Hair and Serum Zinc (Zn) Level in a Group of Egyptian Wheezy Infants and its Relation to Disease Severity

Abstract

Infantile wheezing, which includes viral associated wheeze and asthma, are amongst the most common reasons for children to present urgently to a doctor.

A proposed mechanism related changes in dietary antioxidant intake to reduced lung antioxidant defenses, with increased airway susceptibility to oxidant damage resulting in airway inflammation and asthma.

Trace elements play an important role in various physiological processes, and are crucial for proper functioning of the immune system. The major trace elements such as zinc, selenium, copper, and magnesium have Immune modulatory effects and thus influence susceptibility and the course of a variety of infections.

The dietary Zinc (Zn) plays essential roles in cellular metabolism and gene expression Zinc deficiency results in enhanced oxidative damage in the airways by causing infiltration of inflammatory cells and increased superoxide and nitric oxide production. Our aim is to test the hypothesis of zinc deficiency in infantile wheezing via measuring the hair and serum zinc levels in a group of Egyptian wheezy infants, comparing it to a control group of healthy infants and correlate zinc levels to disease severity. We conducted our study on Thirty wheezy infants & thirty apparently healthy age and sex matched subjected to complete history taking,general examination,chest examination,laboratory investigations e.g. CBC with total eosiniphil count, hair and serum zinc level.

Statistical analysis revealed: • There was no statistically significant difference between cases and control as regards age, gender distribution or residence. • Wheezers (cases) had more number of sibs with less rooming and less flooring when compared to control. They also had less breast feeding, more atopy, more food allergy, stronger family history of atopy &more exposure to smoking, upper respiratory tract infection. • There were no statistical significance differences between cases and control in weight & height percentile, HR or RR. • All the cases had viral induced wheeze. 66.7% of the cases had recurrent wheeze 3 to 6 times/ year. During attack most cases had fever, cough, URTI catarrhal and dyspnea (83.3%, 96.7%, 96.7% and 90% respectively), 60% of the cases treated in hospital. In between attack the cases suffer from wheeze and cough (53.3% & 93.3% respectively). All cases suffer from nocturnal awaking 56.7% of them repeated weekly. All cases suffer from RD. 53.3% of them show wheeze almost all of them expiratory. Inhaled bronchodilator and leukotriene antagonist are the most common used medication. • Eosinophils count was significantly higher in wheezers than control subjects. Serum zinc level was significantly lower in wheezers than control subjects. Zinc deficiency was significantly commoner among wheezers and healthy control. • No age, gender or residence relation to serum zinc level among the studied cases. • There were no statistical significance differences between cases with deficient and adequate Zn level in sibs. No., room no floor, frequency of URTI, type of feeding, atopy, family history and food allergy exposure to smoking or vaccination intake. • There were no statistical significance differences between deficient and adequate cases in weight & height percentile, RR or HR. • Infants with zinc deficiency had significantly higher wheeze frequency & severity. • That there was no statistical significance differences between deficient and adequate cases in weight & height percentile, RR or HR. • Hair zinc & serum zinc are possibly correlated to each other. • Serum zinc cut-off level was 53.6, sensitivity was 87.5%, specificity was 86.4% and accuracy 86.7%.