Effect of zinc pretreatment on pulmonary endothelial cells in vitro and pulmonary function in a porcine model of endotoxemia

Tailored Coatings for Enhanced Performance of Zinc-Magnesium Alloys in Absorbable Implants

Absorbable metals exhibit potential for next-generation temporary medical implants, dissolving safely in the body during tissue healing and regeneration. Their commercial incorporation could substantially diminish the need for additional surgeries and complications that are tied to permanent devices. Despite extensive research on magnesium (Mg) and iron (Fe), achieving the optimal combination of mechanical properties, biocompatibility, and controlled degradation rate for absorbable implants remains a challenge. Zinc (Zn) and Zn-based alloys emerged as an attractive alternative for absorbable implants, due to favorable combination of in vivo biocompatibility and degradation behavior. Moreover, the development of suitable coatings can enhance their biological characteristics and tailor their degradation process. In this work, four different biodegradable coatings (based on zinc phosphate (ZnP), collagen (Col), and Ag-doped bioactive glass nanoparticles (AgBGNs)) were synthesized by chemical conversion, spin-coating, or a combination of both on Zn-3Mg substrates. This study assessed the impact of the coatings on in vitro degradation behavior, cytocompatibility, and antibacterial activity. The ZnP-coated samples demonstrated controlled weight loss and a decreased corrosion rate over time, maintaining a physiological pH. Extracts from the uncoated, ZnP-coated, and Col-AgBGN-coated samples showed higher cell viability with increasing concentration. Bacterial viability was significantly impaired in all coated samples, particularly in the Col-AgBGN coating. This study showcases the potential of a strategic material-coating combination to effectively tackle multiple challenges encountered in current medical implant technologies by modifying the properties of absorbable metals to tailor patient treatments.

Construction of Mussel-Inspired Dopamine-Zn2+ Coating on Titanium Oxide Nanotubes to Improve Hemocompatibility, Cytocompatibility, and Antibacterial Activity

Zinc ions (Zn2+) are a highly potent bioactive factor with a broad spectrum of physiological functions. In situ continuous and controllable release of Zn2+ from the biomaterials can effectively improve the biocompatibility and antibacterial activity. In the present study, inspired by the adhesion and protein cross-linking in the mussel byssus, with the aim of improving the biocompatibility of titanium, a cost-effective one-step metal-catecholamine assembly strategy was developed to prepare a biomimetic dopamine-Zn2+ (DA-Zn2+) coating by immersing the titanium oxide nanotube (TNT) arrays on the titanium surface prepared by anodic oxidation into an aqueous solution containing dopamine (DA) and zinc ions (Zn2+). The DA-Zn2+ coatings with the different zinc contents exhibited excellent hydrophilicity. Due to the continuous release of zinc ions from the DA-Zn2+ coating, the coated titanium oxide nanotubes displayed excellent hemocompatibility characterized by platelet adhesion and activation and hemolysis assay. Moreover, the DA-Zn2+-coated samples exhibited an excellent ability to enhance endothelial cell (EC) adhesion and proliferation. In addition, the DA-Zn2+ coating can also enhance the antibacterial activity of the nanotubes. Therefore, long-term in situ Zn2+-releasing coating of the present study could serve as the bio-surfaces for long-term prevention of thrombosis, improvement of cytocompatibility to endothelial cells, and antibacterial activity. Due to the easy operation and strong binding ability of the polydopamine on various complicated shapes, the method of the present study can be further applied to other blood contact biomaterials or implantable medical devices to improve the biocompatibility.

Zinc supplementation prior to heat shock enhances HSP70 synthesis through HSF1 phosphorylation at serine 326 in human peripheral mononuclear cells

Zinc supplementation prior to heat shock increases HSP70 (Heat shock protein 70) expression, which has cytoprotective effects in tissue cells during inflammation. Effects of zinc deficiency in this regard are...

Immobilization of bioactive complex on the surface of magnesium alloy stent material to simultaneously improve anticorrosion, hemocompatibility and antibacterial activities

Magnesium alloy represents one of the most potential biodegradable vascular stent materials due to its good biodegradability, biocompatibility and suitable mechanical properties, whereas the rapid degradation in physiological environment and the limited biocompatibility remain the challenges. In this study, graphene oxide (GO) was firstly functionalized by chitosan (GOCS), followed by loading zinc ions and propranolol to obtain GOCS@Zn/Pro complex, which was finally covalently immobilized on the self-assembled modified magnesium alloy surface to enhance the corrosion resistance and biocompatibility. The multi-functional coating can significantly improve the corrosion resistance and reduce the degradation rate of the magnesium alloy. Furthermore, the coating can significantly inhibit platelet adhesion and activation, reduce hemolysis rate, prolong activated partial thromboplastin time (APTT), and thus improve the blood compatibility of the magnesium alloy. In addition, the modified magnesium alloy can not only significantly promote the endothelial cell adhesion and proliferation, up-regulate the expression of vascular endothelial growth factor (VEGF) and nitric oxide (NO), but also endow the materials with good antibacterial properties. Therefore, the method of the present study can be used to modify magnesium alloy stent materials to simultaneously enhance corrosion resistance and blood compatibility, promote endothelialilization, and inhibit infections.

Zinc and respiratory tract infections: Perspectives for COVID‑19 (Review)

In view of the emerging COVID‑19 pandemic caused by SARS‑CoV‑2 virus, the search for potential protective and therapeutic antiviral strategies is of particular and urgent interest. Zinc is known to modulate antiviral and antibacterial immunity and regulate inflammatory response. Despite the lack of clinical data, certain indications suggest that modulation of zinc status may be beneficial in COVID‑19. In vitro experiments demonstrate that Zn2+ possesses antiviral activity through inhibition of SARS‑CoV RNA polymerase. This effect may underlie therapeutic efficiency of chloroquine known to act as zinc ionophore. Indirect evidence also indicates that Zn2+ may decrease the activity of angiotensin‑converting enzyme 2 (ACE2), known to be the receptor for SARS‑CoV‑2. Improved antiviral immunity by zinc may also occur through up‑regulation of interferon α production and increasing its antiviral activity. Zinc possesses anti‑inflammatory activity by inhibiting NF‑κB signaling and modulation of regulatory T‑cell functions that may limit the cytokine storm in COVID‑19. Improved Zn status may also reduce the risk of bacterial co‑infection by improving mucociliary clearance and barrier function of the respiratory epithelium, as well as direct antibacterial effects against S. pneumoniae. Zinc status is also tightly associated with risk factors for severe COVID‑19 including ageing, immune deficiency, obesity, diabetes, and atherosclerosis, since these are known risk groups for zinc deficiency. Therefore, Zn may possess protective effect as preventive and adjuvant therapy of COVID‑19 through reducing inflammation, improvement of mucociliary clearance, prevention of ventilator‑induced lung injury, modulation of antiviral and antibacterial immunity. However, further clinical and experimental studies are required.

Improved Blood Compatibility and Endothelialization of Titanium Oxide Nanotube Arrays on Titanium Surface by Zinc Doping

Titanium dioxide nanotube arrays are widely used in biomaterials due to their unique tubular structure and tunable biocompatibility. In the present study, titanium oxide nanotube arrays with different diameters were prepared on the titanium surface by anodization, followed by zinc doping using hydrothermal treatment to enhance the biocompatibility. Both the nanotube dimensions and zinc doping had obvious influences on the hydrophilicity, protein adsorption, blood compatibility, and endothelial cell behaviors of the titanium surface. The increase of the diameter and zinc doping can improve the hydrophilicity of the titanium surface. The increase of nanotube diameter could reduce the albumin adsorption while increasing the fibrinogen adsorption. However, zinc doping can simultaneously promote the adsorption of albumin and fibrinogen, and the effect was more obvious for albumin. Zinc doping can significantly improve the blood compatibility of the titanium oxide nanotubes because it cannot only increase the activity of cyclophosphate guanylate (cGMP) but also significantly reduce the platelets adhesion and hemolysis rate. Moreover, it was also found that both the smaller diameter and zinc doping nanotubes can enhance the endothelial cell adhesion and proliferation as well as up-regulate the expression of NO and VEGF. Therefore, the zinc doped titanium dioxide nanotube array can be used to simultaneously improve the blood compatibility and promote endothelialization of the titanium-based biomaterials and implants, such as intravascular stents.

Current status and perspectives of zinc-based absorbable alloys for biomedical applications

Absorbable metals have the potential to serve as the next generation of temporary medical implant devices by safely dissolving in the human body upon vascular tissue healing and bone regeneration. Their implementation in the market could greatly reduce the need of costly and risky additional surgeries for either implant replacement or removal, often required in current permanent implants. Despite the extensive research done over the last two decades on magnesium (Mg) and iron (Fe) based alloys, they have not generally shown a satisfactory combination of mechanical properties, biocompatibility and controlled degradation rate in the physiological environment. Consequently, zinc (Zn) based alloys were introduced in the last few years as alternative materials to overcome the limitations of Fe and Mg-based alloys. The blend of different alloying elements and processing conditions have led to a wide variety of Zn-based alloys having tunable mechanical properties and corrosion rates. This review provides the most recent progress in the development of absorbable Zn-based alloys for biomedical implant applications, primarily for cardiovascular and orthopedic devices. Their biocompatibility, processability and metallurgical aspects, as well as their mechanical behavior and corrosion properties are presented and discussed, including their opportunities, limitations and future research directions. STATEMENT OF SIGNIFICANCE: Temporary orthopedic bioimplants have become increasingly popular as they offer an alternative to prevent complications, like infections or secondary surgeries, often related to the implantation of permanent devices. Iron and magnesium alloys were extensively studied as candidates for absorbable medical applications, but they generally failed to provide a desirable mechanical performance and corrosion characteristics in the physiological environment. Zinc was introduced in the last decade as a potential implant material after showing outstanding biocompatibility and biodegradability. This review summarizes the research advances to date and provides a thorough discussion of the future challenges of absorbable zinc alloys to satisfy the demanding clinical benchmarks for absorbable medical applications. Their biocompatibility, mechanical, and corrosion aspects, both in vitro and in vivo, are comprehensively reviewed and assessed accordingly.

Zinc and Sepsis

Sepsis, defined as a “life-threatening organ dysfunction caused by a dysregulated host-response to infection” is a major health issue worldwide and still lacks a fully elucidated pathobiology and uniform diagnostic tests. The trace element zinc is known to be crucial to ensure an appropriate immune response. During sepsis a redistribution of zinc from serum into the liver has been observed and several studies imply a correlation between zinc and sepsis outcome. Therefore the alterations of zinc concentrations in different tissues might serve as one part of the host’s defense mechanism against pathogens during sepsis by diverse mechanisms. It has been suggested that zinc is involved in nutritional immunity, acts as a hepatoprotective agent, or a differentiation signal for innate immune cells, or supports the synthesis of acute phase proteins. Further knowledge about these events could help in the evaluation of how zinc could be optimally applied to improve treatment of septic patients. Moreover, the changes in zinc homeostasis are substantial and correlate with the severity of the disease, suggesting that zinc might also be useful as a diagnostic marker for evaluating the severity and predicting the outcome of sepsis.

Endothelial Cellular Responses to Biodegradable Metal Zinc

Biodegradable zinc (Zn) metals, a new generation of biomaterials, have attracted much attention due to their excellent biodegradability, bioabsorbability, and adaptability to tissue regeneration. Compared with magnesium (Mg) and iron (Fe), Zn exhibits better corrosion and mechanical behaviors in orthopedic and stent applications. After implantation, Zn containing material will slowly degrade, and Zn ions (Zn2+) will be released to the surrounding tissue. For stent applications, the local Zn2+concentration near endothelial tissue/cells could be high. However, it is unclear how endothelia will respond to such high concentrations of Zn2+, which is pivotal to vascular remodeling and regeneration. Here, we evaluated the short-term cellular behaviors of primary human coronary artery endothelial cells (HCECs) exposed to a concentration gradient (0-140 μM) of extracellular Zn2+. Zn2+ had an interesting biphasic effect on cell viability, proliferation, spreading, and migration. Generally, low concentrations of Zn2+ promoted viability, proliferation, adhesion, and migration, while high concentrations of Zn2+ had opposite effects. For gene expression profiles, the most affected functional genes were related to cell adhesion, cell injury, cell growth, angiogenesis, inflammation, vessel tone, and coagulation. These results provide helpful information and guidance for Zn-based alloy design as well as the controlled release of Zn2+in stent and other related medical applications.

Alterations in zinc binding capacity, free zinc levels and total serum zinc in a porcine model of sepsis

Zinc is crucial for immune function. In addition, the redistribution of zinc and other nutrients due to infection is an integral part of the host immune response to limit availability to pathogens. However, the major zinc binding protein albumin is down regulated during the acute phase response, implicating a decrease in zinc binding capacity. A prospective animal study with eight female German landrace pigs was conducted to investigate alterations in zinc binding capacity, total serum zinc and free zinc levels in the initial phase of sepsis. Sepsis was induced by instillation of autologous feces via midline laparotomy. Total serum zinc declined significantly after 1 h (10.89 ± 0.42 µM vs. 7.67 ± 0.41 µM, p < 0.001), total serum copper and iron reached a significant reduction at 4 h. Urinary excretion of zinc declined in line with total serum zinc. In comparison to total serum zinc, free zinc levels declined to a lesser, though significant, extent. Zinc binding capacity of serum decreased over time, whereby free zinc levels after addition of zinc correlated negatively with total serum protein and albumin levels. In addition IL-6 and TNF-α concentrations were measured and increased significantly 2 h after induction of sepsis. Hence, total serum zinc was the first marker of inflammation in our experiment, and might therefore be a promising biomarker for the early diagnosis of sepsis. Furthermore the observation of a substantially different serum free zinc homeostasis during sepsis provides valuable information for a potential therapeutic zinc supplementation, which has to take buffering capacity by serum proteins into account.

Endotoxin molecule lipopolysaccharide-induced zebrafish inflammation model: a novel screening method for anti-inflammatory drugs

Lipopolysaccharide (LPS), an endotoxin molecule, has been used to induce inflammatory responses. In this study, LPS was used to establish an in vivo inflammation model in zebrafish for drug screening. We present an experimental method that conveniently and rapidly assesses the anti-inflammatory properties of drugs. The yolks of 3-day post-fertilization (dpf) larvae were injected with 0.5 mg/mL LPS to induce fatal inflammation. After LPS stimulation, macrophages were tracked by NR and SB staining and neutrophil migration was observed using the MPO:GFP line. Larval mortality was used as the primary end-point. Expression levels of key cytokines involved in the inflammatory response including IL-1β, IL-6, and TNF-α, were measured using quantitative reverse transcription polymerase chain reaction (RT-PCR). Macrophages and neutrophils were both recruited to the LPS-injected site during the inflammatory response. Mortality was increased by LPS in a dose-dependent manner within 48 h. Analyses of IL-1β, IL-6, and TNF-α expression levels revealed the upregulation of the inflammatory response in the LPS-injected larvae. Further, the anti-inflammatory activity of chlorogenic acid (CA) was evaluated in this zebrafish model to screen for anti-inflammatory drugs. A preliminary result showed that CA revealed a similar effect as the corticosteroid dexamethasone (DEX), which was used as a positive control, by inhibiting macrophage and neutrophil recruitment to the LPS site and improving survival. Our results suggest that this zebrafish screening model could be applied to study inflammation-mediated diseases. Moreover, the Traditional Chinese Medicine CA displays potential anti-inflammatory activity.

Hemorrhagic shock and surgical stress alter distribution of labile zinc within high- and low-molecular-weight plasma fractions

Zinc ions (Zn) are essential for tissue repair following injury or stress. We hypothesize that during such stresses Zn is redistributed to labile pools in plasma components. Here we tested this hypothesis using a novel assay to monitor labile Zn in plasma in hemorrhagic shock. Adult rats in the shock group (S group) underwent hemorrhage and resuscitation. Blood samples were drawn at baseline and at 1, 4, and 24 h. The surgical control group (SC group) was anesthetized and instrumented, but not bled. Albumin, total Zn, and labile Zn levels were assayed in plasma. Binding capacity for Zn was assessed in high- and low-molecular-weight pools. Significant decreases in total Zn were observed by 24 h, in both S and SC groups. Albumin levels were significantly reduced in the S group at 1 and 4 h but restored at 24 h; significant changes were not observed in other groups. In whole plasma, labile Zn levels were stable initially in the S and SC groups, but declined at 24 h. In the high-molecular-weight pool, marked and significant impairment of binding was noted throughout all time periods following the shock period in the S group. Such changes were observed in the SC group of less intensity and duration. These experiments suggest that shock alters affinity of plasma proteins for Zn, promoting delivery to peripheral tissues during periods of increased Zn utilization.

Trace element status and inflammation parameters after 6 months of Roux-en-Y gastric bypass

BACKGROUND

Knowledge about the practical consequences of the nutritional status of Fe, Zn, and Cu and inflammation in obesity is limited. The objective of this study was to evaluate changes on trace element status and their potential associations with selected inflammation parameters in patients after Roux-en-Y gastric bypass (RYGBP).

METHODS

Sixty-three women (mean age, 36.9 ± 9.2 years, body mass index, 43.8 ± 4.3 kg/m²) were evaluated at baseline and 6 months after RYGBP. Anthropometric (weight, waist circumference), body composition (fat mass and fat-free mass), dietary (nutrient intakes), and metabolic and inflammation (glucose, insulin, HOMA-IR, adiponectin, HDL-cholesterol, LDL-cholesterol, triglycerides, hs-CRP, leukocytes, polymorphonuclear neutrophils (PMN)) parameters were determined in addition to selected indices of Fe, Zn, and Cu status.

RESULTS

All but one (HDL-cholesterol) metabolic and inflammation parameters had significant differences when compared before and after RYGBP. Hemoglobin, serum ferritin, the size of the rapidly exchangeable zinc pool, and plasma copper decreased after RYGBP. Plasma and hair zinc, as well as zinc protoporphyrin increased. The change in Hb was significantly associated (p < 0.05) to the change in leukocytes (r = 0.33) and adiponectin (r = -0.44). Zinc protoporphyrin change was associated to the change in PMN (r = 0.32) and HDL-cholesterol (r = -0.29). No other associations between the changes of the rest of Fe, Zn, and Cu parameters with the changes of any of the metabolic and inflammation parameters were observed.

CONCLUSION

RYGBP produced significant weight and fat mass losses, with improvement of metabolic and inflammation parameters. Iron, zinc, and copper status were impaired after the surgery.

Balancing zinc deficiency leads to an improved healing of colon anastomosis in rats

BACKGROUND

In colorectal surgery, anastomotic leakage is a relevant complication. The aim of this study was to investigate whether intraperitoneally (i.p.) administered zinc improves the healing of colon anastomosis in rats.

MATERIALS AND METHODS

Male Wistar rats (66) received zinc-deficient diet for 21 days. To determine the effective dose of zinc which is necessary to compensate this deficiency, preliminary analysis in 30 rats were performed. In these rats, analysis by atom-absorption spectrophotometry revealed a dose of 1.0 mg zinc aspartate/kg body weight to be the compensatory dosage. In the remaining zinc-deficient rats (n= 36), a transverse colonic anastomosis was performed. Eighteen rats received either a zinc supplementation i.p. or 0.9% NaCl i.p. (n = 18; control group). On postoperative days 3, 5, and 14, the surface of the mucosal villi, expression of MMP 2, MMP 8, MMP 13, TIMP 1, as well as the collagen types I/III ratio were analyzed.

RESULTS

Protein expression of MMP 2 and MMP 8 was significantly higher in the anastomosis of the zinc group on day 3 and on day 5. The collagen types I/III ratio was significantly increased in the zinc group on days 5 and 14.

CONCLUSION

Balancing zinc deficiency benefits wound healing of colonic anastomosis qualitatively due to an increased collagen type I/III ratio. Surprisingly, these zinc supplements, however, increased the expression of MMP 2 and MMP 8 that are supposed to impair wound healing in case of an over-expression. Thus, further investigations are needed to elucidate the influence of zinc supplementation on regulation of MMPs.

Zinc oxide nanoparticles in modern sunscreens: an analysis of potential exposure and hazard

Sunscreens containing metal oxide nanoparticles appear transparent on the skin and provide excellent protection against sunburn caused by UV radiation. While it is likely that nanoparticles remain on the surface of the skin of healthy adult humans, and thus are considered safe for use in sunscreens, there has been no comprehensive assessment of the impact on human health from exposure to the metal oxide nanoparticles destined for use in sunscreens, either in the workplace during the manufacturing process, in long-term use across a range of skin conditions, or upon release into the broader environment, either accidentally or consequent of normal sunscreen use. In this review, we focus on zinc oxide nanoparticles destined for use in modern sunscreens, and discuss the potential for human exposure and the health hazard at each stage of their manufacture and use. We highlight where there is a need for further research.

Zinc deficiency impairs wound healing of colon anastomosis in rats

BACKGROUND

Anastomotic leakage is a relevant surgical complication. The aim of the study was to investigate the influence of a controlled preoperative zinc deficiency on the extracellular matrix composition of colon anastomosis.

MATERIALS AND METHODS

Forty male Wistar rats were randomized to either a zinc deficiency group (n = 20) or a control group (n = 20). In each animal, a transverse colonic end-to-end anastomosis was performed. On postoperative day 7, the surface of the mucosal villi, expression of matrix metalloproteinases (MMP) 2, 8, 9, and 13, and both the number of proliferating cells (Ki67) and apoptotic cells, as well as the collagen types I/III ratio were analyzed. Within the anastomotic area the mesenterial region and the antimesenterial region were analyzed separately.

RESULTS

In each group, one anastomotic leakage was detected. Expression of both MMP 2, 9, and 13 was significantly higher, and expression of Ki67 was significantly reduced in the zinc deficient group both mesenterial and antimesenterial. The collagen types I/III ratio was reduced in the zinc deficiency group by trend, without statistical significance neither mesenterial nor antimesenterial. Likewise, zinc deficiency affected neither the expression of MMP 8 nor the rate of apoptotic cells, respectively. Analyses of the surface of the mucosal villi revealed no significant differences comparing the groups with neither mesenterial nor antimesenterial.

CONCLUSIONS

Our study constitutes the known negative effect of zinc deficiency on wound healing. Zinc deficiency significantly increased the activity of MMPs (2, 9, and 13), caused a reduced collagen type I/III ratio, and delayed cell proliferation and quality of intestinal wound healing.

Infectious etiology modifies the treatment effect of zinc in severe pneumonia

BACKGROUND

Zinc is undergoing evaluation as an inexpensive therapeutic adjuvant for severe pediatric pneumonia.

OBJECTIVE

We explored the effect of etiology on the treatment effect of zinc in young children hospitalized for severe pneumonia.

DESIGN

We analyzed data from a randomized, double-blind, placebo-controlled clinical trial conducted at the Christian Medical College Hospital, a teaching hospital in Tamilnadu, India. Children aged 2-23 mo (n = 299) were randomly assigned to receive a 10-mg tablet of zinc sulfate or placebo twice a day during hospitalization. The primary outcomes were length of hospitalization and time to resolution of severe pneumonia stratified by etiologic classification on the basis of serum C-reactive protein (CRP) concentrations at admission.

RESULTS

CRP concentrations were available for 295 (98.7%) of the enrolled cases. Of these 295 cases, 223 (75.6%) were classified as suspected nonbacterial pneumonias (CRP concentrations <or=40 mg/L). Etiology modified the treatment effect of zinc on the length of the hospital stay [hazard ratio (HR) for interaction term: 0.52; 95% CI: 0.31, 0.91; P = 0.022]. In the 72 suspected bacterial cases (CRP concentrations >40 mg/L), the median length of hospitalization was approximately 20 h longer in the zinc-supplemented group than in the placebo group (87.3 and 68.3 h, respectively; HR: 0.56; 95% CI: 0.34, 0.93; P = 0.025). The treatment effect was not modified in the suspected nonbacterial cases of pneumonia.

CONCLUSIONS

Our results suggest that the treatment effect of zinc for severe pediatric pneumonia may be modified by bacterial infection. Further studies are required to develop appropriate recommendations for the use of zinc in the treatment of severe pneumonia. This trial was registered at clinicaltrials.gov as NCT00198666.

Signal transduction in monocytes: the role of zinc ions

The availability of zinc has a regulatory role in the immune system. It can have either pro- or anti-inflammatory effects, which both seem to be a consequence of a direct interaction of zinc with the cytokine secretion by monocytes. In this review, the molecular basis for this effect, the interaction of zinc with the signal transduction of monocytes, is discussed. In particular, zinc seems to activate or inhibit several signaling pathways that interact with the signal transduction of pathogen sensing receptors, the so-called Toll-like receptors (TLR), which sense pathogen-derived molecular structures and, upon activation, lead to secretion of pro-inflammatory cytokines. The interaction of zinc with protein tyrosine phosphatases and protein kinase C, and a direct modulation of lipopolysaccharide binding to its receptor (TLR-4) all result in enhanced cytokine production. On the other hand, a complex interaction between zinc, NO and cyclic nucleotide signaling, and inhibition of interleukin-1 receptor associated kinase-1, and inhibitor of kappa B kinase all counteract the production of pro-inflammatory cytokines. A role for the zinc binding protein metallothionein as a regulator for intracellular zinc signaling is discussed. By acting on all these signaling molecules, the zinc status of monocytes can have a direct effect on inflammation.

Alterations in zinc homeostasis underlie endothelial cell death induced by oxidative stress from acute exposure to hydrogen peroxide

Oxidative stress has been associated with multiple pathologies and disease states, including those involving the cardiovascular system. Previously, we showed that pulmonary artery endothelial cells (PAECs) undergo apoptosis after acute exposure to H2O2. However, the underlying mechanisms regulating this process remain unclear. Because of the prevalence of H2O2in normal physiological processes and apparent loss of regulation in disease states, the purpose of this study was to develop a more complete understanding of H2O2-mediated adverse effects on endothelial cell survival. Acute exposure of PAECs to H2O2caused a dose-dependent increase in cellular release of lactate dehydrogenase and a significant increase in production of superoxide ions, which appear to be generated within the mitochondria, as well as a significant loss of mitochondrial membrane potential and activity. Subsequent to the loss of mitochondrial membrane potential, PAECs exhibited significant caspase activation and apoptotic nuclei. We also observed a significant increase in intracellular free Zn2+after bolus exposure to H2O2. To determine whether this increase in Zn2+was involved in the apoptotic pathway induced by acute H2O2exposure, we developed an adenoviral construct for overexpression of the Zn2+-binding protein metallothionein-1. Our data indicate that chelating Zn2+, either pharmacologically with N,N,N′, N-tetrakis(2-pyridylmethyl)ethylene diamine or by overexpression of the Zn2+-binding protein metallothionein-1, in PAECs conferred significant protection from induction of apoptosis and cell death associated with the effects of acute H2O2exposure. Our results show that the acute toxicity profile of H2O2can be attributed, at least in part, to liberation of Zn2+within PAECs. We speculate that regulation of Zn2+levels may represent a potential therapeutic target for cardiovascular disease associated with acute oxidative stress.

Zinc L-carnosine protects against mucosal injury in portal hypertensive gastropathy through induction of heat shock protein 72

BACKGROUND AND AIMS

Increased susceptibility to gastric mucosal injury is observed in portal hypertensive gastropathy (PHG). In this study, the effects of zinc L-carnosine, an anti-ulcer drug, were evaluated on expression of heat shock protein (hsp) 72 and cytoprotection in gastric mucosa in a rat model of PHG.

METHODS

Portal hypertensive gastropathy with liver cirrhosis was induced by bile duct ligation for 4 weeks in male Sprague-Dawley rats. Expression of gastric mucosal hsp72 was evaluated by Western blotting at 6 h after intragastric administration of L-carnosine, zinc sulfate, or zinc L-carnosine. Blood was also collected for determination of serum zinc level. Mucosal protective abilities against hydrochloric acid (HCl) (0.6N) followed by pretreatment with L-carnosine, zinc sulfate or zinc L-carnosine were also studied.

RESULTS

L-carnosine, zinc sulfate, and zinc L-carnosine induced hsp72 in gastric mucosa of rats with bile duct ligation. Zinc sulfate and zinc L-carnosine suppressed HCl-induced mucosal injury. However, L-carnosine could not suppress HCl-induced mucosal injury. Serum zinc levels were significantly elevated after zinc L-carnosine administration. Furthermore, pretreatment with zinc L-carnosine (30-300 mg/kg) increased the expression of hsp72 in gastric mucosa and prevented HCl-induced mucosal injury in rats with bile duct ligation in a dose-dependent manner.

CONCLUSIONS

Zinc derivatives, especially zinc L-carnosine, protected portal hypertensive gastric mucosa with increased hsp72 expression in cirrhotic rats. It is postulated that zinc L-carnosine may be beneficial to the mucosal protection in PHG as a 'chaperone inducer'.

Oxidative stress and septic shock: metabolic aspects of oxygen-derived free radicals generated in the liver during endotoxemia

This review describes the role of oxidative stress caused by endotoxin challenge in sepsis or septic shock symptoms. We observed that endotoxin injection resulted in lipid peroxide formation and membrane damage (near 60-150 kDa) in the livers of experimental animals, causing decreased levels of scavengers or quenchers of free radicals. The administration of alpha-tocopherol completely prevented injury to the liver plasma membrane caused by endotoxin, and suggested that lipid peroxidation by free radicals might occur in a tissue ischemic state, probably by disseminated intravascular coagulation (DIC), in endotoxemia. In mice, depression of Ca(2+)-ATPase activity in the liver plasma membrane may contribute to the membrane damage caused by endotoxin, and the increase of [Ca(2+)](i) in the liver cytoplasm may partially explain the oxidative stress that occurs in endotoxemia. It seems that endotoxin-induced free radical formation is regulated by Ca(2+) mobilization. Moreover, we have suggested that the oxidative stress caused by endotoxin may be due, at least in part, to the changes in endogenous zinc or selenium regulation during endotoxemia. Interestingly, the extent of TNF-alpha-induced oxidative stress may be the result of a synergism between TNF-alpha and gut-derived endotoxin. It is likely that bacterial or endotoxin translocation plays a significant role in TNF-alpha-induced septic shock. On the other hand, although nitric oxide (NO) has been implicated in the pathogenesis of vascular hyporesponsiveness and hypotension in septic shock in our experimental model, it is unlikely that NO plays a significant role in liver injury caused by free radical generation in endotoxemia.

Endothelial response to stress from exogenous Zn2+resembles that of NO-mediated nitrosative stress, and is protected by MT-1 overexpression

While nitric oxide (NO)-mediated biological interactions have been intensively studied, the underlying mechanisms of nitrosative stress with resulting pathology remain unclear. Previous studies have demonstrated that NO exposure increases free zinc ions (Zn2+) within cells. However, the resulting effects on endothelial cell survival have not been adequately resolved. Thus the purpose of this study was to investigate the role of altered zinc homeostasis on endothelial cell survival. Initially, we confirmed the previously observed significant increase in free Zn2+with a subsequent induction of apoptosis in our pulmonary artery endothelial cells (PAECs) exposed to the NO donor N-[2-aminoethyl]- N-[2-hydroxy-2-nitrosohydrazino]-1,2-ethylenediamine. However, NO has many effects upon cell function and we wanted to specifically evaluate the effects mediated by zinc. To accomplish this we utilized the direct addition of zinc chloride (ZnCl2) to PAEC. We observed that Zn2+-exposed PAECs exhibited a dose-dependent increase in superoxide (O2−·) generation that was localized to the mitochondria. Furthermore, we found Zn2+-exposed PAECs exhibited a significant reduction in mitochondrial membrane potential, loss of cardiolipin from the inner leaflet, caspase activation, and significant increases in TdT-mediated dUTP nick end labeling-positive cells. Furthermore, using an adenoviral construct for the overexpression of the Zn2+-binding protein, metallothionein-1 (MT-1), we found either MT-1 overexpression or coincubation with a Zn2+-selective chelator, N, N,N′, N′-tetrakis(2-pyridylmethyl)ethylene-diamide, in PAECs significantly protected the mitochondria from both NO and Zn2+-mediated disruption and induction of apoptosis and cell death. In summary, our results indicate that a loss of Zn2+homeostasis produces mitochondrial dysfunction, increased oxidative stress, and apoptotic cell death. We propose that regulation of Zn2+levels may represent a potential therapeutic target for disease associated with both nitrosative and oxidative stress.

Marginal zinc deficiency increased the susceptibility to acute lipopolysaccharide-induced liver injury in rats

Lipopolysaccharide (LPS) triggers a global activation of inflammatory responses leading to liver injury in humans. Zinc pretreatment has been shown to prevent LPS-induced hepatic necrosis. In North America, suboptimal zinc status is more common than once realized. However, the effect of inadequate zinc nutrition on the host's susceptibility to LPS-induced liver injury is not known. The objective of this study was to determine whether marginal zinc deficiency would render rats more susceptible to LPS-induced liver injury. Weanling Sprague-Dawley rats were assigned to one of three dietary treatment groups: marginally low zinc ad libitum (Z3; 3 mg zinc/kg diet), adequate zinc ad libitum (Z30; 30 mg zinc/kg diet), or adequate zinc pair-fed (Z30P) group. After 6 weeks, each dietary treatment group was further divided into LPS-control (saline) groups (C-Z3, C-Z30P, C-Z30) and LPS-treatment (1 mg/kg body weight, intraperitoneal, 8 hrs) groups (LPS-Z3, LPS-Z30P, LPS-Z30). LPS reduced the serum zinc concentration and increased the liver zinc concentration regardless of dietary zinc intake. Serum alanine aminotransferase level was higher in the LPS-Z3 rats than in the LPS-Z30P and LPS-Z30 rats. LPS also induced hepatocyte necrosis and neutrophil infiltration into the liver sinusoids. This LPS-induced liver damage was more severe in the LPS-Z3 rats than in the LPS-Z30P and LPS-Z30 rats. Together these findings have demonstrated that marginal zinc deficiency increased the susceptibility to LPS-induced liver injury in rats. These results indicate that patients with sepsis who have suboptimal zinc nutrition status may be at higher risk of developing greater liver damage.

Missing effects of zinc in a porcine model of recurrent endotoxemia

Background

Chronic human sepsis often is characterised by the compensatory anti-inflammatory response syndrome (CARS). During CARS, anti-inflammatory cytokines depress the inflammatory response leading to secondary and opportunistic infections. Proved in vitro as well as in vivo, zinc's pro-inflammatory effect might overcome this depression.

Methods

We used the model of porcine LPS-induced endotoxemia established by Klosterhalfen et al. 10 pigs were divided into two groups (n = 5). Endotoxemia was induced by recurrent intravenous LPS-application (1.0 μg/kg E. coli WO 111:B4) at hours 0, 5, and 12. At hour 10, each group received an intravenous treatment (group I = saline, group II = 5.0 mg/kg elementary zinc). Monitoring included hemodynamics, blood gas analysis, and the thermal dilution technique for the measurement of extravascular lung water and intrapulmonary shunt. Plasma concentrations of IL-6 and TNF-alpha were measured by ELISA. Morphology included weight of the lungs, width of the alveolar septae, and rate of paracentral liver necrosis.

Results

Zinc's application only trended to partly improve the pulmonary function. Compared to saline, significant differences were very rare. IL-6 and TNF-alpha were predominately measured higher in the zinc group. Again, significance was only reached sporadically. Hemodynamics and morphology revealed no significant differences at all.

Conclusion

The application of zinc in this model of recurrent endotoxemia is feasible and without harmful effects. However, a protection or restoration of clinical relevance is not evident in our setting. The pulmonary function just trends to improve, cytokine liberation is only partly activated, hemodynamics and morphology were not influenced. Further pre-clinical studies have to define zinc's role as a therapeutic tool during CARS.