Zinc and gut microbiota in health and gastrointestinal disease under the COVID‐19 suggestion

Scarpellini, Emidio; Balsiger, Lukas M.; Maurizi, Valentina; Rinninella, Emanuele; Gasbarrini, Antonio; Giostra, Nena; Santori, Pierangelo; Abenavoli, Ludovico; Rasetti, Carlo

doi:10.1002/biof.1829

Cited by 25 publications

(19 citation statements)

References 105 publications

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“…A regular metabolism and sufficient supply of Se and Zn are of central importance for a full activity of the immune system. The trace element Zn is needed for the function of hundreds of different proteins in our organism, influences the activity and response of immune cells, directly serves signal transduction, and apparently also alters the composition of the microbiota (55)(56)(57). Moreover, Zn status is reduced in the elderly, which is associated with a declining activity of the immune system (58).…”

Section: Discussionmentioning

confidence: 99%

Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe

et al. 2022

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IntroductionCertain trace elements are essential for life and affect immune system function, and their intake varies by region and population. Alterations in serum Se, Zn and Cu have been associated with COVID-19 mortality risk. We tested the hypothesis that a disease-specific decline occurs and correlates with mortality risk in different countries in Europe.MethodsSerum samples from 551 COVID-19 patients (including 87 non-survivors) who had participated in observational studies in Europe (Belgium, France, Germany, Ireland, Italy, and Poland) were analyzed for trace elements by total reflection X-ray fluorescence. A subset (n=2069) of the European EPIC study served as reference. Analyses were performed blinded to clinical data in one analytical laboratory.ResultsMedian levels of Se and Zn were lower than in EPIC, except for Zn in Italy. Non-survivors consistently had lower Se and Zn concentrations than survivors and displayed an elevated Cu/Zn ratio. Restricted cubic spline regression models revealed an inverse nonlinear association between Se or Zn and death, and a positive association between Cu/Zn ratio and death. With respect to patient age and sex, Se showed the highest predictive value for death (AUC=0.816), compared with Zn (0.782) or Cu (0.769).DiscussionThe data support the potential relevance of a decrease in serum Se and Zn for survival in COVID-19 across Europe. The observational study design cannot account for residual confounding and reverse causation, but supports the need for intervention trials in COVID-19 patients with severe Se and Zn deficiency to test the potential benefit of correcting their deficits for survival and convalescence.

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Section: Discussionmentioning

confidence: 99%

Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe

et al. 2022

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“…Zinc is also involved in cell cycle regulation, particularly apoptosis, and hence has potential anticarcinogenic effects. All these effects have a “symbiotic” relationship with the gut microbiota [ 28 ]. From a prognostic perspective, zinc deficiency may predispose to growth retardation in young populations, and to loss of appetite, impaired immune function, and structural impairment of the intestinal endothelium.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

et al. 2022

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Malabsorptive disorders are closely associated with micronutrient deficiencies. In inflammatory bowel disease (IBD), trace element deficiencies pose a clinical burden from disease onset throughout its course, contributing to morbidity and poor quality of life. We aimed to conduct a systematic review and meta-analysis of the prevalence of zinc deficiency in IBD. Literature screening was performed on six electronic databases until 1 May 2022. Two independent investigators assessed the 152 retrieved articles for inclusion criteria, met by only nine, that included 17 prevalence entries for Crohn’s disease (CD) (n = 9) and ulcerative colitis (UC) (n = 8). No exclusion criteria were applied to language, deficiency cut-offs, population age, general health status, country, or study setting (cohort or cross-sectional). The prevalence of zinc deficiency in blood was scored positive if due to a single disease, not cumulative factors. Zinc deficiency prevalence across selected studies showed higher values in CD than in UC. Pooled analyses by the IBD subgroup showed a total population of 1677 with CD, for an overall mean zinc deficiency prevalence of 54% and 95% confidence intervals (CI) ranging from 0.51 to 0.56, versus 41% (95%CI 0.38–0.45) in the UC population (n = 806). The overall prevalence at meta-analysis was estimated at 50% (95%CI 0.48–0.52), but with high heterogeneity, I2 = 96%. The funnel plot analysis failed to show any evidence of publication bias. The risk of bias across selected studies was moderate to low. In IBD contexts, one of two patients suffers from zinc deficiency. Mismanagement of micronutrient deficiencies plays a role in inflammation trajectories and related cross-pathways. Clinicians in the field are advised to list zinc among trace elements to be monitored in serum.

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“…However, the modulation of the expression of inflammatory cytokines, the control of oxidative stress, and the control of the transcription component nuclear factor kappa B (NF-B), all of which are essential for good immunological function, figure among the most described mechanisms [ 34 ] ( Figure 2 ). Studies have confirmed the essential role of Zn for the human microbiome, as well as the influence of the Zn-induced modulation of the intestinal microflora and the accumulation of metabolites on the immunological regulation of the body’s status [ 36 ]. Zn impacts numerous parts of the immune system, from the skin’s barrier to gene regulation inside cells, and its molecular processes for modulating immunological response during infection have been investigated for decades, as reviewed by [ 6 , 35 ].…”

Section: Zinc As An Immunomodulatory Element and Its Implications For...mentioning

confidence: 99%

Improving Dietary Zinc Bioavailability Using New Food Fortification Approaches: A Promising Tool to Boost Immunity in the Light of COVID-19

Chemek

Kadi

Merenkova

et al. 2023

Biology

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Zinc is a powerful immunomodulatory trace element, and its deficiency in the body is closely associated with changes in immune functions and viral infections, including SARS-CoV-2, the virus responsible for COVID-19. The creation of new forms of zinc delivery to target cells can make it possible to obtain smart chains of food ingredients. Recent evidence supports the idea that the optimal intake of zinc or bioactive compounds in appropriate supplements should be considered as part of a strategy to generate an immune response in the human body. Therefore, controlling the amount of this element in the diet is especially important for populations at risk of zinc deficiency, who are more susceptible to the severe progression of viral infection and disease, such as COVID-19. Convergent approaches such as micro- and nano-encapsulation develop new ways to treat zinc deficiency and make zinc more bioavailable.

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Zinc and gut microbiota in health and gastrointestinal disease under the COVID‐19 suggestion

Cited by 25 publications

References 105 publications

Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe

Association of COVID-19 mortality with serum selenium, zinc and copper: Six observational studies across Europe

Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Improving Dietary Zinc Bioavailability Using New Food Fortification Approaches: A Promising Tool to Boost Immunity in the Light of COVID-19

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