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Acute diarrhea and pneumonia are the two largest killers of under-five children in the world. Zinc, used in management of acute diarrhea and Amoxicillin, used in community acquired pneumonia, feature in the list of 13 Life Saving Commodities for Women's and Children Health by the UN Commission. Zinc has caught wide scientific attention for the conc...
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... Regulation of fluid movement through the small intestine epithelium is of physiological interest and clinical relevance. We selected zinc as a candidate inhibitor of fluid flow because of its purported antidiarrheal properties [22][23][24][25][26] and influence on epithelial tight junction integrity and ion secretion [27][28][29][30][31]. Fluid flow by cultured enterocytes exposed to vigorous aeration was first measured for 5 min without zinc to obtain a baseline rate of flow. After fluid levels in both chambers were re-balanced, fluid flow was again measured after adding ZnSO4 to either the apical or basolateral chamber or to both chambers to a final concentration of 100 µM, a concentration sufficient to alter epithelial characteristics in various experimental models [27,[31][32][33]. ...
Studies of fluid secretion by the small intestine are dominated by the coupling with ATP-dependent generation of ion gradients, whereas the contribution of filtration secretion has been overlooked, possibly by the lack of a known mechanistic basis. We measured apical fluid flow and generation of hydrostatic pressure gradients by epithelia of cultured mouse enterocytes, Caco-2 and T-84 cells, and fibroblasts exposed to mechanical force provided by vigorous aeration and in response to ion gradients, inhibitors of ion channels and transporters and in vitro using intact mouse and rat small intestine. We describe herein a paracellular pathway for unidirectional filtration secretion that is driven by mechanical force, requires tight junctions, is independent of ionic and osmotic gradients, generates persistent hydrostatic pressure gradients, and would contribute to the fluid shifts that occur during digestion and diarrhea. Zinc inhibits the flow of fluid and the paracellular marker fluorescein isothyocyanate conjugated dextran (MW = 4 kD) across epithelia of cultured enterocytes (>95%; p < 0.001) and intact small intestine (>40%; p = 0.03). We propose that mechanical force drives fluid secretion through the tight junction complex via a "one-way check valve" that can be regulated. This pathway of filtration secretion complements chloride-coupled fluid secretion during high-volume fluid flow. The role of filtration secretion in the genesis of diarrhea in intact animals needs further study. Our findings may explain a potential linkage between intestinal motility and intestinal fluid dynamics.
... http://www.id-press.eu/mjms/ mortality rates [9][10][11]. ...
BACKGROUND: Diarrhea remains the most common infectious disease worldwide. Zinc has been studied extensively recently for its potential effect on prevention, control and treatment of acute diarrhoea.
AIM: This study was designed to correlate the level of zinc with the severity of pediatric diarrhoea estimated by Vesikari Scoring System.
PATIENTS AND METHODS: The present study included 80 children aged two months to 30 months from those suffering from the acute diarrheal episode and admitted to Pediatric Hospital "Abo El Rish" Cairo University. Serum Zinc level was assessed by a colorimetric method with a spectrophotometer.
RESULTS: Zinc deficiency was detected in 45 (56.2%) patient of the studied group Significant negative correlations were found between serum zinc level and severity of dehydration and duration of hospitalization (p < 0.05).
CONCLUSION: Zinc level has an essential role in acute pediatric diarrhoea. Zinc therapy should be considered beside Oral rehydration salts (ORS) to achieve maximum impact on diarrheal diseases; clinical trials are recommended to support the zinc supplementation in developing countries.
INTRODUCTION: Diarrhoea is the major cause of mortality in India for children <5 years of age. Association studies highlight the potential role of zinc in treatment of acute diarrhoea. Zinc deciency is responsible for 4.4% of childhood deaths in under-developed nations. However, zinc supplementation has been shown to be effective in decreasing the prevalence and incidence of diarrhoea. In this regard, we aimed to estimate the serum zinc levels in children suffering from acute diarrhoea AIMS: To assess the zinc levels in children with acute diarrhoea in paediatric age group. OBJECTIVES: To assess the severity of diarrhoea in association with zinc levels. MATERIALS AND METHODS: This Hospital Based Longitudinal Observational Study was done in the Department of Paediatrics at MMIMSR, Mullana over a period of one and a half year. Serum Zinc along with sodium, potassium and chloride levels were measured in cases of acute diarrhoea. RESULTS: In this study, the prevalence of zinc deciency in children with diarrhoea was 62% and was more prevalent in children <5 years of age. There was a negative correlation (p value 0.009) between serum zinc levels and dehydration. A negative correlation (p value <0.001) was also observed between zinc levels and sodium and chloride levels whereas levels of K did not show any signicant difference with mean zinc values.
