Faculty of Life Sciences and Medicine, GKT School of Medical Education, King's College London, London, UK.
Faculty of Life Sciences and Medicine, Centre for Education, King's College London, London, UK.
Clin Exp Med. 2024 Feb 17;24(1):38. doi: 10.1007/s10238-024-01302-6.
This review provides a concise overview of the cellular and clinical aspects of the role of zinc, an essential micronutrient, in human physiology and discusses zinc-related pathological states. Zinc cannot be stored in significant amounts, so regular dietary intake is essential. ZIP4 and/or ZnT5B transport dietary zinc ions from the duodenum into the enterocyte, ZnT1 transports zinc ions from the enterocyte into the circulation, and ZnT5B (bidirectional zinc transporter) facilitates endogenous zinc secretion into the intestinal lumen. Putative promoters of zinc absorption that increase its bioavailability include amino acids released from protein digestion and citrate, whereas dietary phytates, casein and calcium can reduce zinc bioavailability. In circulation, 70% of zinc is bound to albumin, and the majority in the body is found in skeletal muscle and bone. Zinc excretion is via faeces (predominantly), urine, sweat, menstrual flow and semen. Excessive zinc intake can inhibit the absorption of copper and iron, leading to copper deficiency and anaemia, respectively. Zinc toxicity can adversely affect the lipid profile and immune system, and its treatment depends on the mode of zinc acquisition. Acquired zinc deficiency usually presents later in life alongside risk factors like malabsorption syndromes, but medications like diuretics and angiotensin-receptor blockers can also cause zinc deficiency. Inherited zinc deficiency condition acrodermatitis enteropathica, which occurs due to mutation in the SLC39A4 gene (encoding ZIP4), presents from birth. Treatment involves zinc supplementation via zinc gluconate, zinc sulphate or zinc chloride. Notably, oral zinc supplementation may decrease the absorption of drugs like ciprofloxacin, doxycycline and risedronate.
这篇综述简要概述了锌作为一种必需的微量营养素在人体生理学中的细胞和临床作用,并讨论了与锌相关的病理状态。锌不能大量储存,因此需要定期从饮食中摄取。ZIP4 和/或 ZnT5B 将膳食中的锌离子从十二指肠转运到肠细胞,ZnT1 将锌离子从肠细胞转运到循环中,而 ZnT5B(双向锌转运体)促进内源性锌分泌到肠腔中。增加锌生物利用度的假定吸收促进剂包括从蛋白质消化中释放的氨基酸和柠檬酸,而膳食中的植酸盐、酪蛋白和钙可以降低锌的生物利用度。在循环中,70%的锌与白蛋白结合,而大部分锌存在于骨骼肌和骨骼中。锌通过粪便(主要是)、尿液、汗液、月经和精液排泄。过量的锌摄入会抑制铜和铁的吸收,分别导致铜缺乏和贫血。锌毒性会对脂质谱和免疫系统产生不利影响,其治疗取决于锌的获取方式。获得性锌缺乏症通常在生命后期出现,伴有吸收不良综合征等危险因素,但利尿剂和血管紧张素受体阻滞剂等药物也会导致锌缺乏症。遗传性锌缺乏症——肠病性肢端皮炎,是由于 SLC39A4 基因(编码 ZIP4)突变引起的,从出生就会出现。治疗方法包括通过葡萄糖酸锌、硫酸锌或氯化锌进行锌补充。值得注意的是,口服锌补充剂可能会降低环丙沙星、多西环素和利塞膦酸钠等药物的吸收。
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