Cirrhosis sufferers find hope in zinc

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Cirrhosis sufferers find hope in zinc

Provided by Yomiuri Shimbun on 8/25/2004

 

Three years ago, a 58-year-old Osaka woman suffering

from cirrhosis came down with encephalopathy, causing

her to feel groggy, fatigued and feverish.

 

The woman found herself in and out of the hospital,

with her condition improving one day and getting worse

the next.

 

But when doctors at Osaka's Kosei Nenkin Hospital

treated her with zinc supplements, her condition

stabilized and she was able to return home and get

back to life as usual.

 

Doctors believe the key is the way cirrhosis affects

the body's ability to absorb zinc. According to a

study by Yasuyuki Arakawa, professor of internal

medicine at Nihon University, the amount of zinc found

in the blood stream of cirrhosis patients is 30

percent lower than that found in healthy individuals.

 

" The small intestine becomes weaker and unable to take

in enough zinc from food. This coincides with the loss

of the liver's ability to retain zinc, " Arakawa

explained.

 

A lack of zinc impairs the functioning of ornithine

transcarbamylase (OTC)--an enzyme found inside liver

cells that is responsible for metabolizing ammonia.

 

OTC is vital for cirrhosis patients, who tend to

suffer from a buildup of ammonia in the body as a

result of their liver's inability to properly

metabolize urea.

 

That raises the risk of encephalopathy--a common

complication in cirrhosis sufferers that can cause

nerve damage and mental impairment.

 

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Pioneering treatment

 

Kazuhiro Katayama, head of internal medicine at Kosei

Nenkin Hospital, has been testing a treatment in which

cirrhosis patients, whose zinc level is lower than the

standard 70-110 microliters per deciliter of blood,

are given zinc supplements.

 

Previously, the Osaka woman had been given medicine to

stop her body from producing ammonia, and had also

been given branched-chain amino acids (BCAA). The

amino acids are used when ammonia is metabolized in

muscle tissue outside the liver.

 

As part of the treatment, patients are asked to avoid

stress and eat healthily since results can be

negatively affected by changes in eating habits and

lifestyle.

 

With zinc supplements, the woman was taking 600

milligrams of zinc sulfate three times a day,

including medicine taken as part of her amino

treatment.

 

Soon after leaving the hospital, her ammonia levels

had shot up and she developed encephalopathy. But

after starting the treatment, her ammonia levels

stabilized.

 

When Katayama compared the older amino acid-only

treatment with the amino acid and zinc sulfate

treatment in 30 cirrhosis patients, he found that the

level of ammonia in their blood streams three months

after starting the new treatment had fallen by about

20 percent, compared to an increase noted in the

amino-only treatment.

 

" We've used the zinc replacement therapy in close to

100 patients, and their progress has been good, "

Katayama said.

 

However, there is not yet enough data on the method in

Japan, and because it is still an experimental

treatment, doctors must get the patient's written

consent to perform the treatment.

 

===

 

Checking the disease

 

When the body takes in too much zinc there are side

effects such as gastrointestinal damage and nausea. To

avoid this, it is necessary to monitor patients' zinc

levels.

 

The liver can never completely recover from cirrhosis,

but, Katayama said, " With this treatment, we believe

we'll be able to keep patients' conditions in check. "

 

Zinc replacement therapy is not covered by national

health insurance, and there are no medicines approved

as replacement zinc for cirrhosis sufferers. Medical

institutions that conduct the treatment make the zinc

sulfate capsules themselves. Kosei Nenkin Hospital

provides such capsules to its patients free of charge.

 

To see more of The Daily Yomiuri On-Line, go to

http://www.yomiuri.co.jp/daily.

 

The Yomiuri Shimbun. . Copyright

2004