Table_2_Zinc Supplementation Promotes a Th1 Response and Improves Clinical Symptoms in Fewer Hours in Children With Pneumonia Younger Than 5 Years Old. A Randomized Controlled Clinical Trial.docx

Background: Pneumonia caused 704,000 deaths in children younger than 5 years in 2015. Zinc is an important micronutrient due to its role in immune function. Since 2004, WHO recommends zinc supplementation for children with diarrhea to shorten the duration and decrease severity. Zinc supplementation for children with pneumonia is controversial.Methods: A randomized controlled clinical trial was conducted, and 103 children 1 month to 5 years old with pneumonia were included. Zinc or placebo was given during hospitalization. Clinical symptoms were recorded, and a blood draw was obtained to determine serum zinc levels, lymphoproliferation, and cytokines at hospitalization and at discharge of the patient; a nasal wash was obtained to detect viral or bacterial pathogens by multiplex RT-PCR.Results: Zinc supplementation improved in fewer hours the clinical status (76 ± 7 vs. 105 ± 8, p = 0.01), the respiratory rate (37 ± 6 vs. 57 ± 7, p = 0.04), and the oxygen saturation (53 ± 7 vs. 87 ± 9, p = 0.007) compared to the placebo group. An increase in IFNγ and IL-2 after treatment in the zinc group was observed.Conclusions: Zinc supplementation improved some clinical symptoms in children with pneumonia in fewer hours and induced a cellular immune response.Clinical Trial Registration: The trial was retrospectively registered in ClinicalTrials.gov, identifier NCT03690583, URL https://clinicaltrials.gov/ct2/show/NCT03690583?term=zinc+children&cond=Pneumonia&draw=2&rank=1.

背景：2015年，肺炎导致704,000名5岁以下儿童死亡。锌作为一种重要的微量元素，因其对免疫功能的作用而备受关注。自2004年以来，世界卫生组织建议对患有腹泻的儿童补充锌，以缩短病程并减轻症状。对于患有肺炎的儿童进行锌补充存在争议。方法：进行了一项随机对照临床试验，纳入了103名1个月至5岁的肺炎患儿。在住院期间给予锌或安慰剂。记录了临床症状，并抽取血液以确定住院和出院时的血清锌水平、淋巴增殖和细胞因子；通过多重实时聚合酶链反应（RT-PCR）获得鼻腔冲洗液以检测病毒或细菌病原体。结果：与安慰剂组相比，锌补充剂在更短的时间内改善了临床状况（76 ± 7 vs. 105 ± 8，p = 0.01）、呼吸频率（37 ± 6 vs. 57 ± 7，p = 0.04）和血氧饱和度（53 ± 7 vs. 87 ± 9，p = 0.007）。在锌组观察到治疗后IFNγ和IL-2的升高。结论：锌补充剂在较短时间内改善了肺炎儿童的某些临床症状，并诱导了细胞免疫反应。临床试验注册：该试验在ClinicalTrials.gov进行回顾性注册，标识符为NCT03690583，网址为https://clinicaltrials.gov/ct2/show/NCT03690583?term=zinc+children&cond=Pneumonia&draw=2&rank=1。