The Interaction of Zinc as an Essential Trace Element with Leishmania Parasites: A Systematic Review.

Background: The trace element of zinc (Zn) has shown great effectiveness in control of leishmaniasis infection. Hence, the present study conducted a systematic review of in vitro and in vivo studies evaluating the zinc effect in the treatment or prevention of leishmaniasis.

Materials and methods: A systematic literature search was performed of all articles published in PubMed, SciELO, ScienceDirect, Scopus, Google Scholar, and Web of Science databases (1997-2023). The search terms were "zinc" OR "cutaneous leishmaniasis (CL)" OR "visceral leishmaniasis (VL)".

Results: Initial search yielded 89 citations, and 59 subjects were included. Data showed the zinc serum level in CL patients was lower than controls. Also, in vitro studies of zinc were more effective against L. tropica and L. major promastigotes compared to the amastigotes. Moreover, in vivo studies did not show destructive effects of zinc on the mammalian cell viability like macrophages. Furthermore, zinc depletion by specific chelators affected L. donovani survival and growth through promoting apoptosis and reactive oxygen species-dependent mechanisms.

Conclusion: The serum level determination of zinc could be useful for estimating the leishmaniasis pathophysiology. Environmentally or genetically determined increases in zinc levels might augment resístanse to CL. In contrast, zinc depletion using a zinc-specific chelator could be effective treatment of VL in endemic areas.