Role of Zinc in the Development/Progression of Alcoholic Liver Disease

  • Craig McClainEmail author
  • Vatsalya Vatsalya
  • Matthew Cave
Liver (J Bajaj, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Liver

Opinion statement

Many variables, aside from the amount and duration of alcohol consumption, play a role in the development and progression of alcoholic liver disease (ALD). One critical factor that can be modified is diet/nutrition. We have made major recent advances in our understanding of the interactions of nutrition and ALD. In this article, we review advances made in zinc metabolism/therapy for ALD. There is major zinc dyshomeostasis with ALD which is mediated, in part, by poor intake and absorption, increased excretion, and altered zinc transporters, especially ZIP14. Zinc deficiency plays an etiologic role in multiple mechanisms of ALD, ranging from intestinal barrier dysfunction to hepatocyte apoptosis. Zinc supplementation is highly effective at correcting these ALD mechanisms and preventing/treating experimental ALD. There is no Food and Drug Administration (FDA) approved therapy for any stage of ALD. Because animal and human data suggest that zinc deficiency occurs early in the course of ALD, we treat most ALD patients with daily oral zinc supplementation (220 mg zinc sulfate which contains 50 mg elemental zinc).


Zinc deficiency Alcoholic liver disease Liver injury Malnutrition Zinc supplementation 



The work presented in this study was supported by NIH grants K23AA18399 (to Dr. Cave), 1R01ES021375 (to Dr. Cave), T35ES014559 (to Drs. Cave and McClain), U01AA022489 (to Dr. McClain), U01AA021901 (to Dr. McClain), U01AA021893 (to Dr. McClain), R01AA023681 (to Dr. McClain), R01AA018869 (to Dr. McClain), the National Institute On Alcohol Abuse And Alcoholism of the National Institutes of Health under Award Number P50AA024337, (to Dr. McClain), and an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the NIH under grant number P20GM113226. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health; and by a grant from the Department of Veterans Affairs (to Dr. McClain).

Compliance with Ethical Standards

Conflict of Interest

Vatsalya Vatsalya declares no conflict of interest.

Craig McClain is funded by several federal grants, as noted above, and is a part-time government (VA) employee.

Matthew Cave reports the grants noted above.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC (outside the USA) 2017

Authors and Affiliations

  • Craig McClain
    • 1
    Email author
  • Vatsalya Vatsalya
    • 2
  • Matthew Cave
    • 3
  1. 1.Departments of Medicine, Pharmacology & ToxicologyLouisvilleUSA
  2. 2.Department of MedicineLouisvilleUSA
  3. 3.Departments of Medicine, Pharmacology & Toxicology, Biochemistry & Molecular GeneticsLouisvilleUSA

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