6736(72)92143-5

Sandstead HH, 1970, Zinc and wound healing, Am J Clin Nutr, 23, 514, 10.1093/ajcn/23.5.514

10.1007/BF02065548

10.1177/153537020623100203

10.1177/153537020523000108

10.1001/archderm.1977.01640040030002

10.1016/S0140-6736(77)91888-8

10.7326/0003-4819-95-2-154

10.1186/1479-5876-8-118

10.1146/annurev-nutr-033009-083312

10.2119/2008-00033.Prasad

10.1152/ajplung.00368.2009

10.1152/physiolgenomics.00024.2007

10.1007/s00775-011-0797-4

Wang X, 2010, Dietary zinc absorption: a play of Zips and ZnTs in the gut, Life, 62, 176

10.3945/ajcn.110.005744

KimWR BrownRSJr TerraultNA El‐SeragH.Burden of liver disease in the United States: summary of a workshop. Hepatology.2002;36:227–242.

10.1007/s11894-010-0157-5

10.1515/bc.2010.137

PurohitV BodeJC BodeCet al.Alcohol intestinal bacterial growth intestinal permeability to endotoxin and medical consequences: summary of a symposium. Alcohol.2008;42:349–361.

10.1136/gut.31.6.694

10.1016/S0741-8329(96)00103-6

10.1152/ajpgi.00515.2009

10.1002/hep.23090

Zhou Z, 2007, Preservation of hepatocyte nuclear factor‐4alpha is associated with zinc protection against TNF‐alpha hepatotoxicity in mice, Exp Biol Med (Maywood), 232, 622

10.2353/ajpath.2008.070631

10.3181/0710-RM-265

Bjarnason I, 1982, The leaky gut of alcoholism: possible route of entry for toxic compounds, Lancet, 1, 179, 10.1016/S0140-6736(84)92109-3

Keshavarzian A, 1994, The differing effects of acute and chronic alcohol on gastric and intestinal permeability, Am J Gastroenterol, 89, 2205

Keshavarzian A, 2001, Preventing gut leakiness by oats supplementation ameliorates alcohol‐induced liver damage in rats, J Pharmacol Exp Ther, 299, 442

10.1016/S0168-8278(00)80242-1

10.1053/gast.2002.34161

10.1016/j.alcohol.2008.12.009

Keshavarzian A, 2001, Preventing gut leakiness by oats supplementation ameliorates alcohol‐induced liver damage in rats, J Pharmacol Exp Ther, 299, 442

10.1016/j.jhep.2008.10.028

10.1124/jpet.102.047852

10.1152/ajpgi.00350.2009

10.1016/S0002-9440(10)62478-9

Zarski JP, 1987, Serum and tissue concentrations of zinc after oral supplementation in chronic alcoholics with or without cirrhosis, Gastroenterol Clin Biol, 11, 856

10.1016/S0271-5317(00)00194-9

10.1056/NEJMcp1006613

10.3892/mmr_00000267

10.1111/j.1365-2133.2010.09820.x

10.1080/00365520701272409

10.1016/S0946-672X(02)80049-9

10.1111/j.1478-3231.2006.01352.x

10.1046/j.1365-2893.2001.00311.x

10.1385/BTER:75:1-3:53

Kim KI, 2008, Blood cell, liver function, and response changes by PEG‐interferon‐alpha2b plus ribavirin with polaprezinc therapy in patients with chronic hepatitis C, 2, 111

10.1016/j.clinbiochem.2005.04.003

10.3177/jnsv.53.213

10.3748/wjg.v12.i8.1265

10.3164/jcbn.jcbn08-246

Fota‐Markowska H, 2002, Serum zinc (Zn) level dynamics in blood serum of patients with acute viral hepatitis B and early recovery period, Ann Univ Mariae Curie Sklodowska Med, 57, 201

10.1385/BTER:90:1-3:31

10.1007/978-1-60761-753-2_6

10.1016/j.hepres.2006.01.012

10.1016/j.braindev.2005.08.008

Brewer GJ, 1994, Treatment of Wilson's disease with zinc, XIII: therapy with zinc in presymptomatic patients from the time of diagnosis, J Lab Clin Med, 123, 849

10.1016/j.bpg.2010.07.014

10.1053/j.gastro.2010.12.034

10.1002/hep.23355

10.1053/j.gastro.2011.02.028

Centers for Disease Control and Prevention (CDC), 2010, Hepatocellular carcinoma—United States, 2001‐2006, MMWR Morb Mortal Wkly Rep, 59, 517

10.1200/JCO.2008.20.7753

10.1016/j.jhep.2006.05.013

10.1053/j.gastro.2004.09.020

10.1007/s005350300005

10.1248/bpb.25.426

10.1385/BTER:95:1:49

Maeda T, 2005, Role of tissue trace elements in liver cancers and non‐cancerous liver parenchyma, Hepatogastroenterology, 52, 187

Danielsen A, 1970, A study of some selected trace elements in normal and cancerous tissue by neutron activation analysis, J Nucl Med, 11, 260

10.1016/S0168-8278(00)80277-9

Liaw KY, 1997, Zinc, copper, and superoxide dismutase in hepatocellular carcinoma, Am J Gastroenterol, 92, 2260

10.1385/BTER:95:1:49

10.1111/j.1600-0676.1997.tb01036.x

10.1016/j.jtemb.2007.03.003

10.1016/j.apradiso.2008.06.018

10.1248/bpb.28.1137

Franklin RB, 2011, ZIP14 zinc transporter downregulation and zinc depletion in the development and progression of hepatocellular cancer, J Gastrointest Cancer

10.1016/j.febslet.2004.12.006

10.1016/j.abb.2007.02.033

10.1371/journal.pone.0013158