Zinc and respiratory tract infections: Perspectives for COVID‑19 (Review)
Open Access
- 14 April 2020
- journal article
- review article
- Published by Spandidos Publications in International Journal of Molecular Medicine
- Vol. 46 (1), 17-26
- https://doi.org/10.3892/ijmm.2020.4575
Abstract
In view of the emerging COVID‑19 pandemic caused by SARS‑CoV‑2 virus, the search for potential protective and therapeutic antiviral strategies is of particular and urgent interest. Zinc is known to modulate antiviral and antibacterial immunity and regulate inflammatory response. Despite the lack of clinical data, certain indications suggest that modulation of zinc status may be beneficial in COVID‑19. In vitro experiments demonstrate that Zn2+ possesses antiviral activity through inhibition of SARS‑CoV RNA polymerase. This effect may underlie therapeutic efficiency of chloroquine known to act as zinc ionophore. Indirect evidence also indicates that Zn2+ may decrease the activity of angiotensin‑converting enzyme 2 (ACE2), known to be the receptor for SARS‑CoV‑2. Improved antiviral immunity by zinc may also occur through up‑regulation of interferon α production and increasing its antiviral activity. Zinc possesses anti‑inflammatory activity by inhibiting NF‑κB signaling and modulation of regulatory T‑cell functions that may limit the cytokine storm in COVID‑19. Improved Zn status may also reduce the risk of bacterial co‑infection by improving mucociliary clearance and barrier function of the respiratory epithelium, as well as direct antibacterial effects against S. pneumoniae. Zinc status is also tightly associated with risk factors for severe COVID‑19 including ageing, immune deficiency, obesity, diabetes, and atherosclerosis, since these are known risk groups for zinc deficiency. Therefore, Zn may possess protective effect as preventive and adjuvant therapy of COVID‑19 through reducing inflammation, improvement of mucociliary clearance, prevention of ventilator‑induced lung injury, modulation of antiviral and antibacterial immunity. However, further clinical and experimental studies are required.This publication has 132 references indexed in Scilit:
- Nanosized Zinc Oxide Induces Toxicity in Human Lung CellsISRN Toxicology, 2013
- ZIP8 Regulates Host Defense through Zinc-Mediated Inhibition of NF-κBCell Reports, 2013
- Zinc-deficient diet aggravates ventilation-induced lung injury in ratsJournal of Biomedical Research, 2012
- Infection with human coronavirus NL63 enhances streptococcal adherence to epithelial cellsJournal of General Virology, 2011
- Preventive zinc supplementation in developing countries: impact on mortality and morbidity due to diarrhea, pneumonia and malariaBMC Public Health, 2011
- Zinc modulates the innate immune response in vivo to polymicrobial sepsis through regulation of NF-κBAmerican Journal of Physiology-Lung Cellular and Molecular Physiology, 2010
- Influenza Virus Infection Decreases Tracheal Mucociliary Velocity and Clearance ofStreptococcus pneumoniaeAmerican Journal of Respiratory Cell and Molecular Biology, 2010
- Low zinc status: a new risk factor for pneumonia in the elderly?Nutrition Reviews, 2010
- Zinc deficiency increases organ damage and mortality in a murine model of polymicrobial sepsis*Critical Care Medicine, 2009
- Antiviral Activity of the Zinc Ionophores Pyrithione and Hinokitiol against Picornavirus InfectionsJournal of Virology, 2009