Volume 27, Issue 1 p. 8-20
Invited Review

Zinc and Liver Disease

Mohammad K. Mohammad MD

Mohammad K. Mohammad MD

University of Louisville, Louisville, Kentucky

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Zhanxiang Zhou PhD

Zhanxiang Zhou PhD

University of North Carolina Greensboro, Greensboro, North Carolina

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Matthew Cave MD

Matthew Cave MD

University of Louisville Medical Center, Louisville, Kentucky

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Ashutosh Barve MD, PhD

Ashutosh Barve MD, PhD

University of Louisville Medical Center, Louisville, Kentucky

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Craig J. McClain MD

Corresponding Author

Craig J. McClain MD

Craig J. McClain, University of Louisville Medical Center, 550 S Jackson St, ACB 3rd Floor, Louisville, KY 40292, USA; e-mail: [email protected].Search for more papers by this author
First published: 02 February 2012
Citations: 169

Abstract

Zinc is an essential trace element required for normal cell growth, development, and differentiation. It is involved in DNA synthesis, RNA transcription, and cell division and activation. It is a critical component in many zinc protein/enzymes, including critical zinc transcription factors. Zinc deficiency/altered metabolism is observed in many types of liver disease, including alcoholic liver disease (ALD) and viral liver disease. Some of the mechanisms for zinc deficiency/altered metabolism include decreased dietary intake, increased urinary excretion, activation of certain zinc transporters, and induction of hepatic metallothionein. Zinc deficiency may manifest itself in many ways in liver disease, including skin lesions, poor wound healing/liver regeneration, altered mental status, or altered immune function. Zinc supplementation has been documented to block/attenuate experimental ALD through multiple processes, including stabilization of gut-barrier function, decreasing endotoxemia, decreasing proinflammatory cytokine production, decreasing oxidative stress, and attenuating apoptotic hepatocyte death. Clinical trials in human liver disease are limited in size and quality, but it is clear that zinc supplementation reverses clinical signs of zinc deficiency in patients with liver disease. Some studies suggest improvement in liver function in both ALD and hepatitis C following zinc supplementation, and 1 study suggested improved fibrosis markers in hepatitis C patients. The dose of zinc used for treatment of liver disease is usually 50 mg of elemental zinc taken with a meal to decrease the potential side effect of nausea.