PARENTERAL ZINC SUPPLEMENTATION IN ADULT HUMANS DURING THE ACUTE-PHASE RESPONSE INCREASES THE FEBRILE RESPONSE

The acute phase response (APR) that follows injury or infection is cha racterized by a decrease in serum zinc concentrations, which we hypoth esized benefits the host. Additionally, we proposed that preventing th is decline by supplementing zinc would result in an exaggerated APR as indicated by elevated temperatures, increased serum cytokine concentr ations, interleukin 6 and the acute phase protein (ceruloplasmin). A p rospective, randomized, double-blinded, clinical trial was conducted. Patients on home parenteral nutrition with a diagnosis of catheter sep sis and patients with a diagnosis of pancreatitis, also on total paren teral nutrition (TPN), were recruited for the study. Following enrollm ent, block randomization was used to assign patients to receive 0 mg ( n = 23) or 30 mg (n = 21) of zinc per day for the first 3 d of TPN. Bl ood samples for measurement of serum zinc, copper, ceruloplasmin and i nterleukin-6 were obtained upon enrollment and bn d 1 through 3 of TPN . The highest temperatures reported on these days in the medical recor d were also recorded. Repeated measures ANOVA was used to determine di fferences in the primary outcome variables over time. No significant d ifferences between groups were observed in serum interleukin-6 or ceru loplasmin concentrations. A significantly higher (P = 0.035) temperatu re was observed in the zinc-supplemented group compared with the contr ol group on d 3 of parenteral nutrition. We conclude that parenteral z inc supplementation in patients experiencing a mild APR resulted in an exaggerated APR as evidenced by a significantly higher febrile respon se.