Zinc pharmacokinetic parameters in the determination of body zinc status in children

Vale, Sancha Helena de Lima; Leite, Lúcia Dantas; Alves, Camila Xavier; Dantas, Márcia Marília Gomes; Costa, João Batista Sousa; Marchini, Júlio Sérgio; França, Mardone Cavalcante; Brandão-Neto, José

doi:10.1038/ejcn.2013.250

Cited by 7 publications

(4 citation statements)

References 19 publications

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“… Delivery of zinc to the target tissue as informed by the volume of distribution, by plasma protein binding and, if needed, tissue biopsy assays. Zinc stable isotope studies have provided limited data [ 162 , 163 ] especially from EZP but more research in this area is warranted. Proof of concept demonstrating relationship of a clinical response to a pharmacodynamics or pharmacokinetic marker.…”

Section: Discussionmentioning

confidence: 99%

The Potential for Zinc Stable Isotope Techniques and Modelling to Determine Optimal Zinc Supplementation

et al. 2015

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It is well recognised that zinc deficiency is a major global public health issue, particularly in young children in low-income countries with diarrhoea and environmental enteropathy. Zinc supplementation is regarded as a powerful tool to correct zinc deficiency as well as to treat a variety of physiologic and pathologic conditions. However, the dose and frequency of its use as well as the choice of zinc salt are not clearly defined regardless of whether it is used to treat a disease or correct a nutritional deficiency. We discuss the application of zinc stable isotope tracer techniques to assess zinc physiology, metabolism and homeostasis and how these can address knowledge gaps in zinc supplementation pharmacokinetics. This may help to resolve optimal dose, frequency, length of administration, timing of delivery to food intake and choice of zinc compound. It appears that long-term preventive supplementation can be administered much less frequently than daily but more research needs to be undertaken to better understand how best to intervene with zinc in children at risk of zinc deficiency. Stable isotope techniques, linked with saturation response and compartmental modelling, also have the potential to assist in the continued search for simple markers of zinc status in health, malnutrition and disease.

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Section: Discussionmentioning

confidence: 99%

The Potential for Zinc Stable Isotope Techniques and Modelling to Determine Optimal Zinc Supplementation

et al. 2015

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“…Zinc is critical for cell proliferation, cell cycle regulation, differentiation and apoptosis. It plays an essential role for DNA and RNA synthesis, protein synthesis and a functional role in regulating protein–DNA interactions of zinc‐finger proteins, including many transcription factors and steroid hormone receptor 7,8 . Numerous studies have shown a correlation between zinc deficiency and critical illness 9,10 …”

Section: Introductionmentioning

confidence: 99%

“…including many transcription factors and steroid hormone receptor. 7,8 Numerous studies have shown a correlation between zinc deficiency and critical illness. 9,10 Numerous studies have demonstrated zinc's ability to inhibit viral replication.…”

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confidence: 99%

Zinc supplementation as an adjunct therapy for COVID‐19: Challenges and opportunities

Chinni

El-Khoury

Perera

et al. 2021

Brit J Clinical Pharma

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An outbreak of a novel coronavirus (COVID-19 or 2019-CoV) infection has posed significant threats to international health and the economy. Patients with COVID-19 are at risk of cytokine storm, acute respiratory distress syndrome (ARDS), reduced blood oxygenation, mechanical ventilation, and a high death rate. Although recent studies have shown remdesivir and dexamethasone as treatment options, there is an urgent need to find a treatment to inhibit virus replication and to control the progression of the disease. Essential biometal zinc has generated a lot of excitement as one of the promising candidates to reduce the severity of COVID-19 infection. Several published observations outlined in the review are the reasons why there is a global enthusiasm that zinc therapy could be a possible therapeutic option. However, the biggest challenge in realising the therapeutic value of zinc is lack of optimal treatment modalities such as dose, duration of zinc supplementation and the mode of delivery.In this review, we discuss the regulatory mechanism that hinges upon the bioavailability of zinc. Finally, we propose that intravenous zinc could circumvent the confounding factors affecting the bioavailability of zinc and allow zinc to achieve its therapeutic potential. If successful, due to advantages such as lack of toxicity, low cost and ease of availability, intravenous zinc could be rapidly implemented clinically.

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“…Parenterally administered Zn, given as zinc chloride or zinc sulphate, is cleared rapidly (in hours) from the plasma with 400-500 mg turnover daily between plasma and tissues; <0•1 % of body Zn remains in the bloodstream (12) . The clearance rate appears to be determined by Zn status (13) with Zn deficiency causing an increase in turnover rate but a decrease in the amount of each turnover, which would then be expected to reduce urinary losses (14) . A rapid IV dose of 8 mg Zn (described as an 'overload dose') caused a 20 % increase in 24-h urine Zn in one study (15) .…”

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confidence: 99%

Does infusion time affect the retention of parenteral trace elements?

Ferrie

2019

Br J Nutr

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When readymade parenteral nutrition in multi-chamber bags is supplied without vitamins and minerals, these have to be added or given separately. Separate rapid infusion has logistical advantages but has been claimed to saturate tissue mechanisms, potentially increasing urine micronutrient losses. The present study compared urinary losses after fast (1 h) v. slow (10 h) trace elements infusion. The study enrolled thirty-nine consecutive patients who were starting parenteral nutrition postoperatively. One day’s dose of a complete intravenous micronutrient product was infused over 1 h and over 10 h, in random order, with a washout day after each infusion day. Urinary Zn, Mn, Se, Cr, Cu and Fe losses were measured by 24-h urine collection, recorded for each infusion day and subsequent washout day. For Zn, a dose of 100 μmol was given, and total urinary loss over the next 2 d was mean 40·6 (sd 23·8) μmol after the fast (1 h) infusion v. 33·4 (sd 25·4) μmol after the slow (10 h) infusion, that is, 7 % more of the 1-d dose was lost after fast infusion (P = 0·01). For Mn, after a dose of 1000 nmol, losses were 9·8 (sd 23·9) nmol after the fast infusion v. 22·1 (sd 47·2) nmol after the slow infusion, that is, 1 % more of the 1-d dose was lost after slow infusion (P = 0·04). There were no other significant differences: after 1 μmol Se, the losses were 1·5 (sd 0·6) μmol fast v. 1·3 (sd 0·5) μmol slow; after 200 nmol Cr, 257 (sd 92) μmol fast v. 246 (sd 107) nmol slow; after 8 μmol Cu, 1·6 (sd 1·4) μmol fast v. 1·5 (sd 1·3) μmol slow; and after 20 μmol Fe, 0·6 (sd 1·1) μmol fast v. 0·8 (sd 1·6) μmol slow (P > 0·05 for all). Overall, trace element retention appears to be minimally affected by infusion time.

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Zinc pharmacokinetic parameters in the determination of body zinc status in children

Abstract: All three of the formulas used are suitable for studying zinc kinetics; however, CZn-Formula B is particularly effective at detecting small changes in body zinc status in healthy children.

Cited by 7 publications

References 19 publications

The Potential for Zinc Stable Isotope Techniques and Modelling to Determine Optimal Zinc Supplementation

The Potential for Zinc Stable Isotope Techniques and Modelling to Determine Optimal Zinc Supplementation

Zinc supplementation as an adjunct therapy for COVID‐19: Challenges and opportunities

Does infusion time affect the retention of parenteral trace elements?

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