The role of zinc in wound healing. Adv Wound Care
Geriatric and Long Term Care Services, Ross Products Division, Abbott Laboratories, Columbus, OH, USA.Advances in wound care: the journal for prevention and healing 05/1999; 12(3):137-8.
Zinc deficiency has been associated with delayed wound healing. Because zinc deficiency may be common in the United States, foods rich in zinc, as well as all other essential nutrients, should be promoted in the diet of patients who are malnourished or at risk for malnutrition.
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- "Kinetic studies suggest that only a small proportion of total body zinc (approximately 10%) represents the " functional pool " of zinc, which is comprised of zinc, located within the liver and other tissues, that exchanges rapidly with the plasma, and when this functional pool is depleted zinc deficiency ensues (King, 1990). Zinc deficiency in adults can lead to dermatitis, hair loss, diarrhea , loss of appetite, reproductive failure, hypogeusia, loss of cognitive function, susceptibility to infections, and depressed immune function (Shankar and Prasad, 1998), delayed wound healing and depression (Andrews and Gallagher-Allred, 1999). Zinc deficiency has also been associated with three major health diseases prevalent in Europe: Diabetes, cancer, and coronary heart disease (Singh et al., 1998). "
ABSTRACT: Zinc was selected as a priority micronutrient for EURRECA, because there is significant heterogeneity in the Dietary Reference Values (DRVs) across Europe. In addition, the prevalence of inadequate zinc intakes was thought to be high among all population groups worldwide, and the public health concern is considerable. In accordance with the EURRECA consortium principles and protocols, a series of literature reviews were undertaken in order to develop best practice guidelines for assessing dietary zinc intake and zinc status. These were incorporated into subsequent literature search strategies and protocols for studies investigating the relationships between zinc intake, status and health, as well as studies relating to the factorial approach (including bioavailability) for setting dietary recommendations. EMBASE (Ovid), Cochrane Library CENTRAL, and MEDLINE (Ovid) databases were searched for studies published up to February 2010 and collated into a series of Endnote databases that are available for the use of future DRV panels. Meta-analyses of data extracted from these publications were performed where possible in order to address specific questions relating to factors affecting dietary recommendations. This review has highlighted the need for more high quality studies to address gaps in current knowledge, in particular the continued search for a reliable biomarker of zinc status and the influence of genetic polymorphisms on individual dietary requirements. In addition, there is a need to further develop models of the effect of dietary inhibitors of zinc absorption and their impact on population dietary zinc requirements.
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- "Additionally, there are reports of higher rates of malnutrition and deficiencies of vitamins and minerals such as zinc in patients with chronic venous leg ulcers compared to the general population   . Although risk factors for the development of skin ulcers have been identified, clinical indicators of poor wound healing are less well studied. "
ABSTRACT: Chronic nonsurgical skin wounds such as venous stasis and diabetic ulcers have been associated with a number of comorbid conditions; however, the strength of these associations has not been compared. We utilized the Stanford Translational Research Integrated Database Environment (STRIDE) system to identify a cohort of 637 patients with chronic skin ulcers. Preliminary analysis ( n = 300 ) showed that 49.7% of the patients had a poor prognosis such as amputation or a nonhealing ulcer for at least a year. Factors significantly associated ( P < 0.05 ) with these outcomes included diabetes mellitus, chronic kidney disease, peripheral neuropathy, peripheral arterial disease, and need for systemic antibiotics. Patients with poor outcomes also tended to have lower hemoglobin levels ( P = 0.01 ), higher WBC levels ( P < 0.01 ), and lower albumin levels ( P < 0.01 ). On multivariate analysis, however, only diabetes mellitus (OR 5.87, 1.36–25.3), need for systemic antibiotics (OR 3.88, 1.06–14.2), and albumin levels (0.20 per unit, 0.07–0.60) remained significant independent predictors of poor wound-healing outcomes. These data identify patients at the highest risk for poor wound-healing and who may benefit the most from more aggressive wound care and treatment.
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- "Zinc is an essential trace element that is involved in numerous cellular enzymatic reactions and gene regulation through the modulation of several transcription factors . Zinc deficiency is associated with diverse disorders, such as impaired immunity , retarded growth, brain development disorders and delayed wound healing  . In adults, zinc deficiency has been associated with retarded skeletal development and development of osteoporosis  . "
ABSTRACT: Zinc is an essential trace element that is involved in diverse metabolic and signaling pathways. Zinc deficiency is associated with retardation of bone growth. Previous in vitro studies have suggested a direct effect of zinc on both the proliferation and differentiation of osteoblast-like cells. However, the mechanisms for uptake of zinc into osteoblasts have not been examined in detail. Several families of zinc transporters have previously been characterized in mammalian cells; such transporters function in the uptake, intracellular sequestration or efflux of zinc. In the current study, we examined zinc transport in osteoprogenitor cells and have attempted to define a functional role for a zinc transport mechanism in osteogenic differentiation. We identified at least two zinc transporters in both human mesenchymal stem cells (MSCs) and in osteoblastic cells--the ubiquitous zinc transporter, ZIP1, and LIV-1, which was previously characterized as a protein that is expressed in breast cancer cells. The subcellular localization of both these zinc transporters suggested distribution in both the plasma membrane and also diffusely in the cytoplasm. During the differentiation process of pluripotent MSCs into osteoblast-like cells, both zinc uptake and expression of the ZIP1 protein were increased. An adenoviral-mediated overexpression of ZIP1 in MSCs resulted in Alizarin-red-positive mineralization and also increased expression of specific osteoblast-associated markers, such as alkaline phosphatase, and of several osteoblast differentiation genes, including osteopontin, Cbfa1/Runx2, promyelocytic leukemia zinc finger and bone sialoprotein. An siRNA-mediated reduction of ZIP1 protein expression in MSCs caused decreased zinc uptake and inhibition of osteoblastic differentiation under osteogenic culture conditions. Finally, following overexpression of ZIP1 in MSCs, cDNA microarray analysis revealed differential regulation of several genes associated with the proliferation of osteoprogenitor cells and osteoblast differentiation. In conclusion, these studies provide important insights into the role of a plasma membrane zinc transporter in the initiation of an osteogenic lineage from MSCs.
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