Raqib Rubhana, Roy Swapan Kumar, Rahman Muhammad Jubayer, Azim Tasnim, Ameer Syeda Shegufta, Chisti Jobayer, Andersson Jan
International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B): Centre for Health and Population Research, Dhaka, Bangladesh.
Am J Clin Nutr. 2004 Mar;79(3):444-50. doi: 10.1093/ajcn/79.3.444.
Several studies showed benefits of long-term zinc supplementation on the incidence, severity, and duration of diarrhea and on the incidence of respiratory infections. Prolonged zinc supplementation also improves cell-mediated immunity in severely malnourished children.
We studied the effect of short-term zinc supplementation on intrinsic and specific immune and inflammatory responses in moderately malnourished children with acute shigellosis.
A randomized, double-blind, placebo-controlled trial was conducted in Shigella-infected children aged 12-59 mo. Elemental zinc (20 mg) and a multivitamin containing vitamins A and D, thiamine, riboflavin, nicotinamide, and calcium at twice the recommended dietary allowance were given daily for 2 wk to the zinc group (n = 28), whereas the multivitamin alone was given to the control group (n = 28). Standard antibiotic therapy was given to all patients.
Serum zinc concentrations increased in both groups during convalescence; however, zinc supplementation showed a significant effect. The lymphocyte proliferation response in the zinc group increased relative to that in the control group (P = 0.002), but no significant effects were seen on concentrations of cytokines (interleukin 2 and interferon gamma) released from mitogen-stimulated mononuclear cells or on concentrations of cytokines (interleukin 2, interferon gamma, and interleukin 1beta) in feces. Among the antigen [lipopolysaccharide and invasion plasmid-encoded antigen (Ipa)]-specific antibodies, plasma Ipa-specific immunoglobulin G responses at day 30 were significantly higher in the zinc group than in the control group. However, the 2 groups did not differ significantly in the other antigen-specific responses in plasma and stool.
A 14-d course of zinc supplementation during acute shigellosis increases the lymphocyte proliferation response and the Ipa-specific immunoglobulin G response.
多项研究表明，长期补充锌对腹泻的发生率、严重程度和持续时间以及呼吸道感染的发生率有益。长期补充锌还可改善重度营养不良儿童的细胞介导免疫。
我们研究了短期补充锌对中度营养不良的急性志贺菌病患儿固有免疫和特异性免疫及炎症反应的影响。
在12至59个月的志贺菌感染儿童中进行了一项随机、双盲、安慰剂对照试验。锌组（n = 28）每天给予元素锌（20毫克）和一种含有维生素A和D、硫胺素、核黄素、烟酰胺和钙的多种维生素，剂量为推荐膳食摄入量的两倍，持续2周，而对照组（n = 28）仅给予多种维生素。所有患者均接受标准抗生素治疗。
两组在恢复期血清锌浓度均升高；然而，补充锌显示出显著效果。锌组的淋巴细胞增殖反应相对于对照组有所增加（P = 0.002），但对丝裂原刺激的单核细胞释放的细胞因子（白细胞介素2和干扰素γ）浓度或粪便中细胞因子（白细胞介素2、干扰素γ和白细胞介素1β）浓度没有显著影响。在抗原[脂多糖和侵袭质粒编码抗原（Ipa）]特异性抗体中，锌组在第30天的血浆Ipa特异性免疫球蛋白G反应显著高于对照组。然而，两组在血浆和粪便中的其他抗原特异性反应方面没有显著差异。
急性志贺菌病期间为期14天的锌补充疗程可增加淋巴细胞增殖反应和Ipa特异性免疫球蛋白G反应。
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