Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc

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...

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Autores principales:	Kurt Grüngreiff, Thomas Gottstein, Dirk Reinhold, Claudia A. Blindauer
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	liver cirrhosis albumin zinc Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/a20f9cfe3ead4174bc1a66af0e573311
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spelling	oai:doaj.org-article:a20f9cfe3ead4174bc1a66af0e5733112021-11-25T18:36:03ZAlbumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc10.3390/nu131140112072-6643https://doaj.org/article/a20f9cfe3ead4174bc1a66af0e5733112021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/4011https://doaj.org/toc/2072-6643Decompensated 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.Kurt GrüngreiffThomas GottsteinDirk ReinholdClaudia A. BlindauerMDPI AGarticleliver cirrhosisalbuminzincNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 4011, p 4011 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver cirrhosis albumin zinc Nutrition. Foods and food supply TX341-641
spellingShingle	liver cirrhosis albumin zinc Nutrition. Foods and food supply TX341-641 Kurt Grüngreiff Thomas Gottstein Dirk Reinhold Claudia A. Blindauer Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
description	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.
format	article
author	Kurt Grüngreiff Thomas Gottstein Dirk Reinhold Claudia A. Blindauer
author_facet	Kurt Grüngreiff Thomas Gottstein Dirk Reinhold Claudia A. Blindauer
author_sort	Kurt Grüngreiff
title	Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
title_short	Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
title_full	Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
title_fullStr	Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
title_full_unstemmed	Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc
title_sort	albumin substitution in decompensated liver cirrhosis: don’t forget zinc
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a20f9cfe3ead4174bc1a66af0e573311
work_keys_str_mv	AT kurtgrungreiff albuminsubstitutionindecompensatedlivercirrhosisdontforgetzinc AT thomasgottstein albuminsubstitutionindecompensatedlivercirrhosisdontforgetzinc AT dirkreinhold albuminsubstitutionindecompensatedlivercirrhosisdontforgetzinc AT claudiaablindauer albuminsubstitutionindecompensatedlivercirrhosisdontforgetzinc
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Albumin Substitution in Decompensated Liver Cirrhosis: Don’t Forget Zinc

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