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Shahrokhi Nejad S, Golzari Z, Zangiabadian M, Salehi Amniyeh Khozani AA, Ebrahimi R, Nejadghaderi SA, Aletaha A. The association between zinc and prostate cancer development: A systematic review and meta-analysis. PLoS One 2024; 19:e0299398. [PMID: 38507438 PMCID: PMC10954196 DOI: 10.1371/journal.pone.0299398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/09/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Prostate cancer is affecting males globally, with several complications. Zinc can play roles in cancers. We aimed to clarify the association between zinc levels or intake with prostate cancer development. METHODS We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science until May 1, 2023. We included case-controls and cross-sectionals that measured zinc level and/or intake in patients with prostate cancer or cohorts that evaluated the association between zinc and prostate cancer development. Studies that did not have a healthy control group were excluded. Joanna Briggs Institute was used for quality assessment. Publication bias was evaluated using Egger's and Begg's tests and funnel plot. RESULTS Overall, 52 studies (n = 44 case controls, n = 4 cohorts, and n = 4 cross sectionals) with a total number of 163909 participants were included. Serum (standardized mean difference (SMD): -1.11; 95% confidence interval (CI): -1.67, -0.56), hair (SMD: -1.31; 95% CI: -2.19, -0.44), and prostatic fluid or tissue zinc levels (SMD: -3.70; 95% CI: -4.90, -2.49) were significantly lower in prostate cancer patients. There were no significant differences in nail zinc level and zinc intake between those with prostate cancer and healthy controls. There was no publication bias except for serum and hair zinc levels based on Begg's and Egger's tests, respectively. The mean risk of bias scores were 4.61 in case-controls, eight in cohorts, and seven in cross-sectionals. CONCLUSIONS Overall, high zinc levels might have a protective role in prostate cancer, which can be used as a therapeutic or preventive intervention. Future large-scale studies are needed to confirm the association.
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Affiliation(s)
| | - Zahra Golzari
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Moein Zangiabadian
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Rasoul Ebrahimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Azadeh Aletaha
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Wu M, Zhang Y, Zhang X, Lin X, Ding Q, Li P. Combined measurement of serum zinc with PSA ameliorates prostate cancer screening efficiency via support vector machine algorithms. Heliyon 2024; 10:e24292. [PMID: 38293360 PMCID: PMC10824771 DOI: 10.1016/j.heliyon.2024.e24292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/01/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Background Early screening of prostate cancer (PCa) is pivotal but challenging in the clinical scenario due to the phenomena of false positivity or false negativity of some serological evaluations, e.g. PSA testing. Decline of serum Zn2+ levels in PCa patients reportedly plays a crucial role in early screening of PCa. Accordingly, we combined 4 indices comprising the serum levels of total PSA (tPSA), free PSA (fPSA), Zn2+ and demographic information (especially age) in order to ameliorate the efficacies of PCa screening with support vector machine (SVM) algorithms. Methods A total of 858 male patients with prostate disorders and 345 healthy male controls were enrolled. Patients' data included 4 variables and serum Zn2+ was quantified via a self-invented Zn2+ responsive AIE-based fluorescent probe as previously published. tPSA and fPSA were routinely determined by a chemiluminescent method. Mathematical simulations were conducted to establish a SVM model for the combined diagnostics with the four variables. Moreover, ROC and its characteristic AUC were also employed to evaluate the classification efficacy of the model. Sigmoid function was utilized to estimate corresponding probabilities of classifying the clinical subjects as per 5 grades, which were incorporated into our established prostate index (PI) stratification system. Results In SVM model, the mean AUC of the ROC with the quartet of variables was approximately 84% for PCa diagnosis, whereas the mean AUC of the ROCs with tPSA, fPSA, [Zn2+] or age alone was 64%, 62%, 55% and 59%, respectively. We further established an integrated prostate index (PI) stratification system with 5 grades and a software package to support clinicians in predicting PCa, with the accuracy of our risk stratification system being 83.3%, 91.6% and 83.3% in predicting normal, benign and PCa cases in corresponding groups. Follow-up findings especially MRI results and PI-RADS scores supported the reliability of this stratification platform as well. Conclusion Findings from our present study demonstrated that index combination via SVM algorithms may well facilitate clinicians in early differential screening of PCa. Meanwhile, our established PI stratification system based on SVM model and Sigmoid function provided substantial accuracy in preclinical risk prediction of developing prostate cancer.
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Affiliation(s)
- Muyu Wu
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yucan Zhang
- School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoqun Zhang
- School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaozhu Lin
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qiaoqiao Ding
- School of Mathematical Sciences, Shanghai Jiao Tong University, Shanghai, China
| | - Peiyong Li
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Yin JL, Tao T, Wen ZY, Wang R, Sun MH, Gao C, Chang YJ, Yan S, Qin X, Zhao YH, Wang L, Gao S. Association between pre-diagnostic dietary copper, zinc, and copper-to-zinc ratio and severity of ovarian cancer. Front Nutr 2022; 9:1003675. [PMID: 36458167 PMCID: PMC9705584 DOI: 10.3389/fnut.2022.1003675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/19/2022] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The impact of dietary trace elements intake on ovarian cancer (OC) severity is unknown. OBJECTIVE We firstly explore the relationship between dietary copper (Cu), zinc (Zn), and copper-to-zinc (Cu/Zn) ratio and severity of OC. METHODS This cross-sectional study included 701 women from the OC follow-up study between 2015 and 2020. Dietary information was collected by a validated food frequency questionnaire (FFQ). The severity information of OC including age at diagnosis, histological type, International Federation of Gynecology and Obstetrics (FIGO) stage, and histopathologic grade was ascertained from medical records. Logistic regression model was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of aforementioned associations. RESULTS Among 701 participants, the number of patients age at diagnosis older than 50 were 443 (63.2%). The number of patients diagnosed as serous, III-IV stage, and poorly differentiation OC were 477 (68.05%), 336 (47.93%), and 597 (85.16%), respectively. In addition, compared with the lowest tertile intake, higher possibility of non-serous OC was associated with the pre-diagnosis dietary Cu (OR = 2.39, 95% CI = 1.28-4.47, p trend < 0.05) and Cu/Zn ratio (OR = 2.06, 95% CI = 1.26-3.39, P trend < 0.05) in the highest tertile intake. The risk of poorly differentiation OC at diagnosis was significant inversely related to dietary Cu intake (OR = 0.40, 95% CI = 0.18-0.88, P trend < 0.05). Besides, the results of subgroup analyses were consistent with the main findings but not all of them showed statistical significance. CONCLUSION Pre-diagnostic dietary Cu and Cu/Zn ratio were contributed to reducing the severity of OC at diagnosis, especially for the risk of serous OC and poorly differentiation OC.
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Affiliation(s)
- Jia-Li Yin
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tao Tao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhao-Yan Wen
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ran Wang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming-Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Jiao Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lan Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Song Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang, China
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Lossow K, Schwarz M, Kipp AP. Are trace element concentrations suitable biomarkers for the diagnosis of cancer? Redox Biol 2021; 42:101900. [PMID: 33642247 PMCID: PMC8113050 DOI: 10.1016/j.redox.2021.101900] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 12/24/2022] Open
Abstract
Despite advances in cancer research, cancer is still one of the leading causes of death worldwide. An early diagnosis substantially increases the survival rate and treatment success. Thus, it is important to establish biomarkers which could reliably identify cancer patients. As cancer is associated with changes in the systemic trace element status and distribution, serum concentrations of selenium, iron, copper, and zinc could contribute to an early diagnosis. To test this hypothesis, case control studies measuring trace elements in cancer patients vs. matched controls were selected and discussed focusing on lung, prostate, breast, and colorectal cancer. Overall, cancer patients had elevated serum copper and diminished zinc levels, while selenium and iron did not show consistent changes for all four cancer types. Within the tumor tissue, mainly copper and selenium are accumulating. Whether these concentrations also predict the survival probability of cancer patients needs to be further investigated.
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Affiliation(s)
- Kristina Lossow
- Department of Molecular Nutritional Physiology, Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, 07743, Germany; TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena-Wuppertal, Germany
| | - Maria Schwarz
- Department of Molecular Nutritional Physiology, Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, 07743, Germany; TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena-Wuppertal, Germany
| | - Anna P Kipp
- Department of Molecular Nutritional Physiology, Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, 07743, Germany; TraceAge-DFG Research Unit on Interactions of Essential Trace Elements in Healthy and Diseased Elderly, Potsdam-Berlin-Jena-Wuppertal, Germany.
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Singh CK, Chhabra G, Patel A, Chang H, Ahmad N. Dietary Phytochemicals in Zinc Homeostasis: A Strategy for Prostate Cancer Management. Nutrients 2021; 13:nu13061867. [PMID: 34070833 PMCID: PMC8226978 DOI: 10.3390/nu13061867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 01/30/2023] Open
Abstract
Studies have suggested an important role of the trace element zinc (Zn) in prostate biology and functions. Zn has been shown to exist in very high concentrations in the healthy prostate and is important for several prostatic functions. In prostate cancer (PCa), Zn levels are significantly decreased and inversely correlated with disease progression. Ideally, restoration of adequate Zn levels in premalignant/malignant prostate cells could abort prostate malignancy. However, studies have shown that Zn supplementation is not an efficient way to significantly increase Zn concentrations in PCa. Based on a limited number of investigations, the reason for the lower levels of Zn in PCa is believed to be the dysregulation of Zn transporters (especially ZIP and ZnT family of proteins), metallothioneins (for storing and releasing Zn), and their regulators (e.g., Zn finger transcription factor RREB1). Interestingly, the level of Zn in cells has been shown to be modulated by naturally occurring dietary phytochemicals. In this review, we discussed the effect of selected phytochemicals (quercetin, resveratrol, epigallocatechin-3-gallate and curcumin) on Zn functioning and proposes that Zn in combination with specific dietary phytochemicals may lead to enhanced Zn bioaccumulation in the prostate, and therefore, may inhibit PCa.
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Affiliation(s)
- Chandra K. Singh
- Department of Dermatology, University of Wisconsin, Madison, WI 53705, USA; (C.K.S.); (G.C.); (A.P.); (H.C.)
| | - Gagan Chhabra
- Department of Dermatology, University of Wisconsin, Madison, WI 53705, USA; (C.K.S.); (G.C.); (A.P.); (H.C.)
| | - Arth Patel
- Department of Dermatology, University of Wisconsin, Madison, WI 53705, USA; (C.K.S.); (G.C.); (A.P.); (H.C.)
| | - Hao Chang
- Department of Dermatology, University of Wisconsin, Madison, WI 53705, USA; (C.K.S.); (G.C.); (A.P.); (H.C.)
| | - Nihal Ahmad
- Department of Dermatology, University of Wisconsin, Madison, WI 53705, USA; (C.K.S.); (G.C.); (A.P.); (H.C.)
- William S. Middleton VA Medical Center, Madison, WI 53705, USA
- Correspondence: ; Tel.: +1-(608)-263-5359
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6
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Daragó A, Klimczak M, Stragierowicz J, Jobczyk M, Kilanowicz A. Age-Related Changes in Zinc, Copper and Selenium Levels in the Human Prostate. Nutrients 2021; 13:nu13051403. [PMID: 33919444 PMCID: PMC8143557 DOI: 10.3390/nu13051403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/12/2023] Open
Abstract
Pathophysiological changes in the prostate gland-benign prostatic hyperplasia (BPH) and prostatic adenocarcinoma (PCa)-are closely related to the age of men. In the prostate gland, zinc is of particular importance for its proper functioning, especially with regard to the effects of hormonal disorders. The aim of this study was to evaluate zinc, copper and selenium concentrations in different parts of the prostate gland in relation to age and the nature of pathological changes. Zinc and copper were determined by the AAS method and selenium by the spectrofluorometric method. The concentration of zinc in the central part of the prostate increases with age, and in patients over 36 years it is twice as high as in the peripheral part, where no increase in the level of this element was observed with the age of patients. The above data confirm a possible influence of zinc on the formation of PCa (located mostly in the peripheral part of the prostate, with low levels of zinc) and BPH in the central part where the levels of this element are the highest. The results apparently confirm the disturbed homeostasis of zinc and other essential elements in the etiology of BPH and PCa.
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Affiliation(s)
- Adam Daragó
- Department of Toxicology, Medical University of Lodz, 90-151 Lodz, Poland; (M.K.); (J.S.); (A.K.)
- Correspondence:
| | - Michał Klimczak
- Department of Toxicology, Medical University of Lodz, 90-151 Lodz, Poland; (M.K.); (J.S.); (A.K.)
| | - Joanna Stragierowicz
- Department of Toxicology, Medical University of Lodz, 90-151 Lodz, Poland; (M.K.); (J.S.); (A.K.)
| | - Mateusz Jobczyk
- Department of Urology, The Hospital Ministry of the Interior and Administration, 91-425 Lodz, Poland;
| | - Anna Kilanowicz
- Department of Toxicology, Medical University of Lodz, 90-151 Lodz, Poland; (M.K.); (J.S.); (A.K.)
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7
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Sauer AK, Vela H, Vela G, Stark P, Barrera-Juarez E, Grabrucker AM. Zinc Deficiency in Men Over 50 and Its Implications in Prostate Disorders. Front Oncol 2020; 10:1293. [PMID: 32850402 PMCID: PMC7424038 DOI: 10.3389/fonc.2020.01293] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/22/2020] [Indexed: 02/06/2023] Open
Abstract
Research has been consistently showing the role of zinc (Zn) in prostate function. In this article, we review the current literature on the anatomy and main functions of the prostate, highlighting the role of zinc. In particular, we will review the etiology of benign prostate enlargement (BPH), its prevalence in men over 50, the likelihood of BPH becoming prostate cancer (PCa), and explain the relationship of zinc and apoptosis in the prostate cells and the implications for BPH and PCa. We present a model that explains how endogenous factors provoke excretion of zinc or limit zinc absorption, and how exogenous factors like nutrition and drugs regularly used in men over 50 can significantly decrease zinc status and thereby increase the risk of BPH. Finally, we explain how Zn amino acid (AA) complexes may be capable of avoiding antagonists and inhibitors of zinc absorption, thereby increasing the bioavailability of zinc for the necessary biological processes in the prostate.
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Affiliation(s)
- Ann Katrin Sauer
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.,Bernal Institute, University of Limerick, Limerick, Ireland.,Health Research Institute (HRI), University of Limerick, Limerick, Ireland
| | - Hector Vela
- Vela Staines y Asociados SA de CV, Monterrey, Mexico
| | - Guillermo Vela
- Zinpro Corporation, Eden Prairie, MN, United States.,Autismo ABP, Monterrey, Mexico
| | - Peter Stark
- Zinpro Corporation, Eden Prairie, MN, United States
| | | | - Andreas M Grabrucker
- Department of Biological Sciences, University of Limerick, Limerick, Ireland.,Bernal Institute, University of Limerick, Limerick, Ireland.,Health Research Institute (HRI), University of Limerick, Limerick, Ireland
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Advances of Zinc Signaling Studies in Prostate Cancer. Int J Mol Sci 2020; 21:ijms21020667. [PMID: 31963946 PMCID: PMC7014440 DOI: 10.3390/ijms21020667] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/16/2022] Open
Abstract
Prostate cancer (PCa) is one of the most common cancers and the second leading cause of cancer-related death among men worldwide. Despite progresses in early diagnosis and therapeutic strategies, prognosis for patients with advanced PCa remains poor. Noteworthily, a unique feature of healthy prostate is its highest level of zinc content among all soft tissues in the human body, which dramatically decreases during prostate tumorigenesis. To date, several reviews have suggested antitumor activities of zinc and its potential as a therapeutic strategy of PCa. However, an overview about the role of zinc and its signaling in PCa is needed. Here, we review literature related to the content, biological function, compounds and clinical application of zinc in PCa. We first summarize zinc content in prostate tissue and sera of PCa patients with their clinical relevance. We then elaborate biological functions of zinc signaling in PCa on three main aspects, including cell proliferation, death and tumor metastasis. Finally, we discuss clinical applications of zinc-containing compounds and proteins involved in PCa signaling pathways. Based on currently available studies, we conclude that zinc plays a tumor suppressive role and can serve as a biomarker in PCa diagnosis and therapies.
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