Intestinal Research

Original Article

IBD

Effectiveness of administering zinc acetate hydrate to patients with inflammatory bowel disease and zinc deficiency: a retrospective observational two-center study: Kensuke Sakurai, Shigeru Furukawa, Takehiko Katsurada, Shinsuke Otagiri, Kana Yamanashi, Kazunori Nagashima, Reizo Onishi, Keiji Yagisawa, Haruto Nishimura, Takahiro Ito, Atsuo Maemoto, Naoya Sakamoto; Intest Res 2022;20(1):78-89. Published online January 22, 2021; DOI: https://doi.org/10.5217/ir.2020.00124

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Background/Aims
Inflammatory bowel disease (IBD) patients frequently have zinc deficiency. IBD patients with zinc deficiency have higher risks of IBD-related hospitalization, complications, and requiring surgery. This study aimed to examine the effectiveness of zinc acetate hydrate (ZAH; Nobelzin) in IBD patients with zinc deficiency.
Methods
IBD patients with zinc deficiency who received ZAH from March 2017 to April 2020 were registered in this 2-center, retrospective, observational study. Changes in serum zinc levels and disease activity (Crohn’s Disease Activity Index [CDAI]) before and after ZAH administration were analyzed.
Results
Fifty-one patients with Crohn’s disease (CD, n = 40) or ulcerative colitis (UC, n = 11) were registered. Median serum zinc level and median CDAI scores significantly improved (55.5–91.0 μg/dL, P< 0.001; 171.5–129, P< 0.001, respectively) in CD patients 4 weeks after starting ZAH administration. Similarly, median serum zinc levels and CDAI scores significantly improved (57.0–81.0 μg/dL, P< 0.001; 177–148, P= 0.012, respectively) 20 weeks after starting ZAH administration. Similar investigations were conducted in groups where no treatment change, other than ZAH administration, was implemented; significant improvements were observed in both serum zinc level and CDAI scores. Median serum zinc levels in UC patients 4 weeks after starting ZAH administration significantly improved from 63.0 to 94.0 μg/dL (P= 0.002), but no significant changes in disease activity were observed. One patient experienced side effects of abdominal discomfort and nausea.
Conclusions
ZAH administration is effective in improving zinc deficiency and may contribute to improving disease activity in IBD.

Citations

Citations to this article as recorded by

Zinc Deficiency Among Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Rahman Hameed Mohammed Abdul , Nafisa Reyaz, Abebe Yigzaw, Bilal Asad Mohammed, Helai Hussaini, Adil Amin, Mohammed Qasim Rauf, Neelum Ali
Cureus.2026;[Epub] CrossRef
Zinc and Inflammatory Bowel Disease: From Clinical Study to Animal Experiment
Xi Peng, Yingxiang Yang, Rao Zhong, Yuexuan Yang, Fang Yan, Na Liang, Shibin Yuan
Biological Trace Element Research.2025; 203(2): 624. CrossRef
The association between serum zinc level and clinical features in patients with inflammatory bowel disease
Tatsushi Omatsu, Tomohisa Takagi, Takeshi Yasuda, Yuki Nakahata, Sadanari Hayashi, Rieko Mukai, Takuya Kurobe, Yuriko Yasuda, Nobuhiro Fukuta, Naoyuki Sakamoto, Kazuhiko Uchiyama, Akihiro Obora, Yoshiki Murakami, Takao Kojima, Yuji Naito, Yoshito Itoh, No
Journal of Clinical Biochemistry and Nutrition.2025; 76(1): 50. CrossRef
Metal Dyshomeostasis as a Driver of Gut Pathology in Autism Spectrum Disorders
Katelyn O'Grady, Andreas M. Grabrucker
Journal of Neurochemistry.2025;[Epub] CrossRef
Nano Zinc Oxide Restores Gut Barrier Integrity and Modulates Microbiota to Mitigate TNBS-Induced Colitis in Mice
Zhengqiang Yu, Yi Qiu, Yingxiang Yang, Changlin Wen, Shiyuan Huang, Tao Liu, Rao Zhong, Xi Peng
Biological Trace Element Research.2025; 203(12): 6213. CrossRef
Clinical Significance of Marginal Zinc Deficiency as a Predictor of Covert Hepatic Encephalopathy in Patients with Liver Cirrhosis
Takuya Matsuda, Tadashi Namisaki, Akihiko Shibamoto, Shohei Asada, Fumimasa Tomooka, Takahiro Kubo, Aritoshi Koizumi, Misako Tanaka, Satoshi Iwai, Takashi Inoue, Yuki Tsuji, Yukihisa Fujinaga, Norihisa Nishimura, Shinya Sato, Koh Kitagawa, Kosuke Kaji, Ak
International Journal of Molecular Sciences.2025; 26(9): 4184. CrossRef
Micronutrient Deficiencies in Pediatric IBD: How Often, Why, and What to Do?
Tiziana Galeazzi, Sara Quattrini, Elena Lionetti, Simona Gatti
Nutrients.2025; 17(9): 1425. CrossRef
Investigation of competitive binding of the essential trace elements zinc, iron, copper, and manganese by gastrointestinal mucins and the effect on their absorption in vitro
Maria Maares, Vincent Einhorn, Jacqueline Behrendt, Matthias Marczynski, Christoph Schüßler, Oliver Lieleg, Hajo Haase
The Journal of Nutritional Biochemistry.2025; 144: 109983. CrossRef
Roles of zinc and zinc transporters in development, progression, and treatment of inflammatory bowel disease (IBD)
S. B. Mitchell, T. B. Aydemir
Frontiers in Nutrition.2025;[Epub] CrossRef
Prevalence and Impact of Zinc Deficiency on Clinical Outcomes in Inflammatory Bowel Disease
Hend Almuhaya, Raghad Alsalamah, Asma Sallam, Amgad Alonazy, Atheer AlAwwad, Gamal Mohamed, Abdulelah Almutairdi, Mashary Attamimi, Badr Al-Bawardy
Nutrients.2025; 17(21): 3378. CrossRef
The role of dietary factors in the prevention and management of inflammatory bowel disease: a comprehensive review
Elyas Nattagh-Eshtivani, Hanieh Barghchi, Amir Hossein Mansouri, Pegah Rahbarinejd, Amin Mokari-Yamchi, Mehdi Barati, Mohammad Rashidmyvan, Ali Jafazadeh Esfehani, Alireza Mohammadzadeh, Zachry Clyton, Parisa Marabi, Saeedeh Talebi, Naseh Pahlavani
Nutrition & Metabolism.2025;[Epub] CrossRef
The Aging Gut–Brain Axis: Effects of Dietary Polyphenols and Metal Exposure
Luqi Cao, Saurabh Kumar Jha, Neha Gupta, Xiang Chen, Renuka Soni, Luoxi Yuan, Rashi Srivastava, Zhe‐Sheng Chen
Chronic Diseases and Translational Medicine.2025; 11(4): 251. CrossRef
Dietary Zinc Ameliorates TNBS-Induced Colitis in Mice Associated with Regulation of Th1/Th2/Th17 Balance and NF-κB/NLRP3 Signaling Pathway
Changlin Wen, Jiayu Wang, Zhenhua Sun, Rao Zhong, Mengjie Li, Xuemei Shen, Qiaobo Ye, Kaihua Qin, Xi Peng
Biological Trace Element Research.2024; 202(2): 659. CrossRef
Nutritional Biomarkers for the Prediction of Response to Anti-TNF-α Therapy in Crohn’s Disease: New Tools for New Approaches
Fernando Rizzello, Ilaria Maria Saracino, Paolo Gionchetti, Maria Chiara Valerii, Chiara Ricci, Veronica Imbesi, Eleonora Filippone, Irene Bellocchio, Nikolas Konstantine Dussias, Thierry Dervieux, Enzo Spisni
Nutrients.2024; 16(2): 280. CrossRef
Zinc supplementation for dysgeusia in patients with unresectable pancreatic cancer
Yusuke Seiki, Kenji Ikezawa, Ko Watsuji, Makiko Urabe, Yugo Kai, Ryoji Takada, Takuo Yamai, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Miki Ishibashi, Kazuyoshi Ohkawa
International Journal of Clinical Oncology.2024; 29(8): 1173. CrossRef
Role of Combination Treatment of Aspirin and Zinc in DMH-DSS-induced Colon Inflammation, Oxidative Stress and Tumour Progression in Male BALB/c Mice
Singothu Siva Nagendra Babu, Shivani Singla, Gopabandhu Jena
Biological Trace Element Research.2023; 201(3): 1327. CrossRef
Retrospective study on the therapeutic efficacy of zinc acetate hydrate administration to patients with hypozincemia-induced dysgeusia
Tomoaki Shintani, Kouji Ohta, Toshinori Ando, Yasutaka Hayashido, Souichi Yanamoto, Mikihito Kajiya, Hideki Shiba
BMC Oral Health.2023;[Epub] CrossRef
Nutrition, Nutritional Status, Micronutrients Deficiency, and Disease Course of Inflammatory Bowel Disease
Marco Valvano, Annalisa Capannolo, Nicola Cesaro, Gianpiero Stefanelli, Stefano Fabiani, Sara Frassino, Sabrina Monaco, Marco Magistroni, Angelo Viscido, Giovanni Latella
Nutrients.2023; 15(17): 3824. CrossRef
Prevalence of Zinc Deficiency in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis
Roberta Zupo, Annamaria Sila, Fabio Castellana, Roberto Bringiotti, Margherita Curlo, Giovanni De Pergola, Sara De Nucci, Gianluigi Giannelli, Mauro Mastronardi, Rodolfo Sardone
Nutrients.2022; 14(19): 4052. CrossRef

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Corrigendum

Corrigendum: Randomized, crossover questionnaire survey of acceptabilities of controlled-release mesalazine tablets and granules in ulcerative colitis patients: Keiji Yagisawa, Taku Kobayashi, Ryo Ozaki, Shinji Okabayashi, Takahiko Toyonaga, Miki Miura, Mari Hayashida, Eiko Saito, Masaru Nakano, Hajime Matsubara, Tadakazu Hisamatsu, Toshifumi Hibi; Intest Res 2020;18(3):343-344. Published online July 20, 2020; DOI: https://doi.org/10.5217/ir.2018.00078-c1; Corrects: Intest Res 2019;17(1):87

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Original Articles

IBD

Individualized treatment based on CYP3A5 single-nucleotide polymorphisms with tacrolimus in ulcerative colitis: Shinji Okabayashi, Taku Kobayashi, Eiko Saito, Takahiko Toyonaga, Ryo Ozaki, Shintaro Sagami, Masaru Nakano, Junichi Tanaka, Keiji Yagisawa, Satoshi Kuronuma, Osamu Takeuchi, Toshifumi Hibi; Intest Res 2019;17(2):218-226. Published online February 7, 2019; DOI: https://doi.org/10.5217/ir.2018.00117

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Background/Aims
The pharmacokinetics of tacrolimus (TAC) is known to be largely influenced by single-nucleotide polymorphisms (SNPs) in CYP3A5. Patients starting TAC require careful dose adjustment, owing to the wide range of optimal dosages, depending on their CYP3A5 expression status. Here, we evaluated whether individualization of TAC dosages based on CYP3A5 SNPs would improve its therapeutic efficacy in ulcerative colitis.
Methods
Twenty-one patients were prospectively treated, with their initial dosage adjusted according to their CYP3A5 status (0.1, 0.15, and 0.2 mg/kg/day for CYP3A5*3/*3, CYP3A5*1/*3, and CYP3A5*1/*1, respectively). Their clinical outcomes were compared with those of patients treated with a fixed dose (0.1 mg/kg/day).
Results
The first blood trough level of CYP3A5 expressors, CYP3A5*1/*3 or CYP3A5*1/*1, and the overall rate in achieving the target blood trough level within a week in the individualized-dose group were significantly higher than those in the fixed-dose group (5.15±2.33 ng/mL vs. 9.63±0.79 ng/mL, P=0.035 and 12.5% vs. 66.7%, P=0.01). The remission rate at 2 weeks in the expressors was as high as that in the nonexpressors, CYP3A5*3/*3, in the individualized-dose group.
Conclusions
Individualized TAC treatment is effective against ulcerative colitis regardless of the CYP3A5 genotype.

Citations

Citations to this article as recorded by

The impact of cytochrome P450 3A genetic polymorphisms on tacrolimus pharmacokinetics in ulcerative colitis patients
Maizumi Furuse, Shuhei Hosomi, Yu Nishida, Shigehiro Itani, Yuji Nadatani, Shusei Fukunaga, Koji Otani, Fumio Tanaka, Yasuaki Nagami, Koichi Taira, Noriko Kamata, Toshio Watanabe, Kenji Watanabe, Yasuhiro Fujiwara, Erika Cecchin
PLOS ONE.2021; 16(4): e0250597. CrossRef
Advances in research of tacrolimus for treatment of inflammatory bowel disease
Jing-Jing Wang, Yi-Hong Fan
World Chinese Journal of Digestology.2019; 27(13): 842. CrossRef

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IBD

Randomized, crossover questionnaire survey of acceptabilities of controlled-release mesalazine tablets and granules in ulcerative colitis patients: Keiji Yagisawa, Taku Kobayashi, Ryo Ozaki, Shinji Okabayashi, Takahiko Toyonaga, Miki Miura, Mari Hayashida, Eiko Saito, Masaru Nakano, Hajime Matsubara, Tadakazu Hisamatsu, Toshifumi Hibi; Intest Res 2019;17(1):87-93. Published online December 14, 2018; DOI: https://doi.org/10.5217/ir.2018.00078; Correction in: Intest Res 2020;18(3):343

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Background/Aims
Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazine increases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilities of these formulations may influence patient adherence; however, they have not been compared to date. This study aimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossover questionnaire survey.
Methods
UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group took either 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6 to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analog scale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed.
Results
A total of 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found the tablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2 formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence rate was slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was not significant (P=0.139).
Conclusions
CR mesalazine granules are more acceptable than tablets, and may therefore be a better option for long-term medication.

Citations

Citations to this article as recorded by

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