Effects of Zinc Sulfate Supplementation on Cell-Mediated Immune Response in Head and Neck Cancer Patients Treated with Radiation Therapy

Abstract

Zinc deficiency is an important factor that impairs cellular immunity and contributes to low T lymphocyte counts in head and neck cancers. Persistent T lymphopenia is clinically relevant in terms of tumor persistence and/or recurrence. The primary objective was to evaluate the impact of zinc sulfate supplementation on the absolute numbers of circulating T lymphocytes and T lymphocyte subpopulations. The secondary objectives were to evaluate overall survival, progression-free survival, and the adverse events of zinc sulfate. Seventy-two head and neck cancer patients were enrolled in a randomized, double-blind, placebo-controlled trial. Zinc sulfate 50 mg in 10 cc and an identically appearing placebo were self-administered 3 times daily at meal times. Blood samples were obtained for complete blood count, total T lymphocytes and T lymphocyte subpopulations before radiation therapy as baselines, at the fifth week during radiation therapy, and at the first month after completion of radiation therapy. The baseline characteristics of patients, tumors, and treatments and the baseline lymphocyte parameters were not significantly different between the 2 groups. Zinc sulfate supplementation during head and neck radiation therapy showed no increase in absolute numbers of circulating T lymphocytes, T lymphocyte subpopulations, or survival with acceptable side effects.

A Meta-Analysis on the Efficacy of Zinc in Oral Mucositis during Cancer Chemo and/or Radiotherapy—An Evidence-Based Approach

“…The incidence of xerostomia and pain decreased in zinc supplementation group more than in the placebo group in one of the studies (7,17). However, the quality of life did not undergo a significant change to that of the controls with the usage of zinc.…”

“…Notably, a study by Sangthawan et al showed that the zinc had no effect on the number or the survival of circulating T lymphocytes (17). Areca nut chewing with increased copper content may have had a significant role when such lesions were treated with zinc therapy, because of potential interaction of zinc with mucosal metaallothionein, interfering with copper metabolism (6).…”

“…Three articles were excluded from the study for the following reasons. A study by Sangthawan et al was excluded as it had the primary objective evaluating the impact of zinc sulfate supplementation on the absolute numbers of circulating T lymphocytes and T lymphocyte subpopulations in cancer patients but not on oral mucositis (17). The other two articles had assessed the efficacy of oral polaprezinc on oral mucositis during cancer chemo/radiotherapy.…”

Antitumoral Properties of the Nutritional Supplement Ocoxin Oral Solution: A Comprehensive Review

“…In fact, its antitumoral effect seems to be mediated by anti-inflammatory, antioxidant, and immunostimulatory actions [62] (Figure 1). Furthermore, in head and neck cancers, a zinc deficit mediates cellular immunity impairment, contributing to a decrease in T lymphocyte numbers and such effect can be reverted by zinc sulfate supplementation [63].…”

The crosstalk between trace elements with DNA damage response, repair, and oxidative stress in cancer

“…19,20,60 Interestingly, Zn deficiency has been reported in a large percentage of patients with head and neck, breast, and gastrointestinal (GI) system cancers. [60][61][62] Some studies have investigated the chemopreventive effects of Zn on several cancers such as gut, liver, and lung cancer. 31,63,64 In addition, it has been found that supplementation with combinations of retinol and Zn does not decrease primary liver and lung cancer mortality.…”