Biochemical role of zinc in dengue fever

Background: Zinc is an essential trace element that has been shown to play a crucial role in viral infections. As a part of RNA polymerases, zinc helps in the replication of many viruses. Cholinesterases are low-grade inflammatory markers that have zinc-dependent carboxypeptidase activity. Plasma butyrylcholine esterase is an indicator of dietary zinc level. Matrix metalloproteinases (MMP) that participate in inflammatory processes and contribute to tissue remodeling and repair are zinc containing endopeptidases. The present study attempts to establish the association of zinc with these enzymes in dengue. Materials and Methods: Plasma zinc, butyrylcholinesterase (BChE), and erythrocyte acetylcholinesterase (AChE) were estimated spectrophotometrically in 100 dengue patients and 50 healthy controls. MMP9 was determined using ELISA. Results: Plasma zinc was markedly lower in dengue fever patients compared to healthy controls (P < 0.05). Both BChE and AChE decreased significantly in these patients (P < 0.001) compared to healthy controls. There was an elevation of MMP9 in dengue, although the increase was statistically insignificant. Cholinesterases and MMP9 correlated positively with zinc in controls and dengue, although the correlation was statistically insignificant. Conclusion: The study highlights the role of zinc in the pathology of dengue, as it is essential for the maintenance of activities of cholinesterases and MMP9 that are involved in anti-inflammatory and tissue remodeling processes. Further, prompt administration of micronutrients like zinc may reduce the adverse manifestations and morbidity in dengue.