Zinc in gastrointestinal and liver disease

Zinc is an essential trace element with important biological functions, depending on the structural and/or catalytic role played by zinc ions in a large variety of enzymes. Zinc plays a critical role in cellular integrity, protein synthesis, nucleic acid metabolism, contributing to cell growth, proliferation, differentiation and death. The present review reports data on zinc homeostasis and metabolism, zinc absorption, intercellular trafficking, intracellular transport inside enterocytes and hepatocytes. Particular emphasis is given to data regarding the role of zinc carriers ZnTs and Zips, and to their expression in liver and gut in experimental and in human studies. The role of zinc in the gastrointestinal tract and in the liver as a powerful antioxidant and its relationship with apoptosis is discussed. Possible implications of zinc status in different disorders of the gastrointestinal tract are presented, focusing on its possible introduction in the therapy of inflammatory bowel diseases. Data on the role of zinc and zinc carriers in the evolution of liver fibrosis towards cirrhosis are also discussed. Finally, data on the ability of zinc therapy to obtain regression of liver cirrhosis in patients affected by Wilson's disease are reported, and the hypothesis that zinc could protect against liver fibrosis in chronic liver disease of different origin is presented.