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Zinc supplementation and TNF-α levels in vaccinated cardiac patients
S Songül Yalçın1, Defne Engür-Karasimav, Dursun Alehan
1Unit of Social Pediatrics, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey. siyalcin@hacettepe.edu.tr
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Zinc supplementation may reduce adverse reactions to influenza vaccines in children with heart conditions. It also helped lower serum tumor necrosis factor-alpha (TNF-α) levels, indicating a potential immune benefit.
Area of Science:
- Immunology
- Pediatric Cardiology
- Nutritional Science
Background:
- Children with congenital or acquired heart disease may have altered immune responses.
- Influenza vaccination is crucial for this vulnerable population.
- Zinc deficiency can impact immune function.
Purpose of the Study:
- To evaluate the effect of zinc supplementation on serum tumor necrosis factor-alpha (TNF-α) levels in pediatric cardiac patients receiving an influenza vaccine.
- To assess vaccine-associated adverse events and upper respiratory tract infection (URTI) rates.
Main Methods:
- A randomized controlled trial involving children aged 9-18 with heart disease.
- Participants received either zinc supplementation plus influenza vaccine (ZV group) or influenza vaccine alone (V group).
- Serum zinc, TNF-α levels, and antibody titers were measured; adverse events and URTI incidence were recorded.
Main Results:
- Congenital heart disease patients had lower baseline serum zinc levels compared to acquired heart disease patients.
- Serum TNF-α levels significantly decreased in the ZV group post-vaccination.
- Malaise as a vaccine side effect was significantly lower in the ZV group.
- URTI incidence decreased significantly after vaccination in both groups.
Conclusions:
- Zinc supplementation appears beneficial in mitigating malaise associated with influenza vaccination in children with heart disease.
- Zinc supplementation may help reduce serum TNF-α levels following influenza vaccination in this population.
- Further research into zinc's role in pediatric cardiac patient immunity is warranted.
Objective:
To investigate whether zinc supplementation could affect serum tumor necrosis factor-alpha (TNF-α) levels in congenital and acquired cardiac patients attending for an influenza vaccine.
Methods:
9-18 years old, voluntary children with cardiac disease were weighed, measured height and blood samples for hemoglobin level, zinc level, IgA and IgG titers of influenza A and B serotypes and TNF-α levels were obtained. The children were randomly assigned to 1 of 2 groups: ZV group received both zinc supplementation and influenza vaccine; V group received influenza vaccine. Serum TNF-α levels were measured at 28 days after the immunization.
Results:
Mean (±SD) serum zinc level was 100 (±20) μg/dL. Cases with congenital heart disease had lower serum zinc levels than acquired ones (93±17 μg/dL, 116±18 μg/dL; respectively, p<0.001). Median titers of serum TNF-α decreased after vaccination (78.9 pg/mL, 74.8 pg/mL; p<0.05) but this significant change occurred only in ZV group (77.1 pg/mL, 73.4 pg/mL; p=0.001). Vaccine associated adverse events were similar in ZV and V groups except malaise (0% in ZV and 23.8% in V group; p<0.05). Adverse events were similar in patients with congenital and acquired heart diseases. During the previous influenza season, 77.3% had more than two episodes of upper respiratory tract infection (URTI), however, after vaccination only 13.6% had more than two episode of URTI.
Conclusion:
Zinc supplementation has a beneficial effect on malaise, one of the influenza vaccine associated adverse events, and decrease serum TNF-α levels.
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