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Albumin substitution in decompensated liver cirrhosis : don’t forget zinc
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Grüngreiff, Kurt, Gottstein, Thomas, Reinhold, Dirk and Blindauer, Claudia A. (2021) Albumin substitution in decompensated liver cirrhosis : don’t forget zinc. Nutrients, 13 (11). e4011. doi:10.3390/nu13114011 ISSN 2072-6643.
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Official URL: https://doi.org/10.3390/nu13114011
Abstract
Decompensated liver cirrhosis has a dismal prognosis, with patients surviving on average for 2–4 years after the first diagnosis of ascites. Albumin is an important tool in the therapy of cirrhotic ascites. By virtue of its oncotic properties, it reduces the risk of cardiovascular dysfunction after paracentesis. Treatment with albumin also counteracts the development of hepatorenal syndrome and spontaneous bacterial peritonitis. More recently, the positive impact of long-term albumin supplementation in liver disease, based on its pleiotropic non-oncotic activities, has been recognized. These include transport of endo- and exogenous substances, anti-inflammatory, antioxidant and immunomodulatory activities, and stabilizing effects on the endothelium. Besides the growing recognition that effective albumin therapy requires adjustment of the plasma level to normal physiological values, the search for substances with adjuvant activities is becoming increasingly important. More than 75% of patients with decompensated liver cirrhosis do not only present with hypoalbuminemia but also with zinc deficiency. There is a close relationship between albumin and the essential trace element zinc. First and foremost, albumin is the main carrier of zinc in plasma, and is hence critical for systemic distribution of zinc. In this review, we discuss important functions of albumin in the context of metabolic, immunological, oxidative, transport, and distribution processes, alongside crucial functions and effects of zinc and their mutual dependencies. In particular, we focus on the major role of chronic inflammatory processes in pathogenesis and progression of liver cirrhosis and how albumin therapy and zinc supplementation may affect these processes.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Chemistry | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Liver -- Cirrhosis, Serum albumin | ||||||
Journal or Publication Title: | Nutrients | ||||||
Publisher: | MDPI | ||||||
ISSN: | 2072-6643 | ||||||
Official Date: | 10 November 2021 | ||||||
Dates: |
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Volume: | 13 | ||||||
Number: | 11 | ||||||
Article Number: | e4011 | ||||||
DOI: | 10.3390/nu13114011 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 29 November 2021 | ||||||
Date of first compliant Open Access: | 1 December 2021 | ||||||
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