Zinc gluconate supplementation impacts the clinical improvement in patients with ulcerative colitis

Abstract

Ulcerative colitis is an inflammatory bowel disease that affects the mucous membrane of the colon. The pathogenesis is not clear, but there is evidence of a complex interaction between genetic, environmental, and immunological factors. In this regard, we highlight the role of zinc in the immune system and probable control of the disease. This study evaluated the effect of zinc supplementation on the inflammatory response in patients with ulcerative colitis. A blind interventional study involving 41 patients of both sexes, who underwent either zinc gluconate supplementation (n = 23), or treatment with a placebo (corn starch) (n = 18). Patients were evaluated for dietary zinc intake, plasma and erythrocyte zinc concentrations, and serum levels of Th1/Th2/Th17 type cytokines at baseline (T0) and 30 (T1) and 60 (T2) days after intervention. Patients in the zinc supplementation group had a lower probability of having an adequate zinc intake than placebo. In this same group, there was a significant difference between plasma zinc concentrations (T1 in relation to T0, T2 in relation to T1, and T2 in relation to T0) and erythrocyte zinc (T1 in relation to T0 and T2 in relation to T1). Zinc supplementation resulted in significant changes in the concentrations of IL-2 and IL-10 without differences in the other interleukins. Zinc gluconate intervention in patients with ulcerative colitis improves the nutritional status of this mineral in these patients and positively influences their clinical outcome, reinforcing the role of zinc as an important dietary component in disease control.

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Acknowledgements

The authors would like to thank the University Hospital of the Federal University of Piauí for access to its services and for sample collection; the Experimental Nutrition Laboratory (LANEX) for sample preparation, the Interinstitutional Nucleus of New Technologies Generation (GERATEC) group from the State University of Piauí for performing the Zn analysis; the Laboratory of Leishmaniasis (LABLEISH) for performing the citokynes analyses; the Coordination for the Improvement of Higher Education Personnel (CAPES) for granting a scholarship during the entire period of the Master’s degree; the Foundation for Research Support of the State of Piauí-FAPEPI, for financial support and Moita Neto JM for collaborating in the statistical analysis.

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MSBM and NRMS have collected the blood samples, analyzed the biochemical parameters, analysis and interpretation of the study results, have provided the statistical analyzes of the data and have participated to the redaction and the review of the manuscript; SELB, TMCS and ECV have participated to the analysis of zinc parameters, redaction and the review of the manuscript; FAP, DCB and ASS have participated to the analysis of the cytokines, redaction and the review of the paper; JMLP have made the clinical evaluation of the patients; DNM participated in the redaction and the review of the paper; NNN had guided and supervised all the development of the study, participated in the redaction and the review of the manuscript.

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Correspondence to Nadir do Nascimento Nogueira.

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de Moura, M.S.B., Soares, N.R.M., Barros, S.É.d. et al. Zinc gluconate supplementation impacts the clinical improvement in patients with ulcerative colitis. Biometals 33, 15–27 (2020). https://doi.org/10.1007/s10534-019-00225-0

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Keywords

  • Ulcerative colitis
  • Zinc
  • Inflammation
  • Cytokines
  • Biomarkers