T-helper type 1 cytokine release is enhanced by in vitro zinc supplementation due to increased natural killer cells

Zinc deficiency as possible link between immunosenescence and age-related diseases

As global life expectancy increases, research reveals a critical challenge in aging: the progressive deterioration of immune function, termed immunosenescence. This age-related immune decline is characterized by a complex dysregulation of immune responses, which leaves older adults increasingly vulnerable to infections, chronic inflammatory states, and various degenerative diseases. Without intervention, immunosenescence significantly contributes to morbidity and mortality among the elderly, intensifying healthcare burdens and diminishing quality of life on both individual and societal levels. This review explores the essential role of zinc, a trace element critical for immune health, in mitigating the impact of immunosenescence and slowing the cascade of immunological dysfunctions associated with aging. By modulating the activity of key immune cells and pathways, zinc supplementation emerges as a promising approach to strengthen immunity, reduce oxidative stress, and counteract "inflammaging," a state of chronic, low-grade inflammation that accelerates tissue damage and drives disease progression. Zinc's involvement in cellular defense and repair mechanisms across the immune system highlights its ability to enhance immune cell functionality, resilience, and adaptability, strengthening the body's resistance to infection and its ability to manage stressors that contribute to diseases of aging. Indeed, zinc has demonstrated potential to improve immune responses, decrease inflammation, and mitigate the risk of age-related conditions including diabetes, depression, cardiovascular disease, and vision loss. Given the prevalent barriers to adequate zinc intake among older adults, including dietary limitations, decreased absorption, and interactions with medications, this review underscores the urgent need to address zinc deficiency in aging populations. Recent findings on zinc's cellular and molecular effects on immune health present zinc supplementation as a practical, accessible intervention for supporting healthier aging and improving quality of life. By integrating zinc into targeted strategies, public health efforts may not only sustain immunity in the elderly but also extend healthy longevity, reduce healthcare costs, and potentially mitigate the incidence and impact of chronic diseases that strain healthcare systems worldwide.

Zinc as an adjunct in radiation-based therapies: Evidences of radioprotection and mechanistic insights

BackgroundRadiation-based therapies are a progressive modality for managing life-threatening diseases such as cancer. However, these treatments often inflict damage on non-target tissues, necessitating the development of effective radioprotective agents. Zinc, known for its diversified role under various pathological conditions, has emerged as a potential protective agent against radiation-induced injuries due to its antioxidant, anti-inflammatory and immune-regulating properties.AimThis review aims to evaluate the potential of zinc in mitigating the adverse effects associated with radiation-based therapies, focusing on its protective role in normal tissue injury.MethodsA comprehensive literature review was conducted using multiple databases, including PubMed, NCBI, SciFinder, Google Scholar and Science Direct. Relevant studies assessing the radioprotective effects of zinc were identified and analysed to summarise its efficacy and potential benefits in radiation therapy.ResultsThe review highlights the beneficial effects of zinc in managing radiation-induced adverse effects, such as oral mucositis, skin injury, dermatitis, xerostomia, dysgeusia, dysosmia, bone marrow regeneration and oxidative stress reduction. Zinc's role as an antioxidant and anti-inflammatory agent, along with its ability to regulate immune system homeostasis, underpins these protective effects.ConclusionsZinc shows promising potential as a radioprotective agent in mitigating the adverse effects of radiation-based therapies. Despite the positive preclinical and clinical findings, further randomised trials with larger sample sizes and rigorous methodologies are needed to confirm zinc's efficacy. Additionally, further research is warranted to explore zinc's potential in addressing other radiation-induced events, ultimately contributing to improved patient care during radiation therapy.

Effects of zinc supplementation and implant abscess on the immune system and growth performance of growing beef steers

Seventy-two Angus-cross steers (261 ± 14 kg) were utilized to determine the effects of supplemental Zn sulfate on growth, trace mineral status, circulating immune cells, and functional innate immune responses. Steers were stratified by weight and implanted with a Component E-S with Tylan implant (Elanco Animal Health, Greenfield, IN) on day 0. Dietary treatments included: control (CON; no supplemental Zn), Zn100 (100 mg supplemental Zn/kg DM), and Zn150 (150 mg supplemental Zn/kg DM). Analyzed dietary concentrations of Zn were 58, 160, and 207 mg Zn/kg DM, respectively. On days 13 and 57, blood from nine steers per treatment was collected for immune analyses (cell phenotyping and response to stimulus). On day 16, implant abscesses were evaluated by palpation and visual appraisal. Sixty percent of steers had abscesses; however, there were no differences in abscess prevalence due to treatment (P = 0.67). Data were analyzed as a split-plot design using the Mixed procedure of SAS 9.4 (Cary, NC) with effects of dietary treatment, abscess, and their interaction. There was a tendency (treatment × abscess; P ≤ 0.09) for steers without abscesses to have greater average daily gain (ADG; treatment × abscess P = 0.06) and gain:feed (G:F; treatment × abscess P = 0.09) from d 14 to 27 in CON and Zn100 while within Zn150 steers without abscesses tended to have lesser ADG and G:F than abscessed steers. There were no other treatment × abscess effects for growth performance, but steers with abscesses tended to have decreased final body weight (P = 0.10) and overall G:F (days 0 to 57; P = 0.08). There was no interaction of treatment and abscess on immune cell populations on days 13 or 58 (treatment × abscess P ≥ 0.11). On day 13, Zn150 steers had increased CD45RO + gamma delta (P = 0.04) T cells. Abscessed steers had increased CD21 + B cells (P = 0.03) and tended to have increased CD21 + (P = 0.07) and CD21 + MHCIIhi (P = 0.07) B cells in circulation. This study shows zinc supplementation and implant abscesses can alter the immune system and growth performance of growing beef steers.

The nutritional roles of zinc for immune system and COVID-19 patients

Zinc (Zn) is a vital micronutrient that strengthens the immune system, aids cellular activities, and treats infectious diseases. A deficiency in Zn can lead to an imbalance in the immune system. This imbalance is particularly evident in severe deficiency cases, where there is a high susceptibility to various viral infections, including COVID-19 caused by SARS-CoV-2. This review article examines the nutritional roles of Zn in human health, the maintenance of Zn concentration, and Zn uptake. As Zn is an essential trace element that plays a critical role in the immune system and is necessary for immune cell function and cell signaling, the roles of Zn in the human immune system, immune cells, interleukins, and its role in SARS-CoV-2 infection are further discussed. In summary, this review paper encapsulates the nutritional role of Zn in the human immune system, with the hope of providing specific insights into Zn research.

The changes and potential effects of zinc homeostasis in periodontitis microenvironment

Zinc is a very important and ubiquitous element, which is present in oral environment, daily diet, oral health products, dental restorative materials, and so on. However, there is a lack of attention to the role of both extracellular or intracellular zinc in the progression of periodontitis and periodontal regeneration. This review summarizes the characteristics of immunological microenvironment and host cells function in several key stages of periodontitis progression, and explores the regulatory effect of zinc during this process. We find multiple evidence indicate that zinc may be involved and play a key role in the stages of immune defense, inflammatory response and bone remodeling. Zinc supplementation in an appropriate dose range or regulation of zinc transport proteins can promote periodontal regeneration by either enhancing immune defense or up-regulating local cells proliferation and differentiation functions. Therefore, zinc homeostasis is essential in periodontal remodeling and regeneration. More attention is suggested to be focused on zinc homeostasis regulation and consider it as a potential strategy in the studies on periodontitis treatment, periodontal-guided tissue regeneration, implant material transformation, and so on.

Nutraceuticals as Modulators of Immune Function: A Review of Potential Therapeutic Effects

Dietary supplementation with nutraceuticals can promote optimal immune system activation, modulating different pathways that enhance immune defenses. Therefore, the immunity-boosting effects of nutraceuticals encompass not only immunomodulatory but also antioxidant, antitumor, antiviral, antibacterial, and antifungal properties, with therapeutic effects against diverse pathological conditions. However, the complexity of the pathways that regulate the immune system, numerous mechanisms of action, and heterogeneity of the immunodeficiencies, and subjects treated make their application in the clinical field difficult. Some nutraceuticals appear to safely improve immune system function, particularly by preventing viral and bacterial infections in specific groups, such as children, the elderly, and athletes, as well as in frail patients, such as those affected by autoimmune diseases, chronic diseases, or cancer. Several nutraceuticals, such as vitamins, mineral salts, polyunsaturated omega-3 fatty acids, many types of phytocompounds, and probiotic strains, have the most consolidated evidence in humans. In most cases, further large and long-term randomized clinical trials are needed to confirm the available preliminary positive data.

Effects of supplemental Zn concentration and trace mineral source on immune function and associated biomarkers of immune status in weaned beef calves received into a feedlot

Low-risk, weaned Angus-crossbred steers (n = 72; 284 ± 25 kg) were used in a 42-d receiving study. Steers were housed in pens (n = 6 steers per pen) equipped with GrowSafe bunks for determination of individual animal feed disappearance. Dietary treatments (n = 24 steers per treatment) included: 1) trace minerals (TM) from an organic source (Availa4; Zinpro Corp., Eden Prairie, MN) at 7 g·steer-1·d-1; for 42 d (ORG); 2) ORG for entire 42-d plus AvailaZn (Zn amino acid complex, Zinpro Corp., Eden Prairie, MN) to provide 1,000 mg Zn·steer-1·d-1 for first 14 d (ORG+Z); 3) inorganic TM sources to supplemented at equivalent concentration as in ORG for 42-d (ING). Cattle were weighed on day -1, 0, 14, 41, and 42. Whole blood was collected (n = 72 steers) on day 0, 14, and 42. Liver biopsies were conducted (n = 36 steers; 3 steers per pen) on day 0, 14, and 42. Flow cytometry measures were conducted using whole blood on day 1, 14, and 42 for determination of circulating frequencies of immune cell populations. There was a tendency for improved overall average daily gain (P = 0.07) where both ORG and ORG+Z were greater than ING. Final body weight did not differ (P = 0.21) and overall dry matter intake was unaffected by dietary treatment (P ≥ 0.18). However, overall gain-to-feed ratio was improved (P = 0.01) in steers supplemented organic TM (ORG and ORG+Z) compared to ING. Plasma Zn concentration did not differ at any time point during the study (P ≥ 0.20). Liver Zn concentration did not differ between treatments on day 0 or 42; however, on day 14 ING tended (P = 0.09) to be greater than ORG+Z with ORG being intermediate. Plasma Cu was unaffected by dietary treatment (P ≥ 0.34) on day 0, 14, and 42. Plasma Fe did not differ on day 0 or 42 but tended to be greater in ORG and ORG+Z compared to ING (P = 0.08) on day 14. Dietary treatment did not alter (P ≥ 0.22) liver Fe or Mn concentration at any time point. Frequency of total circulating natural killer (NK) and CD8 T cells measured on day 0, 14, and 42 did not differ (P ≥ 0.07). However, cell surface markers of activation (CD16, CD44, and CD8) on NK cells measured on day 14 did differ because of treatment (P ≤ 0.05). Results presented herein indicate TM from an organic source supplemented to steers during receiving can positively influence growth rate and feed efficiency. Regardless of source, TM supplementation affected markers of immune function but did not influence the prevalence of circulating NK and CD8 T-cell populations.

Rebalancing the unbalanced aged immune system - A special focus on zinc

Nowadays, aging is understood as a dynamic and multifaceted dysregulation process that spares almost no human organ or cell. The immune system being among the most affected, it has been shown predominantly that its integrity determines the tightrope walk between the difference of escaping or suffering from age-related diseases. Next to drug-based anti-aging strategies, micronutrient intervention may represent an emerging but less radical way to slow immune aging. While a sufficient supply of a variety of micronutrients is undeniably important, adequate intake of the trace element zinc appears to tower over others in terms of reaching old age. Inconveniently, zinc deficiency prevalence among the elderly is high, which in turn contributes to increased susceptibility to infection, decreased anti-tumor immunity as well as attenuated response to vaccination. Driven by this research, this review aims to provide a comprehensive and up-to-date overview of the various rebalancing capabilities of zinc in the unbalanced immune system of the elderly. This includes an in-depth and cell type-centered discussion on the role of zinc in immunosenescence and inflammaging. We further address upcoming translational aspects e.g. how zinc deficiency promotes the flourishing of certain pathogenic taxa of the gut microbiome and how zinc supply counteracts such alterations in a manner that may contribute to longevity. In the light of the ongoing COVID-19 pandemic, we also briefly review current knowledge on the interdependency between age, zinc status, and respiratory infections. Based on two concrete examples and considering the latest findings in the field we conclude our remarks by outlining tremendous parallels between suboptimal zinc status and accelerated aging on the one hand and an optimized zinc status and successful aging on the other hand.

Bioinorganic Chemistry of Zinc in Relation to the Immune System

Zinc is well-known to have a central role in human inflammation and immunity and is itself an anti-inflammatory and antiviral agent. Despite its massively documented role in such processes, the underlying chemistry of zinc in relation to specific proteins and pathways of the immune system has not received much focus. This short review provides an overview of this topic, with emphasis on the structures of key proteins, zinc coordination chemistry, and probable mechanisms involved in zinc-based immunity, with some focus points for future chemical and biological research.

Dietary and Physiological Effects of Zinc on the Immune System

Evidence for the importance of zinc for all immune cells and for mounting an efficient and balanced immune response to various environmental stressors has been accumulating in recent years. This article describes the role of zinc in fundamental biological processes and summarizes our current knowledge of zinc's effect on hematopoiesis, including differentiation into immune cell subtypes. In addition, the important role of zinc during activation and function of immune cells is detailed and associated with the specific immune responses to bacteria, parasites, and viruses. The association of zinc with autoimmune reactions and cancers as diseases with increased or decreased immune responses is also discussed. This article provides a broad overview of the manifold roles that zinc, or its deficiency, plays in physiology and during various diseases. Consequently, we discuss why zinc supplementation should be considered, especially for people at risk of deficiency. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

The Influence of Nutritional Factors on Immunological Outcomes

Through food intake, humans obtain a variety of nutrients that are essential for growth, cellular function, tissue development, energy, and immune defense. A special interaction between nutrients and gut-associated lymphoid tissue occurs in the intestinal tract. Enterocytes of the intestinal barrier act as sensors for antigens from nutrients and the intestinal microbiota, which they deliver to the underlying immune system of the lamina propria, triggering an immune response. Studies investigating the mechanism of influence of nutrition on immunological outcomes have highlighted an important role of macronutrients (proteins, carbohydrates, fatty acids) and micronutrients (vitamins, minerals, phytochemicals, antioxidants, probiotics) in modulating immune homeostasis. Nutrients exert their role in innate immunity and inflammation by regulating the expression of TLRs, pro- and anti-inflammatory cytokines, thus interfering with immune cell crosstalk and signaling. Chemical substrates derived from nutrient metabolism may act as cofactors or blockers of enzymatic activity, influencing molecular pathways and chemical reactions associated with microbial killing, inflammation, and oxidative stress. Immune cell function appears to be influenced by certain nutrients that form parts of the cell membrane structure and are involved in energy production and prevention of cytotoxicity. Nutrients also contribute to the initiation and regulation of adaptive immune responses by modulating B and T lymphocyte differentiation, proliferation and activation, and antibody production. The purpose of this review is to present the available data from the field of nutritional immunology to elucidate the complex and dynamic relationship between nutrients and the immune system, the delineation of which will lead to optimized nutritional regimens for disease prevention and patient care.

Update on the multi-layered levels of zinc-mediated immune regulation

The significance of zinc for an efficient immune response is well accepted. During zinc deficiency, an increase in the myeloid to lymphoid immune cells ratio was observed. This results in a disturbed balance of pro- and anti-inflammatory processes as well as defects in tolerance during infections. Consequently, instead of efficiently defending the body against invading pathogens, damage of host cells is frequently observed. This explains the increased susceptibility to infections and their severe progression observed for zinc deficient individuals as well as the association of autoimmune diseases with low serum zinc levels. Together with the advances in techniques for investigating cellular development, communication and intracellular metabolism, our understanding of the mechanisms underlying the benefits of zinc for human health and the detriments of zinc deficiency has much improved. As analyses of the zinc status and effects of zinc supplementation were more frequently included into clinical studies, our knowledge of the association of zinc deficiency to a variety of diseases was strongly improved. Still there are several areas in zinc biology that require further in-depth investigation such as the interaction with other nutritional elements, the direct association between zinc transportation, membrane-structure, receptors, and signaling as well as its role in cell degeneration. This article will describe our current understanding of the role of zinc during the immune response focusing on the most recent findings and underlying mechanisms. Research questions that need to be addressed in the future will be discussed as well.

Zinc deficiency impairs interferon-γ production on post-transcriptional level

BACKGROUND

Zinc is a trace element and is thus commonly known to be indispensable for regular cellular function. Until today, zinc deficiency is a widespread health problem, affecting approximately one sixth of the world's population. Especially the immune system has proven to be highly dependent on zinc. Interferon-γ (IFN-γ) is a key element in the defense against intracellular pathogens. A lack of this cytokine results in immunological impairment, whereas an excess can lead to autoimmunity, highlighting the importance of a well-regulated IFN-γ expression. In a state of zinc deficiency, the production of this cytokine has long been shown to be reduced. Providing further insight into the molecular mechanisms responsible for this interaction is the primary objective of this study.

METHODS

Zinc-deficient or -supplemented cell culture, ELISA, quantitative PCR, methylation analysis.

RESULTS

Promoter methylation is a typical mechanism of gene silencing and a strong regulating factor for IFN-γ production. An analysis of the methylation status of IFN-γ and its transcription factor IRF4 in human PBMC in a state of cellular zinc deficiency or excess showed no dependency on the trace metal. Unexpectedly, zinc-deficient PBMC, which secreted significantly less IFN-γ protein, showed significantly higher mRNA levels of the cytokine compared to cells with high total zinc levels.

CONCLUSION

This report is the first about this unconventional ratio of IFN-γ mRNA to protein. Such a mismatch is highly relevant to the study of protein production in general and that of IFN-γ in particular. Based on our results and the latest research, we hypothesize a strong post-transcriptional effect of zinc on IFN-γ.

The immunomodulatory role of zinc in asthmatic patients

BACKGROUND

Zinc deficiency may play an important role in the development of atopic asthma.

THE AIM OF THE WORK

To assess serum zinc levels in adult atopic, non-atopic asthmatic patients, and in healthy controls and to investigate its modulatory effect on production of interferon gamma (IFN-γ) and interleukin-10 (IL-10) by peripheral blood mononuclear cells (PBMCs) in vitro.

METHODS

Sixty asthmatics and 30 apparently healthy volunteers were included in this study. All patients were subjected to history taking, clinical examination, pulmonary function tests, skin prick test (SPT), serum zinc assessment by a colorimetric method as well as serum total IgE measurement by Enzyme-linked immunosorbent assay (ELISA). PBMCs were activated in vitro in the presence and absence of zinc, and then cell culture supernatants were analyzed for IFN-γ and IL-10 by ELISA.

RESULTS

Serum zinc levels were significantly lower in atopic asthmatics than non-atopic asthmatics and healthy controls. In atopic asthmatics, highly significant correlations were found between zinc levels and total Ig E levels as well as FEV1. In culture, zinc triggers IFN-γ and inhibits IL-10 production by PBMCs, in atopic asthmatics. In non atopic asthmatics and healthy controls, IFN-γ and IL-10 were slightly affected by zinc supplementation in culture.

CONCLUSION

Serum zinc levels affect asthma phenotypes. Atopic asthmatics might benefit from zinc supplements.

Boron Affects Immune Function Through Modulation of Splenic T Lymphocyte Subsets, Cytokine Secretion, and Lymphocyte Proliferation and Apoptosis in Rats

This study demonstrated the mechanisms of boron effects in a rat model and provided a scientific basis for the rational of boron use. These findings were achieved by investigating the effects of boron (10, 20, 40, 80, 160, 320, and 640 mg/L in drinking water or 1.5, 3, 6, 12, 24, 48, and 96 mg/kg BW) on rat serum immunoglobulins (IgGs), splenic cytokines, lymphocyte subsets, as well as on lymphocyte proliferation and apoptosis. Addition of 20 (3) and 40 (6) mg/L (mg/kg BW) of boron to drinking water significantly increased rat serum IgG concentrations, splenic IFN-γ and IL-4 expression as well as the number of splenic CD3⁺, CD4⁺ and proliferating cell nuclear antigen (PCNA)⁺ cells. Supplementation of drinking water with 40 mg/L (6 mg/kg BW) boron also markedly increased splenic IL-2 expression and the CD4⁺/CD8⁺ cell ratio and reduced splenic CD8⁺ cell number. Supplementation with 80 mg/L (12 mg/kg BW) boron significantly increased CD3⁺ and PCNA⁺ cell numbers (P < 0.05) and decreased the IL-10 expression in the spleen. Addition of 320 (48) and 640 (96) mg/L (mg/kg BW) boron markedly reduced the serum IgG concentrations; splenic IL-2 and IL-10 expression; the number of CD3⁺, CD4⁺ and PCNA⁺ cells; and increased the number of splenic CD8⁺ and caspase-3⁺ cells and promoted caspase-3 expression in CD3⁺ cells. In conclusion, these findings suggest that the supplementation of rat drinking water with 20(3) and 40(6) mg/L (mg/kg BW) boron can markedly enhance humoral and cellular immune functions, while boron concentrations above 320 mg/L (48 mg/kg BW) can have an inhibitory effect or even toxicity on immune functions. These results exhibit a U-shaped response characteristic of low and high doses of boron supplementation on immune function and imply that proper boron supplementation in food for humans and animals could be used as an immunity regulator.

Zinc and immunity: An essential interrelation

The significance of the essential trace element zinc for immune function has been known for several decades. Zinc deficiency affects immune cells, resulting in altered host defense, increased risk of inflammation, and even death. The micronutrient zinc is important for maintenance and development of immune cells of both the innate and adaptive immune system. A disrupted zinc homeostasis affects these cells, leading to impaired formation, activation, and maturation of lymphocytes, disturbed intercellular communication via cytokines, and weakened innate host defense via phagocytosis and oxidative burst. This review outlines the connection between zinc and immunity by giving a survey on the major roles of zinc in immune cell function, and their potential consequences in vivo.

Activation of Cell-mediated Immunity by Morinda citrifolia Fruit Extract and Its Constituents

Morinda citrifolia, commonly known as noni, is a traditional natural medicine in French Polynesia and Hawaii. Functional foods derived from M. citrifolia fruit have been marketed to help prevent diseases and promote good health. The objective of this study was to assess the effects of M. citrifolia fruit on cell-mediated immunity. In the picryl chloride-induced contact dermatitis test, M. citrifolia fruit extract (Noni-ext) inhibited the suppression of cell-mediated immunity by immunosuppressive substances isolated from freeze-dried ascites of Ehrlich carcinoma-bearing mice (EC-sup). In addition, Noni-ext inhibited reduction of IL-2 production in EC-sup-treated mice and activated natural killer cells in normal mice. These results suggest that Noni-ext has multiple effects on the recovery of cell-mediated immunity. Furthermore, we investigated the active principles of Noni-ext and identified an iridoid glycoside, deacetylasperulosidic acid. Oral administration of deacetylasperulosidic acid inhibited the reduction of ear swelling, and also cancelled the suppression of IL-2 production along with the activation of natural killer cells in the same manner as that of Noni-ext.

Effect of micronutrient deficiency on QuantiFERON-TB Gold In-Tube test and tuberculin skin test in diagnosis of childhood intrathoracic tuberculosis

BACKGROUND/OBJECTIVES

Data on performance of QuantiFERON-TB Gold In-Tube test (QFT) and tuberculin skin test (TST) in children with active tuberculosis from high burden countries in the context of micronutrient deficiency are scarce. The objective of this study was to evaluate the effect of micronutrient deficiency on the performance of TST and QFT in children with intrathoracic tuberculosis.

SUBJECTS/METHODS

Children with probable intrathoracic tuberculosis underwent TST, QFT, gastric lavages and induced sputum examination for AFB (Acid-Fast Bacilli) smear and culture. Zinc, copper, ferritin and vitamin D were measured on stored serum samples. The study used cross-sectional data at initiation of anti-tubercular therapy.

RESULTS

Three hundred and sixty-two children (median age 115.5 months (interquartile range: 73, 144), 200 (55.3%) girls) were enrolled in the study. Microbiological confirmation of tuberculosis could be obtained in 128 patients. TST and QFT were positive in 337 (93%) and 297 (82%) children, respectively. Performance of both the tests was unaffected by weight-for-age and height-for-age 'z-scores' or by serum copper levels. TST was not affected by serum zinc and ferritin levels. Children with negative QFT results had lower mean serum zinc level (P=0.01) and higher ferritin levels (P=0.007) as compared to those with positive test. Higher proportion of children with positive TST were vitamin D deficient/insufficient (P=0.003).

CONCLUSION

Micronutrient status, especially serum levels of zinc, may influence the performance of QFT in children with intrathoracic tuberculosis. Considering the high prevalence of zinc deficiency in developing countries, QFT should be used cautiously for diagnosing tuberculosis.

Zinc and regulation of inflammatory cytokines: implications for cardiometabolic disease

In atherosclerosis and diabetes mellitus, the concomitant presence of low-grade systemic inflammation and mild zinc deficiency highlights a role for zinc nutrition in the management of chronic disease. This review aims to evaluate the literature that reports on the interactions of zinc and cytokines. In humans, inflammatory cytokines have been shown both to up- and down-regulate the expression of specific cellular zinc transporters in response to an increased demand for zinc in inflammatory conditions. The acute phase response includes a rapid decline in the plasma zinc concentration as a result of the redistribution of zinc into cellular compartments. Zinc deficiency influences the generation of cytokines, including IL-1β, IL-2, IL-6, and TNF-α, and in response to zinc supplementation plasma cytokines exhibit a dose-dependent response. The mechanism of action may reflect the ability of zinc to either induce or inhibit the activation of NF-κB. Confounders in understanding the zinc-cytokine relationship on the basis of in vitro experimentation include methodological issues such as the cell type and the means of activating cells in culture. Impaired zinc homeostasis and chronic inflammation feature prominently in a number of cardiometabolic diseases. Given the high prevalence of zinc deficiency and chronic disease globally, the interplay of zinc and inflammation warrants further examination.

Specific micronutrient concentrations are associated with inflammatory cytokines in a rural population of Mexican women with a high prevalence of obesity

It has been recognised recently that obese individuals have lower concentrations of micronutrients and this may affect the concentrations of inflammatory cytokines. A cross-sectional study was carried out to evaluate the association of specific micronutrients' status with chronic inflammation caused by obesity in 280 women (36·1 (SD 7·5) years) from seven rural communities in Mexico. Measurements of weight, height and waist circumference were made on all women and body composition was determined by dual-energy X-ray absorptiometry. Concentrations of the cytokines IL-1, TNF-α, IL-6, IL-10 and IL-12, lipid profile, and the micronutrients Zn and vitamins A, C and E were determined in fasting blood samples. Ordered logistic regression models were used to determine associations between categorised cytokine levels and micronutrients. It was found that 80% of women were overweight or obese, and had significantly higher concentrations of C-reactive protein than normal-weight women (P= 0·05). The risk of higher levels of TNF-α, IL-6, IL-10 and IL-12 was reduced significantly among women with higher Zn concentrations (OR 0·63, 95% CI 0·42, 0·96, P= 0·03; OR 0·57, 95% CI 0·39, 0·86, P= 0·025; OR 0·63, 95% CI 0·41, 0·96, P= 0·04; OR 0·62, 95% CI 0·41, 0·95, P= 0·03, respectively). Higher concentrations of vitamin A were slightly associated with reduced risks of higher levels of IL-1 and IL-12 (OR 0·97, 95% CI 0·95, 0·99, P= 0·03; OR 0·97, 95% CI 0·94, 0·99, P= 0·03, respectively); when adjusting for BMI, this association was lost. No associations were found between vitamin C or vitamin E:lipids concentrations and inflammatory cytokines. In conclusion, higher Zn concentrations are associated with reduced risks of higher concentration of inflammation markers in a population of women with a high prevalence of obesity.

Functional significance of zinc-related signaling pathways in immune cells

Recent years have brought a paradigm shift for the role of the essential trace element zinc in immunity. Although its function as a structural component of many enzymes has been known for decades, current experimental evidence points to an additional function of the concentration of free or loosely bound zinc ions as an intracellular signal. The activity of virtually all immune cells is modulated by zinc in vitro and in vivo. In this review, we discuss the interactions of zinc with major signaling pathways that regulate immune cell activity, and the implications of zinc deficiency or supplementation on zinc signaling as the molecular basis for an effect of zinc on immune cell function.

The immune system and the impact of zinc during aging

The trace element zinc is essential for the immune system, and zinc deficiency affects multiple aspects of innate and adaptive immunity. There are remarkable parallels in the immunological changes during aging and zinc deficiency, including a reduction in the activity of the thymus and thymic hormones, a shift of the T helper cell balance toward T helper type 2 cells, decreased response to vaccination, and impaired functions of innate immune cells. Many studies confirm a decline of zinc levels with age. Most of these studies do not classify the majority of elderly as zinc deficient, but even marginal zinc deprivation can affect immune function. Consequently, oral zinc supplementation demonstrates the potential to improve immunity and efficiently downregulates chronic inflammatory responses in the elderly. These data indicate that a wide prevalence of marginal zinc deficiency in elderly people may contribute to immunosenescence.

Zinc deficiency

PURPOSE OF REVIEW

Zinc plays an essential role in numerous biochemical pathways. Zinc deficiency affects many organ systems, including the integumentary, gastrointestinal, central nervous system, immune, skeletal, and reproductive systems. This article aims to discuss zinc metabolism and highlights a few of the diseases associated with zinc deficiency.

RECENT FINDINGS

Zinc deficiency results in dysfunction of both humoral and cell-mediated immunity and increases the susceptibility to infection. Supplementation of zinc has been shown to reduce the incidence of infection as well as cellular damage from increased oxidative stress. Zinc deficiency is also associated with acute and chronic liver disease. Zinc supplementation protects against toxin-induced liver damage and is used as a therapy for hepatic encephalopathy in patients refractory to standard treatment. Zinc deficiency has also been implicated in diarrheal disease, and supplementation has been effective in both prophylaxis and treatment of acute diarrhea.

SUMMARY

This article is not meant to review all of the disease states associated with zinc deficiency. Rather, it is an introduction to the influence of the many roles of zinc in the body, with an extensive discussion of the influence of zinc deficiency in selected diseases. Zinc supplementation may be beneficial as an adjunct to treatment of many disease states.

Pro-inflammatory genetic background and zinc status in old atherosclerotic subjects

Inflammation and genetics are prominent mechanisms in the pathogenesis of atherosclerosis (AT) and its complications. In this review we discuss the possible impact on AT development of several genetic determinants involved in inflammation, oxidative stress and cytoprotection (IL-6, TNF-alpha, IL-10, CD14, TLR4, MT, HSP70). Genetic polymorphisms of these genes may affect a differential inflammatory response predisposing to AT. However, allelic polymorphisms of genes which increase the risk of AT frequently occur in the general population but, only adequate gene-environment-polymorphism interactions promote the onset of the disease. Zinc deficiency has been suggested as an environmental risk factor for AT. With advancing age, the incidence of zinc deficiency increases for several reasons. Among them, dietary intake, malabsorption and genetic background of inflammatory markers may be involved. A crucial contribution may also be played by increased oxidative stress which may lead to the appearance of dysfunctional proteins, including metallothioneins (MT) that are in turn involved in zinc homeostasis. The detection of candidate genes related to inflammation and promoting AT and their reciprocal influence/interaction with zinc status might allow earlier appropriate dietary interventions in genetically susceptible subjects.

Zinc and diarrheal disease: current status and future perspectives

PURPOSE OF REVIEW

To evaluate clinical data indicating the benefits of oral zinc supplementation to prevent and/or treat diarrhea in children and extend these findings to adults.

RECENT FINDINGS

Zinc plays an important role in modulating host resistance to infectious agents and reducing the risk, severity, and duration of diarrheal diseases. Zinc is important in the developing world and in low-income and middle-income countries where mild-to-moderate zinc deficiency is highly prevalent.The WHO/UNICEF recommendations for zinc supplementation are based on meta-analyses of randomized, controlled intervention trials on children: 20 mg zinc/day for 10-14 days for children with acute diarrhea and 10 mg/day for infants under 6 months of age. Effective forms include sulfate, gluconate, or acetate. No similar studies have been conducted on adults. Thus, carefully conducted clinical trials are necessary to ascertain the efficacy of zinc in prevention of acute and persistent diarrhea in adults.

SUMMARY

Faced with rising antibiotic resistance and the lack of effective antidiarrheal vaccines, oral zinc provides substantial benefit in the reduction of stool output and disease duration combined with safety, selectivity of action, and low cost. Thus, oral zinc supplementation is a practical therapeutic intervention for the treatment of diarrhea in children, and by extension, should be provided to adults.

Effects of long-term zinc supplementation and deprivation on gene expression in human THP-1 mononuclear cells

Zinc is an essential trace element that is critical for cellular function and structural integrity. It has an important regulatory role in the immune system, in particular in monocytes. To identify the diverse cellular targets and mechanisms of action of zinc in this cell type, we used microarray technology to assess the effects of zinc supplementation and depletion on global gene expression. mRNA expression in the human monocytic cell line THP-1 was analyzed and compared in response to 40h supplementation with 50micromol/L zinc, or zinc deprivation by 2.5micromol/L of the membrane-permeant zinc chelator TPEN [N,N,N',N'-tetrakis-(2-pyridyl-methyl)ethylenediamine]. Analysis of microarrays consisting of approximately 19,000 unique oligonucleotides identified over 1400 genes, or approximately 7%, as zinc-sensitive. Notably, this yielded several sets of structurally or functionally related genes. Among those groups, which were mainly affected by zinc deprivation, were histones, S100 calcium and zinc binding proteins, and chemokines and their receptors. These groups of genes may mediate zinc-effects on chromatin regulation, zinc homeostasis, and chemotaxis, respectively. In addition, functional networks were analyzed, showing that the well known effect of zinc on pro-inflammatory cytokines is not limited to these genes; it acts on a number of functionally connected genes, as well. These results provide novel molecular targets and pathways that may aid in explaining the role of zinc in monocyte function.

Effect of zinc supplementation on plasma IL-6 and MCP-1 production and NK cell function in healthy elderly: interactive influence of +647 MT1a and -174 IL-6 polymorphic alleles

Pro-inflammatory cytokine response and NK activity are controlled by the availability of zinc ion, whose intra-cellular transport is regulated by metallothioneins. In order to closely examine the importance of circulating zinc in the modulation of immune response during ageing, in the balance of Th2/Th1 equilibrium and finally in the reversibility of systemic low grade inflammation, we evaluated the changes occurring in plasma IL-6 and MCP-1 concentrations and NK lytic activity in a healthy low grade inflamed elderly population, following zinc-aspartate supplementation. In addition, we aimed to highlight the potential interaction among circulating zinc increments, changes in immunological parameters and +647 MT1a and -174 IL-6 polymorphic alleles. Thirty-nine healthy individuals (60-83 years) from the ZINCAGE cohort (previously typed for +647 MT1a and -174 IL-6 polymorphisms) were supplied with zinc-aspartate. Blood samples collected before and after supplementation underwent basal laboratory determinations (circulating zinc, albumin and C-reactive protein) and immunological studies (plasma IL-6 and MCP-1 and NK lytic activity). Zinc supplementation in subjects with low or borderline-normal circulating zinc increased the concentration of this ion and modulated plasmatic IL-6 and MCP-1 as well as NK lytic activity. An interactive effect of polymorphic alleles of MT1a and IL-6 genes on zinc, IL-6, MCP-1 and NK activity was evidenced following supplementation, indicating the genetic background as one of the determinants for identifying groups of subjects that can take advantage of therapeutic intervention.