Roles of Zinc in the Pathophysiology of Acute Diarrhea

Abstract

Zinc has caught wide scientific attention for the conceptual promise it has to offer for prevention, control and treatment of acute diarrhea. This review focuses on the mechanisms by which zinc might contribute to the pathogenesis of acute diarrhea and the degree of success achieved in diarrhea control and treatment by zinc supplementation. Animal and in vitro studies have continued to fascinate the scientific fraternity and form a solid basis for the potential use of zinc supplementation against diarrhea. However, emerging evidence in terms of controlled studies in humans beckons a more complete understanding of the mechanistic basis for zinc supplementation. Current evidence indicates that studies specifically addressing the variability in response to zinc supplementation need to be undertaken to better comprehend these mechanisms.

The zinc sensing receptor, ZnR/GPR39, triggers metabotropic calcium signalling in colonocytes and regulates occludin recovery in experimental colitis

“…Zinc enhances functional integrity of the digestive system [6][7][8]. Zinc deficiency is frequently found in IBD patients and linked to attenuated renewal of the epithelium and the onset severe diarrhoea [9][10][11].…”

Zinc supplementation for treating diarrhea in children: a systematic review and meta-analysis

“…Zinc's mechanism of action for the treatment of diarrhea caused by different pathogens is not fully understood, but studies conducted in this field reveal that zinc plays different roles in the intestine, such as regulation of intestinal fluid transport and mucosal integrity and modulation of expression of genes encoding important zinc-dependent enzymes like cytokines, which play important roles in the immune system and in modulation of oxidative stress (49,50). These different roles might explain the positive effect of zinc intake during acute diarrhea in children.…”

“…Five studies evaluated only malnourished children or included an evaluation of this subgroup (31,35,38,41,49). Three of these studies (29,36,37) included children with zinc deficiency, who are labeled as malnourished children in this review.…”

Diarrea y micronutrientes

“…Los países con alto riesgo de deficiencias nutricionales tienen una mayor morbilidad por diarrea (4). La suplementación con zinc en el tratamiento de diarreas esta recomendada desde el año 2004 (7); sin embargo, múltiples ensayos clínicos que han traído nuevas interrogantes han sido publicados luego de esta recomendación (8,9). En el caso de la vitamina A, la suplementación con este micronutriente en niños entre los 6 y 59 meses existe hace mucho tiempo.…”

“…El zinc interfiere en la patogénesis de la diarrea a través de muchos mecanismos. Dificulta la invasión de la mucosa intestinal de varias maneras: Promueve la proliferación de los enterocitos y favorece la integridad de la mucosa (2,8,11); estimula la función inmune innata y adaptativa (8,11) y; favorece la respuesta Th1 por los linfocitos T de ayuda, la que es necesaria para combatir infecciones por bacterias invasivas (2,8,11).…”