Daniela Florea1, Jorge Molina-López2, Christer Hogstrand3, Imre Lengyel4, Antonio Pérez de la Cruz5, Manuel Rodríguez-Elvira6, Elena Planells7. 1. Department of Physiology, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Health Campus, University of Granada, 18071, Granada, Spain; Moorfields Eye Hospital, NHS, London, EC1 V2PD, United Kingdom. Electronic address: bio_danyy@yahoo.com. 2. Department of Physiology, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Health Campus, University of Granada, 18071, Granada, Spain. Electronic address: jrgmolinalopez@ugr.es. 3. Metal Metabolism Group, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King's College London, SE1 9NH, United Kingdom. Electronic address: christer.hogstrand@kcl.ac.uk. 4. Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Science, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom. Electronic address: i.lengyel@qub.ac.uk. 5. Nutrition & Dietetic Unit. Virgen de las Nieves Hospital. 18014. Granada, Spain. Electronic address: antonioj.perez.sspa@juntadeandalucia.es. 6. Intensive Care Unit, Virgen de las Nieves Hospital, 18014, Granada, Spain. Electronic address: manuel.rodriguez.elvira.sspa@juntadeandalucia.es. 7. Department of Physiology, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, Health Campus, University of Granada, 18071, Granada, Spain. Electronic address: elenamp@ugr.es.
Abstract
INTRODUCTION: Critically ill patients develop severe stress, inflammation and a clinical state that may raise the utilization and metabolic replacement of many nutrients and especially zinc, depleting their body reserves. This study was designed to assess the zinc status in critical care patients with systemic inflammatory response syndrome (SIRS), comparing them with a group of healthy people, and studying the association with expression of zinc transporters. MATERIAL AND METHODS: This investigation was a prospective, multicentre, comparative, observational and analytic study. Twelve critically ill patients from different hospitals and 12 healthy subjects from Granada, Spain, all with informed consent were recruited. Data on daily nutritional assessment, ICU severity scores, inflammation, clinical and nutritional parameters, plasma and blood cell zinc concentrations, and levels of transcripts for zinc transporters in whole blood were taken at admission and at the seventh day of the ICU stay. RESULTS: Zinc levels on critical ill patient are diminish comparing with the healthy control (HS: 0.94 ± 0.19; CIPF: 0.67 ± 0.16 mg/dL). The 58% of critical ill patients showed zinc plasma deficiency at beginning of study while 50.0% of critical ill after 7 days of ICU stay. ZnT7, ZIP4 and ZIP9 were the zinc transporters with highest expression in whole blood. In general, all zinc transporters were significantly down-regulated (P < 0.05) in the critical ill population at admission in comparison with healthy subjects. Severity scores and inflammation were significantly associated (P < 0.05) with zinc plasma levels, and zinc transporters ZIP3, ZIP4, ZIP8, ZnT6, ZnT7. Expression of 11 out of 24 zinc transporters was analysed, and ZnT1, ZnT4, ZnT5 and ZIP4, which were downregulated by more than 3-fold in whole blood of patients. CONCLUSION: In summary, in our study an alteration of zinc status was related with the severity-of-illness scores and inflammation in critical ill patients since admission in ICU stay. SIRS caused a general shut-down of expression of zinc transporters in whole blood. That behavior was associated with severity and inflammation of patients at ICU admission regardless zinc status. We conclude that zinc transporters in blood might be useful indicators of severity of systemic inflammation and outcome for critically ill patients.
INTRODUCTION:Critically illpatients develop severe stress, inflammation and a clinical state that may raise the utilization and metabolic replacement of many nutrients and especially zinc, depleting their body reserves. This study was designed to assess the zinc status in critical care patients with systemic inflammatory response syndrome (SIRS), comparing them with a group of healthy people, and studying the association with expression of zinc transporters. MATERIAL AND METHODS: This investigation was a prospective, multicentre, comparative, observational and analytic study. Twelve critically illpatients from different hospitals and 12 healthy subjects from Granada, Spain, all with informed consent were recruited. Data on daily nutritional assessment, ICU severity scores, inflammation, clinical and nutritional parameters, plasma and blood cell zinc concentrations, and levels of transcripts for zinc transporters in whole blood were taken at admission and at the seventh day of the ICU stay. RESULTS: Zinc levels on critical ill patient are diminish comparing with the healthy control (HS: 0.94 ± 0.19; CIPF: 0.67 ± 0.16 mg/dL). The 58% of critical ill patients showed zinc plasma deficiency at beginning of study while 50.0% of critical ill after 7 days of ICU stay. ZnT7, ZIP4 and ZIP9 were the zinc transporters with highest expression in whole blood. In general, all zinc transporters were significantly down-regulated (P < 0.05) in the critical ill population at admission in comparison with healthy subjects. Severity scores and inflammation were significantly associated (P < 0.05) with zinc plasma levels, and zinc transporters ZIP3, ZIP4, ZIP8, ZnT6, ZnT7. Expression of 11 out of 24 zinc transporters was analysed, and ZnT1, ZnT4, ZnT5 and ZIP4, which were downregulated by more than 3-fold in whole blood of patients. CONCLUSION: In summary, in our study an alteration of zinc status was related with the severity-of-illness scores and inflammation in critical ill patients since admission in ICU stay. SIRS caused a general shut-down of expression of zinc transporters in whole blood. That behavior was associated with severity and inflammation of patients at ICU admission regardless zinc status. We conclude that zinc transporters in blood might be useful indicators of severity of systemic inflammation and outcome for critically illpatients.
Authors: Christine M McDonald; Parminder S Suchdev; Nancy F Krebs; Sonja Y Hess; K Ryan Wessells; Sanober Ismaily; Sabuktagin Rahman; Frank T Wieringa; Anne M Williams; Kenneth H Brown; Janet C King Journal: Am J Clin Nutr Date: 2020-04-01 Impact factor: 7.045