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Hewlings S, Kalman D. 2022 A Review of Zinc-L-Carnosine and its positive effects on oral mucositis, taste disorders, and gastrointestinal disorders.

Jun 17, 2025

Overview

This lecture reviews the properties, mechanisms, and clinical benefits of Zinc-L-carnosine (ZnC) in treating oral mucositis, taste disorders, gastrointestinal disorders, pressure ulcers, and liver conditions, highlighting its antioxidant and anti-inflammatory effects.

Introduction to Zinc-L-Carnosine (ZnC)

  • ZnC (polaprezinc) is a chelated compound combining zinc and L-carnosine.
  • Zinc is essential for tissue repair and found in various foods.
  • L-carnosine acts as a buffer and antioxidant, aiding wound healing.
  • ZnC may have superior benefits by improving zinc absorption and delivering it more effectively to tissues.
  • Approved in the US as a dietary supplement and in Japan for gastric ulcers.

Mechanisms of Action

  • ZnC reduces inflammation and oxidative stress by inhibiting NF-kB and boosting antioxidant enzymes.
  • It increases growth factors that promote tissue repair.
  • Enhances heat shock protein production, providing cellular protection.
  • Stimulates cell migration and proliferation, supporting early and late wound healing stages.

Oral Mucositis and Esophagitis

  • Oral mucositis is a frequent, painful complication of cancer therapy.
  • ZnC oral rinses and suspensions significantly reduce severity and incidence of mucositis and esophagitis in patients undergoing chemo/radiotherapy.
  • ZnC reduces pain, analgesic use, and hospital stay durations.

Taste Disorders

  • Taste disorders are common in cancer patients and can reduce nutritional intake.
  • Supplementation with ZnC improves taste function, even in non-cancer patients.
  • Higher doses of ZnC yield greater improvement; benefits are seen regardless of baseline zinc levels.

Gastrointestinal Disorders

  • ZnC accelerates healing of gastric ulcers, outperforming some mucosal protection agents.
  • Reduces GI mucosal injury from drugs like NSAIDs by anti-inflammatory and antioxidant actions.
  • ZnC as adjunct to H. pylori eradication improves outcomes and is safe.

Pressure Ulcers

  • ZnC supplementation promotes the healing of pressure ulcers in clinical trials.
  • Both carnosine and ZnC improve healing rates compared to controls.

Liver Health

  • ZnC supplementation aids in reducing liver inflammation and oxidative stress in chronic hepatitis C and liver disease patients.
  • ZnC increases serum zinc, decreases liver enzymes and ferritin, and offers cytoprotective effects.

Safety

  • Usual ZnC doses do not significantly risk copper deficiency.
  • ZnC has a strong safety profile with minimal adverse events reported in human studies.

Key Terms & Definitions

  • Zinc-L-carnosine (ZnC) — A compound of zinc and L-carnosine with healing, antioxidant, and anti-inflammatory properties.
  • Oral mucositis — Inflammation and ulceration of the mouth lining, often caused by cancer treatment.
  • NF-kB — A protein complex that controls inflammation and immune responses.
  • Heat shock proteins — Proteins that help protect cells from stress or damage.

Action Items / Next Steps

  • Review mechanisms of ZnC and its role in tissue repair.
  • Understand clinical evidence supporting ZnC’s use for oral mucositis, GI disorders, and pressure ulcers.
  • Prepare for exam questions on ZnC’s mechanism, clinical uses, and safety profile.