Zinc exchange by blood cells in nearly physiologic standard conditions

Biological and pathological mechanisms leading to the birth of a small vulnerable newborn

The pathway to a thriving newborn begins before conception and continues in utero with a healthy placenta and the right balance of nutrients and growth factors that are timed and sequenced alongside hormonal suppression of labour until a mature infant is ready for birth. Optimal nutrition that includes adequate quantities of quality protein, energy, essential fats, and an extensive range of vitamins and minerals not only supports fetal growth but could also prevent preterm birth by supporting the immune system and alleviating oxidative stress. Infection, illness, undernourishment, and harmful environmental exposures can alter this trajectory leading to an infant who is too small due to either poor growth during pregnancy or preterm birth. Systemic inflammation suppresses fetal growth by interfering with growth hormone and its regulation of insulin-like growth factors. Evidence supports the prevention and treatment of several maternal infections during pregnancy to improve newborn health. However, microbes, such as Ureaplasma species, which are able to ascend the cervix and cause membrane rupture and chorioamnionitis, require new strategies for detection and treatment. The surge in fetal cortisol late in pregnancy is essential to parturition at the right time, but acute or chronically high maternal cortisol levels caused by psychological or physical stress could also trigger labour onset prematurely. In every pathway to the small vulnerable newborn, there is a possibility to modify the course of pregnancy by supporting improved nutrition, protection against infection, holistic maternal wellness, and healthy environments.

Biomarkers of Cardiovascular Risk in Obese Women and their Relationship with Zinc Status

Background:

Excessive adipose tissue, in the case of common obesity, has been associated with an endocrine-metabolic alteration that contributes to a manifestation of dyslipidemia. To identify mechanisms which are involved in disorders of lipid metabolism, several nutrients have been studied, especially zinc, which act by regulating transcription factors that are important for synthesis and oxidation of lipids and act as an anti-inflammatory and antioxidant nutrient. Thus, the study makes an assessment of the zinc status and biomarkers of cardiovascular risk in obese women.

Methods:

A case-control study enrolling obese (body mass index (BMI) ≥35 kg/m²) and eutrophic (BMI 18.5-24.9 kg/m²) Brazilian women was conducted. Dietary zinc intake was assessed by the three-day food registry. Plasma, erythrocyte and urinary zinc concentrations were determined by inductively coupled plasma optical emission spectrometry. Cardiovascular risk was assessed by plasma concentrations of lipid fractions, and by anthropometric measures.

Results:

Both groups showed a dietary zinc intake above the recommendations, with no statistical difference between them (p >0.05). Mean plasma and erythrocyte zinc concentrations were significantly reduced in obese women, compared to the control group (p <0.05). Urinary zinc excretion was significantly higher in obese women (p <0.05), who also had a significantly higher cardiovascular risk when compared to the control group (p <0.05). An inverse correlation between dietary zinc intake and waist-hip ratio was found in obese women.

Conclusion:

Obese women presented zinc redistribution characterized by reduced concentrations in plasma and erythrocytes, dietary zinc intake above the recommended, and increased zinc excretion in the urine. This study shows dyshomeostasis of zinc in obesity, a possible role in adiposity control and, consequently, its protective role against cardiovascular risk, due to its influence on risk biomarkers, such as waist-hip ratio.

The science and practice of micronutrient supplementations in nutritional anemia: an evidence-based review

Nutritional anemia is the most common type of anemia, affecting millions of people in all age groups worldwide. While inadequate access to food and nutrients can lead to anemia, patients with certain health status or medical conditions are also at increased risk of developing nutritional anemia. Iron, cobalamin, and folate are the most recognized micronutrients that are vital for the generation of erythrocytes. Iron deficiency is associated with insufficient production of hemoglobin. Deficiency of cobalamin or folate leads to impaired synthesis of deoxyribonucleic acid, proteins, and cell division. Recent research has demonstrated that the status of copper and zinc in the body can significantly affect iron absorption and utilization. With an increasing number of patients undergoing bariatric surgical procedures, more cases of anemia associated with copper and zinc deficiencies have also emerged. The intestinal absorption of these 5 critical micronutrients are highly regulated and mediated by specific apical transport mechanisms in the enterocytes. Health conditions that persistently alter the histology of the upper intestinal architecture, expression, or function of these substrate-specific transporters, or the normal digestion and flow of these key micronutrients, can lead to nutritional anemia. The focus of this article is to review the science of intestinal micronutrient absorption, discuss the clinical assessment of micronutrient deficiencies in relation to anemia, and suggest an effective treatment plan and monitoring strategies using an evidence-based approach.

Development of a compartmental model of human zinc metabolism: identifiability and multiple studies analyses

A compartmental model of zinc metabolism has been developed from stable isotope tracer studies of five healthy adults. Multiple isotope tracers were administered orally and intravenously, and the resulting enrichment was measured in plasma, erythrocytes, urine, and feces for as long as 3 wk. Data from total zinc measurements and model-independent calculations of various steady-state parameters were also modeled with the kinetic data. A structure comprised of 14 compartments and as many as 25 unknown kinetic parameters was developed to adequately model the data from each of the individual studies. The structural identifiability of the model was established using the GLOBI2 identifiability analysis software. Numerical identifiability of parameter estimates was evaluated using statistical data provided by SAAM. A majority of the model parameters was estimated with sufficient statistical certainty to be considered well determined. After the fitting of the model and data from the individual studies using SAAM/CONSAM, results were submitted to SAAM extended multiple studies analysis for aggregation into a single set of population parameters and statistics. The model was judged to be valid based on criteria described elsewhere.

Body weight-specific zinc compartmental masses in girls significantly exceed those reported in adults: a stable isotope study using a kinetic model

Maintaining optimal zinc status is important for normal growth and development in children, but minimal data are available regarding zinc metabolism in this age group. Our objectives were to utilize stable isotope-based compartmental modeling techniques to investigate zinc metabolism in healthy children; to expand a current stable isotope-based model to include red blood cell data; and to compare kinetic parameters in children with those previously reported in adults. Seven healthy girls, age 9.94 +/- 0.79 y, received 1.1 mg of a (67)zinc-enriched tracer orally and 0.5 mg of a (70)zinc-enriched tracer intravenously. Blood, urine and fecal samples were collected for 6 d. Stable isotope enrichments were measured by thermal ionization magnetic sector mass spectrometry. A six-compartment model based on a model previously reported in adults was used; the model excluded red blood cell data. Body weight-corrected masses of the body zinc compartments derived using this model were significantly greater in children than those reported in adults. Modification of the model to include a red blood cell compartment increased the total identifiable zinc mass of the nongastrointestinal compartments by approximately 2.5%. We conclude that compartmental modeling can be used to describe zinc kinetics in children, and that the body weight-corrected zinc pool masses are significantly greater in children than in adults.

Zinc-altered immune function and cytokine production

Although the intriguing role of zinc as an essential trace element for immune function is well established, particular progress in determining the molecular principles of action of this ion was made recently. Leukocyte responsiveness is delicately regulated by zinc concentration. Zinc deficiency as well as supraphysiologic levels impair immune function. Furthermore, the activities of many immunostimulants frequently used in immunologic studies are influenced by zinc concentration. Therefore, our knowledge from in vitro studies is widely dependent on the zinc concentration, and when not in physiologic range, immunologic responses are artificially low. Decreased production of TH1 cytokines and interferon-alpha by leukocytes in the healthy elderly person is correlated with low zinc serum level. The defect in interferon-alpha production is reconstituted by the addition of physiologic amounts of zinc in vitro. Interestingly, zinc induces cytokine production by isolated leukocytes. Zinc induces monocytes to produce interleukin-1, interleukin-6 and tumor necrosis factor-alpha in peripheral blood mononuclear cells and separated monocytes. This effect is higher in serum-free medium. However, only in the presence of serum does zinc also induce T cells to produce lymphokines. This effect on T cells is mediated by cytokines produced by monocytes. Stimulation also requires cell-to-cell contact of monocytes and T cells. Information is presented to illustrate the concepts that the zinc concentration must be taken into account whenever in vitro studies are made or complex alterations of immune functions are observed in vivo.

Effect of zinc on carp (Cyprinus carpio L.) erythrocytes

The effect of zinc exposure on some properties of the carp erythrocyte membrane was studied in vitro. Red blood cells plasma membranes were separated from other cellular membranes using a combination of differential and density gradient centrifugation. The purity of obtained plasma membrane preparations was determined by measuring the activity of the marker enzymes. Electrophoretic patterns of the main erythrocyte membrane proteins excluded their degradation during the isolation and purification procedure. Carp erythrocyte membranes, obtained from cells previously incubated with increasing ZnSO4 concentrations, were used to elucidate the effect of zinc ions on their physical and biochemical properties. Using fluorescent probes: 12-AS and TMA-DPH, we found that zinc ions reduced the fluidity of the lipid bilayer, both in the middle and near the aqueous interface. Moreover, it was observed that zinc had no significant influence neither on the Na,K-ATPase activity nor on the thiol groups content in the erythrocyte membrane. We also detected that incubation of erythrocytes with zinc lead to the marked decrease of hemolytic resistance of the cells. Our studies demonstrate that zinc at higher concentrations may be toxic to carp erythrocytes causing changes in the membrane fluidity and hemolytic resistance.

The value of methods to determine zinc deficiency in patients with Crohn's disease

BACKGROUND

The serum zinc concentration is frequently applied for the assessment of zinc deficiency, but this concentration is also influenced by other factors. The aim of this study was to compare various methods of assessing the zinc status in patients with Crohn' s disease.

METHODS

Serum levels of zinc, serum alkaline phosphatase activity, and zinc in various types of cells were related to factors potentially inducing zinc deficiency: the number of liquid stools, weight loss, bowel resection, and the extent and severity of inflammation.

RESULTS

Thirty-one patients with more or less active Crohn's disease were included. In 68% of these patients the serum zinc concentration was less than the reference level, and it was correlated with the extent of bowel resection and the van Hees Index but not with the Crohn's Disease Activity Index. Serum alkaline phosphatase activity was correlated with bowel resection. Zinc in blood cells was poorly correlated with factors inducing zinc deficiency.

CONCLUSION

A decrease of serum zinc concentration is frequently seen in active Crohn's disease. This study suggests that the determination of zinc in blood cells is not superior to the determination of the serum zinc concentration and serum alkaline phosphatase activity.