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Sunday, 16 September 2012

“Metal complexes in biological systems”-- by LAW JIA JUIN with reliable references




In this holiday, i am so bored that  it drives me to do some hardcore reading. i had read through few reputable journals. And after reading those journals i had decided to summarize what i had learnt in this blog. The title of this article/post/portfolio is “Metal complexes in biological systems”. Which i found it will be interesting and useful to those people who are interested in research.
  So what is meant by biological molecule? A bioorganic molecule is defined as an organic molecule which is found in living organisms. Bioorganic chemistry is a cross discipline between biology and chemistry, it is relatively new field to be explored. Metallic elements are essential for many of the processes in life. Sodium, potassium, calcium, and magnesium are known as minerals because they are essential and are required in large quantities. Metals which are required in small amount < 0.01% of the body mass are known as trace metals. Examples of them are lithium, cobalt, nickel, and zinc. These metals can combine with bioorganic molecule to form a new complex.


A.     Cytochrome P450 Enzymes
The first metal-bioorganic complexes in biological system which I am discussing here is Cytochrome P450 Enzymes or CYP450. CYP450 is known hemoproteins ,this is because it belongs to the superfamily of protein that contains heme as a cofactor. The cofactor heme contains an iron center, which is tethered to the CYP450 protein via thiolate ligands. CYP40 is an important class of enzyme, this is because it metabolizes majority of the endogenous and exogenous chemicals. It performs these by the process called oxidation. This class of enzyme utilizes the redox chemistry of the Fe3+/Fe2+ couple for the activation of oxygen (O2) molecules. Oxygen (O2) is been split into two oxygen atoms ,but only one out of two of the oxygen atoms is been used for the oxidation of substrates (can be exogenous or endogenous chemicals), while the second oxygen atom is been used to form H2O as a by-product.
RH + O2 + NADPH + H+ ----- >ROH + H2O + NADP+

          First, I would like to discuss on a journal published on July 2000, I found this journal very interesting because it integrated the knowledge and skills we acquired in Semester 4 Central Nervous System , Medical Chemistry, Biotechnology and Statistics. I love this journal very much. It can be served as reference for further research purposes in IMU. The title of this journal is “The Cytochrome P450 2D6 (CYP2D6) and Serotonin Transporter (5-HTT) Polymorphisms in depressed Inpatients compared to a Control Group”. This study was carried out by a group of leading researchers named, Professor W Steimer, Dr B Müller,Professor S Leucht, W Kissling and their members. The institutes and departments involved in this research were Institute for Clinical Chemistry and Pathobiochemistry , Department of Psychiatry and Psychotherapy ,and Munich University of Technology, Germany. The purpose of this study was to discover the relationships between genetic differences among different individuals (which will directly affects the CYP450 expressed) with the treatment of non-psychotic depressions using the selective serotonin reuptake inhibitors ,SSRIs. Cytochrome P450 (CYP450) enzymes play a role in the metabolisms of selective serotonin reuptake inhibitors (SSRI) antidepressants. According to the researchers Professor Mugdha Thakur and Professor  Iris Grossman, these effects will directly affect the prognosis of the depression treatment as well as the degree of adverse effects experienced by our patients. Thus, if a positive results can be obtained then more time and funds should be spent in the development of individualized and anti-depressants which is more specific.
                    A significant number of depressed patients which had been treated with Tricyclic Antidepressants (TCA) and Selective Serotonine Reuptake Inhibitors (SSRI) had been said to be non-responsive towards these treatments. Thus a research and study had been carried out. In this study,  few advance biotech techniques had been applied, named nested multiplex sequence specific PCR and long PCR for the detection of CYP 2D6 polymorphisms (*3 to *8 and duplication) , besides that conventional PCR for the determination of the long and short variants of the 5-HTT gene-linked polymorphic region (5-HTTLPR) was also applied. These genetic study techniques were applied because the genetic polymorphisms of cytochrome P450 2D6 enzymes(responsible for the metabolisms of Tricyclic Antidepressants) and the promoter of the serotonin transporter gene (SSRIs) have been said to play a role in these non-responsiveness.
            In this research 75 depressed inpatients were randomly picked as sample of study, and 159 anonymous made up of 115 hospital staffs and 45 medical students were treated as control samples. Their DNA samples were extracted out from leukocytes by standard methods (learned in sem 4 biotech). Later the genes responsible for CYP450 2D6 were been amplified using the unique primers designed together with the help of Polymerase Chain Reaction thermocycle machines. The genes responsible for CYP450 2D6 were then treated with restriction enzymes, giving to us many genes fragments of different length and bases.  Finally, the resulting fragments of the various PCRs were separated on standard agarose gels (1.5% and 0.7%) and visualized by ethidium bromide staining. The bands they obtained under X-rays were then analysed. 
          The results they obtained shown that out of 75 depressed inpatients 41 of them were having extensive metabolizers (EM) which were wild types of genes, 19 were having  intermediate metabolizers (IM) which were heterozygotes types of genes, 8 out of 75 were having ultra-rapid metabolizers (UM), 5 poor metabolizers (PM) and the other 2 patients were having a combined duplication and defect mutations. The number of ultra-rapid metabolizers was significantly higher in patients than in controls, with chi2:p les than 0.01. Later blood tests were conducted for EM, IM, UM and PM patients. The results obtained shown that the serum concentrations of TADs and SSRIs were higher in PM patients, normal in EM and IM patients, but is lower in UM (ultrametabolizer) patients. These had proved to us that the therapeutic effects of TCAs and SSRIs were directly affected by CYP450 2D6 polymorphism. Ultra-metabolizer  patients were Those patients who were unresponsive to TADs and SSRIs treatments are usually those with ultra-metabolism CYP450 2D6, whereas, the poor metabolizers are the group of patients who suffered more therapeutic side effects. (chi2: p < 0.01)

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            From the table above we can conclude by saying that the numbers of CYP450 2D6 polymorphisms are higher than those in healthy individuals. Besides that, the phenotypic studies and classifications had revealed that the number of ultra-rapid metabolizers was significantly higher in the patients group than in the control group. This implies to us that the polymorphisms and ultra-rapid metabolisms phenotypes may be a reason for the treatment failure in these depressed patients.
On the other hand, the result for 5HTT test shown no significant differences in the patients and controls. There is no direct relationship between 5HTT genes and  SSRI  therapeutic failures.
            Repeated changes of medications as well as dose adjustments for both UM and PM patients are needed in order to increase the treatments efficacy and minimizing the therapeutic side effects. Co-therapy of SSRI with other substrates of CYP2D6 can also be a choice for UM patients.
            Next, I am discussing on a journal titled Hepatic Lipid Peroxidation and Cytochrome P-450 2E1 in Pediatric Nonalcoholic Fatty Liver Disease (NFLD) and Its Subtypes. This studywas done by Professor Lauren N. Bell,  Dr Jean P. Molleston, Dr Michael J. Morton, and their group members. This study was aimed to establish a relationship between CYP450 2E1 and hepatic lipid peroxidation with non-alcoholic fatty liver disease in paediatrics. This study was carried out at the Pediatric Liver Clinic at Riley Hospital for Children (Indianapolis, IN). CYP450 2E1 enzymes are enzymes which responsible for normal metabolisms, but if they are over-expressed the oxidations may lead to liver damage. On the other hand, hepatic lipid peroxidations are processes by which the free radicals in the body withdraw the electrons from the phospholipid bilayers membranes of liver cells, leading to liver damage by oxidations.
            All together there were 78 children under the ages of 19 were included in this study. 59 of them were having NFLD, 9 of them were having chronic hepatitis C disease, and another 10 children with normal liver biopsies were treated as control group. Their previous liver biopsies were collected and analyzed. Hepatic malondialdehydes (a measure of lipid peroxidation) levels and CYP2E1 proteins contents were quantitated, as a percentage of the total area, by immunohistochemical staining of livers biopsies collected from different children followed by digital image quantitation.
            The results obtained had proved to us that hepatic lipid peroxidation, but not CYP2E1 protein content, is raised in children with NFLD compared to those with normal liver histology or chronic HCV infection. This also shown to us that there are some differences in the pathophysiology of NFLD in children with that of adult. With the new understanding of pathophysiology established ,a more specific therapies targeting the oxidative stress like free radicals can be designed for children.
            The third journal I am going to share here is CYP2C9 and CYP2C19 polymorphisms on tamoxifen pharmacokinetics in Asian breast cancer patients. Tamoxifens are anti-breast cancer drugs. Before any pharmacological actions, they must first be metabolized into their active metabolites called 4-hydroxytamoxifen and endoxifen, this conversions are carried out by multiple cytochrome P450 (CYP) enzymes including CYP2D6, CYP3A4/5, CYP2C9/19, CYP1A2 and CYP2B6. This study is to investigate the impact of genetic polymorphisms in CYP2D6, CYP3A5, CYP2C9 and CYP2C19 on the pharmacokinetics of tamoxifens, which will directly affect the serum concentrations of their metabolites in Asian breast cancer patients.
            Now I am going to summarize the methods used for this study. There are a total of 393 subjects participated in this study. 165 of them are Asian breast cancer patients receiving 20mg tamoxifen daily and the rest (228) of them are made up of healthy Asian subjects (Chinese ,Malay and Indian), these healthy patients were used as control for this study. CYP2D6 polymorphisms of all the samples were genotyped using the INFINITI™ CYP450 2D6I assay, while the polymorphisms in CYP3A5, CYP2C9 and CYP2C19 were determined via direct sequencing. The blood samples of patients were collected respectively and were analysed using high-performance liquid chromatography in order to quantified the steady-state plasma concentrations of tamoxifens and their metabolites.
         There were no significant relationships observed between polymorphisms of CYP3A5, CYP2C9 ,CYP2C19 and the metabolisms of tamoxifens and metabolites of tamoxifens. On the other hand, polymorphisms of CYP2D6 were said to have direct effects on the metabolisms of tamoxifens and the serum concentrations of their metabolites. The polymorphisms, CYP2D6*5 and *10, were significantly associated with lower endoxifen and higher N-desmethyltamoxifen (NDM) concentrations. Besides that, the endoxifen concentrations were found to be 1.8- to 2.6-times higher in *1/*5 or *1/*10 carriers compared with *10/*10 and *5/*10 carriers .Patients who were *1/*1 carriers exhibited 2.4- to 2.6-fold higher endoxifen concentrations and 1.9- to 2.1-fold lower NDM concentrations than either *10/*10 or *5/*10 carriers .
         Thus, the pharmacists can actually develop a treatment regimens which are specific for our patients, for example those with gene polymorphisms at CYP2D6*5 and *10 should be given with artificial direct endoxifens ,this is because the polymorphism they having actually decreases the endoxifens level in their blood. Similarly, the unwanted effects due to the excess high of NDM metabolites resulted from gene polymorphism in these patients can be reduced by adjusting the doses of tamoxifens administered, or others drugs can be used as prophylaxis of these adverse effects.


          Metallothioneins (MTs) are low molecular weight proteins ranging from 500 to 14000 Da. They are classified under the family of cysteine-rich proteins. They are found in the membrane of Golgi apparatus. They have the abilities to bind with many metals both physiological such as zinc, copper, selenium, as well as xenobiotic heavy metals such as cadmium, mercury, silver, arsenic through the thiol groups of their cysteine residues. Cysteine is a sulfur-containing amino acid, hence the word “–thionein” was incorporated into “metallothioneins. The cysteines residues made up of nearly one third of their total amino acidic residues.
            MTs play important roles in metal binding. Metallothioneins can bind to a wide range of metals including cadmium, zinc, mercury, copper, arsenic, silver, etc. Metal-binding of MT occurs via a sequential, non-cooperative mechanism. Some MTs only bind partially to metals but the rest bind completely to the metals. Metallothioneins also participate in the uptake, transport, and regulation of zinc in biological systems. Each mammalian MTs binds and holds four Zn(II) ions in the alpha domain and three in its beta domain. Most MTs in bacterials eg histidine participates in zinc binding. By binding and releasing zinc, metallothioneins (MTs) may regulate zincs levels within the body. Zincs, in turns, play the keys roles for the activation and binding of transcription factors to DNA. Before zincs can activate the transcription factors they should bind to the zincs fingers regions of MTs proteins. Obviously, MTs do help to regulate tumor suppressor proteins p53 by controlling the processes of transcriptions and genes expressions. Third, Metallothioneins also play important roles in carrying zinc ions (signals) from one part of a cell to another part of it. When zinc enters a cell, it will bind to metallothionein  protein and form metallothionein.  Metallothioneins will be carried to another part of the cell where zinc is released from it to another organelle or protein. Thus, MTs are important in the regulations of neurons’ zincs signaling between and within nerve cells.
            First, I am going to discuss on a research article titled “New Proteins Found Interacting with Brain Metallothionein-3 Are Linked to Secretion” written by IssamEl Ghazi, Bruce L.Martin, and IanM. Armitage. I found out that this article is interesting and can be served as reference for further research purposes in IMU.    In a previous study conducted by Uchida et al ,using brain extraction of alzheimer’s sample (rat) and normal sample (also rat). They found out that neurotrophic effect in the brain extract of Alzheimer’s disease (AD) sample was higher than that in normal control sample. High neurotrophic effect subsequently leads to the reduction of a protein originally called, growth inhibitory factor (GIF). GIFs were first thought to be involved in the formation of senile plaques, leading to the exhaustion of the neurons and raised the susceptibility of these neurones to the damages from exocitotoxic substances. But latter they found out in a follow up study that it was the reduction of the GIFs activity and the presence of neurofibrillary tangles (not with the senile plaques)
which lead to Alzheimer’s diseases.  Further interpretation of this GIFs structure by the process of isolation, purification, and sequencing revealed that GIFs actually belonged to a class of protein, known as metallothionein (MT). As only the third isoform of MT had been isolated and purified ,the name metallothionein-3 (MT-3) was given to GIF. In 2010, again Uchida and his group members decided to find out whether there are any special proteins in the body which are able to stimulate the release of MT-3 in the brain, thus giving neuroprotectivity to the brains of Alzheimer’s patients. They conducted this research by 5 major processes. The first process was brain proteins extractions from a rat. This step enabled them to collect all types of proteins sample found in the brain. The second step involved Affinity Chromatography, in which the samples extracted were analyzed. This technique allowed them to separate proteins of different types, as well as allow them to measure their individual fractions in the brain. The third step involves SDS-PAGE and In-Gel Trypsin Digestion. This step was for them to digest the bands and also for them to collect the supernatant. The fourth step involved Mass Spectrometry Analysis. This step was important for them to know the identities of the sample proteins. The mass spectra were later been analyzed using BioWorks SeQuest Analysis Software package so that the functions of sample proteins extracted can be predicted. The results obtained were recorded and discussed on the next page:


Protein ID             MALDITOF          MS/MS       Function
Exo84p                         x                                          Transport
ATP synthase βsubunit             x                          x               Transport
Valosin containing
Protein                                                      x
HSP 84                         x                          x               Chaperoning
HSP70 glucose-regulated
Protein                                                            x               Chaperoning
HSP70 protein 8                                       x               Chaperoning
Tubulin alpha 3                                        x                Scaffold
γ-Actin x
β-Actin                          x                         x                Scaffold
14-3-3 zeta                    x                         x                Scaffold/regulation
Pyruvate kinase 3                                     x                Glycolytic metabolism
γ-Enolase                                                 x                 Glycolytic metabolism
α-Enolase                      x                        x                 Glycolytic metabolism
Creatine Kinase BB      x                        x                 Glycolytic metabolism
Aldolase 3                                               x
Aldolase 1                     x                        x                 Glycolytic metabolism
Malate dehydrogenase  x                        x                 Glycolytic metabolism
DRP-2                           x                        x                 Neuronal growth
DRP-3                                                     x
           
            MT-3 by itself is not toxic nor does it inhibit the growth of neurons. Indeed, it maintains the survival of neurons in culture. MT-3 knockout mice show a higher susceptibility to kainic acid induced neuronal injury, while mice overexpressing MT-3 show enhanced resistance. These results suggested that MT-3 may play a neuroprotective role against toxic substances. MT-3 is abundantly expressed in astrocytes of normal brain, and according to the results obtained above their secretions can be enhanced by giving or raising the expression of others proteins which can interact with MT-3 and help in the transport and release of MT-3. These proteins include Exo84p,Rab3a and ATP synthase βsubunits (as shown on the table above). Thus a revolution in the preventions and treatments of Alzheimer’s diseases may soon be occurred, by targeting on the expression of the MT-3 and special proteins listed above.
           
            The second journal which is related to metallothoneins is “Hepatic Metallothionein in Patients With Chronic Hepatitis C: Relationship With Severity of Liver Disease and Response to Treatment”. The study of this journal was carried out by Prof Georges Carrera et.al. The aim of this study was to study the relationships between hepatic levels and MTs levels in the livers of different patients. Besides that, the distributions of MTs in hepatitis C virus (HCV) infected livers were also studied. Reactive oxygen species involved in the mechanisms of chronic hepatitis C virus infection. Metallothionein (MT) plays a key role in the protection of cells against reactive oxygen species.
           
            In this study, 32 patients with chronic HCV infections were involved. Besides that a control group made up of 12 healthy subjects were also assigned.  Their respective liver biopsies samples were collected. MTs in the samples were quantified separately using radioimmunoassay. Wherease, Interleukin IL-1, IL-6, and tumor necrosis factors INF were quantified using the technique of reverse transcription–polymerase chain reaction
(PCR). And not to forget, the cellular distribution was also studied, and the technique used was immunohistochemistry.
           
            In this study, there were no correlations been found between MTs of chronic HCV infected patients and intra-hepatic cytokine mRNA expression. Nevertheless, they observed that the livers’ MTs proteins in HCV-infected patients were 3-fold lower than that of healthy control subjects. In addition to that, a significant inverse linear regressions between MT proteins or mRNAs expressions with the Histological Activities Indexes, the necro-inflammatory grades, as well as the stages of fibrosis were obtained. These relationships had proved to us that MT proteins play important role in suppressing the histological activities, necro-inflammations, and fibrosis developments. From the study, they also found that MTs immunostainings were located in the nucleuses and cytoplasms of the liver cells of healthy control subjects, whereas those of HCV-infected patients were been found in cytoplasms of the liver cells.
           
            They also found out that those patients given with interferon (IFN) anti-virus therapies but did not respond well to the treatments had less MTs level than those who responded to the therapies. (about half of the total MTs level in those who responded to the interferon therapies

            This study shows to us that the hepatic MT expression could reflect the severity of chronic HCV infection .Besides that, the levels of MTs can also affect the susceptibility of a healthy person towards  the HVC infections. MTs levels also affect the prognosis of an individual upon starting of Interferon therapies. May be doses adjustments should be done according to the MTs levels in patients, so that safe therapeutics doses can be established for maximum therapeutics outcomes.

            The third metallothionein I am sharing here is “Change of Zinc, Copper, and Metallothionein
Concentrations and the Copper-Zinc Superoxide Dismutase Activity in Patients With Pancreatitis”. This study was carried out by Professor Halina Milnerowicz and his research team.
           
                This study was aimed to measure and correlate the concentrations of metallothioneins, zincs, coppers, as well as Cu/Zn superoxide dismutase activities to chronic exacerbated pancreatitis and chronic pancreatitis. The concentrations of these proteins and metals will affect the balance of pro-oxidative and anti-oxidative activities in living organisms . Professor Halina Milnerowicz and his research team had measured the concentrations of metallothioneins by using the method of immune-enzymatic .On the other hand, serum Cu/Zn superoxide dismutases activities were determined by using commercial test. The measurements of Zincs and Coppers concentrations in serums were assessed with the help of flame atomic absorption spectrometry. The results and observations they obtained had shown that the serum Zincs concentrations had been lowered but the Coppers levels had been raised in the serum of patients with chronic exacerbated pancreatitis and chronic pancreatitis. Besides that, significant increase of metallothioneins concentrations and Cu/Zn superoxide dismutase activities (but still lower that pro-inflammatory activities) were also been observed in the blood of these patients. In addition to that, by observing the slices obtained from the pancreases of patients with chronic exacerbated pancreatitis and chronic pancreatitis, they found out that there are many immunohistochemical reaction occurred, involving the actions of Cu/Zn superoxide dismutases and metallothioneins.
All these results and observations prove to us that the presences of variable antioxidants like Cu/Zn superoxide dismutases and metallothioneins are important for a healthy pancreas. Any disorder or dysfunction affecting the homeostasis of metallothioneins , Cu/Zn superoxide dismutases, coppers and zincs will lead to inflammatory processes and thus causing pancreatitis. On the other way, we can also say that patients at different stages of pancreatitis will be having different degrees of metallothioneins , Cu/Zn superoxide dismutases , zincs, and coppers levels imbalances. So a treatment targeting on the recovery of these imbalances can be developed for the treatment and prevention of pancreatitis. 

Next I am going to discuss on the biochemistry of zinc. Biochemistry of zinc means the chemical reactions and biological processes happen inside the body with the involvement of zinc. Zinc is classified as metal, because it can conduct electricity and heat. Zinc is the 24th most abundant element in the Earth's crust and has five stable isotopes. It is the first element in group 12 of the periodic table. It has an atomic number of 30. Both zinc and magnesium are having similar chemical properties. This is because its’ ion is having common oxidation number (+2) as magnesium ion. Although zinc is an element but it usually exists in the form of zinc ore examples, zinc sulfide mineral. In human body, zinc is required in trace amount , < 0.01% of total body mass. Since zinc is a very reactive metal, it is very useful in industrial field. It can be used as anti- corrosive agent for other corrosive metals. Zincs are used in battery and protection of cars’ metals surfaces. Zincs when mixed with coppers will form alloys called bronze, which are stronger, more ductile, lighter, resistant towards corrosion and cheaper. Besides that, zincs are also used as catalysts for many industries chemical reactions like Frankland-Duppa Reaction in which an oxalate ester(ROCOCOOR) reacts with an alkyl halide R'X, zinc and hydrochloric acid to form the α-hydroxycarboxylic esters RR'COHCOOR. There are 2–4 grams of zincs distributed throughout the human bodies. Most zincs are found in the brain, muscle, bones, kidney, and liver, with the highest concentrations in the prostates and parts of the eyes. Semen is particularly rich in zinc. Zincs also play a key role in the prostate gland function and the growth of reproductive organ. Zincs are transferred and stored in metallothioneins. In proteins, Zn ions are often coordinated to the amino acid side chains of aspartic acid, glutamic acid, cysteine and histidine. In humans, zincs act as ubiquitous biological role by interacting with a wide range of organic ligands. Zincs also help in the metabolisms of RNAs and DNAs, signals transduction, regulation of apoptosis ,and genes expressions. Zincs are also important in the brain functions like learning and memory. In brain zincs are stored glutamatergic neurons in the form of specific synaptic vesicles. But excessive of it may lead to neurotoxicity, thus the homeostasis of zincs in brain are extremely important.
            The first article regarding the biochemistry of zinc which I am discussing here is “Copper, zinc, and magnesium levels in non-insulin dependent diabetes mellitus”. The research in this journal was done by Abdul Hamid Zargar, Nissar Ahmad Shah, Shariq Rashid Masoodi, Bashir Ahmad Laway, Farooq Ahmad Dar, Abdul Rashid Khan, Fayaz Ahmad Sofi, and Arshad Iqbal Wani.
            This study was designed to find out the  relationships between trace elements, (zinc, copper, magnesium) and diabetes mellitus. In this study, 83 patients with non-insulin dependent diabetes mellitus were involved. 40 of them were men and 43 of them were women. These samples were having the diabetes with the durations between 3.6 to 3.9 years. However, the patients with nephropathy were excluded in this study. A control group was also been used, this control group was made up of thirty healthy non-diabetic subjects. All the subjects were subdivided into obese and non-obese groups. Diabetic subjects were also subdivided into controlled and un-controlled groups. The controlled patients were made up of those people with fasting blood glucose and serum fructosamine levels. The serum concentrations of zinc, copper and magnesium were analysed using a GBC 902 double beam atomic absorption spectrophotometer.
Age, sex, duration and control of diabetes patients did not affect the copper, zinc, or magnesium concentrations. The copper levels of diabetic patients were seriously elevated (p<0.01) ,while the plasma concentration of zinc and magnesium were comparable between diabetic and nondiabetic subjects. We conclude that zinc and magnesium levels are not altered in diabetes mellitus. Thus it is the copper and not zinc concentration should be the targeted for the development of drugs for non-insulin dependent diabetes mellitus.
Next, I am going to discuss on an official journal published by American Academy of Pediatrics. The title of this journal is “A Meta-analysis of the Effects of Oral Zinc in the Treatment of Acute and Persistent Diarrhea.” The study in this journal was conducted and written by Marek Lukacik ,Ronald L. Thomas and Jacob V. Aranda.
Diarrheas and zincs deficiencies are considered as two main problems faced by children in developing countries. These are due to the lacking of clean water and the problem of starvations. Zincs supplements are usually given by United Nations to the children in poor developing countries. This is because supplementary zincs were previously been thought to provide therapeutic benefits in diarrhea. So the aim of this study was to examine the efficacy and safety of these oral zincs therapies in the managements of acute or persistent diarrheas.
In this study, children suffering from acute and persistent diarrhea were used as samples. There were divided into a manipulation group and control group. The first group was treated with oral zincs supplements, the second group, which is the control group, was treated with placebos. The efficacy and safety were assessed among these two groups of patients. All the results were reported using a pooled relative risk or a weighted mean difference.
From the results they obtained, they concluded that oral zincs supplements can help in the alleviations of acute and persistent diarrheas in children, by reducing the severity and duration of diarrhea. But the mechanisms behind these actions remained un-clear to them. Although these zincs supplements do help in the treatments of acute and persistent diarrheas but they lead to the problems like vomits and constipations. Basically, the mean durations of acute diarrhea and persistent diarrhea were significantly reduced for those children treated with oral zincs supplements. In facts, these treatments were more effective for those with persistent diarrhea than for those with acute diarrhea. At day 1 (one day after the zincs supplements and placebos were given to respective groups of patients), the occurrences and severities of diarrheas between zinc and placebo treated patients do not show any significant difference. It is only at day 3 that a significant difference been observed. At day 3, the occurrences of diarrheas in patients treated with oral zincs supplements were significantly lower than those who were treated with placebos. And also, the improvements seen in patients with persistent diarrheas were more than those with acute diarrheas. Vomits experienced by patients with acute diarrheas were also found to be more severe in those with acute diarrhea (11 cases) but lower in those with persistent diarrhea (only 4 cases). They also found out that children given with zinc gluconate vomited more than those given with zinc sulfate/acetates. In this study, some children actually experienced the problems of constipations right after their diarrhea had been stopped by oral zinc therapies.
These results showed to us that oral zinc supplements benefit those children with persistent diarrhea than those children with acute diarrhea, and also the side effects experienced by those with persistent diarrheas were lower than those with acute diarrheas. Zinc sulfate/acetates can be used to relace zinc glutamate if the side effect like vomit is to be reduced. With these new findings in mind the healthcare providers can actually adjust their treatments choices for children with different types of diarrhea. And whether the results obtained here can be extrapolated to adults or children of different backgrounds was still a mist. Further researches and studies are needed before these extrapolations can be made.
           
The last journal I am discussing here which is related to the biochemistry of zinc is “Zinc-Alpha 2-Glycoprotein Gene Expression in Adipose Tissue Is Related with Insulin Resistance and Lipolytic.” This study was conducted by Lourdes Garrido-Sa´nchez and his research team. Zinc-α2 glycoprotein (ZAG) is a gene which produces Zinc-α2 glycoprotein. This Zinc-α2 glycoprotein has a binding site for zinc. And it needs zinc for its’ function. Thus its’ activity is directly related to the biochemistry and concentration of zinc in our body. Zinc-α2 glycoprotein is a metal-complex which will stimulate the lipid loss of the body by adipocytes and may be involved in the regulation of adipose tissue metabolism. But their relationship with lipogenic and lipolytic genes and with insulin resistance (IR) remained unknown. Thus the study conducted here was to correlate the biochemistry of zinc and the expression of ZAG with the lipogenic, lipolytic and insulin resistance. There are total of 50 samples involved in this study, 25 of them were made up of non-diabetic morbidly obese patients, 11 of them made up of low IR patients and 14 of them made up of high IR patients. The mRNA expression levels of PPARγ, IRS-1, IRS-2, lipogenic and lipolytic genes as well as ZAG gene in visceral (VAT) and subcutaneous adipose tissue (SAT) were also quantified. Plasma ZAG was also analyzed. From the results they obtained, they concluded that patients with high VAT ZAG expressions are usually those from morbidly obese group. Besides that, they also found out that those with low IR had a higher VAT ZAG expression as compared with those  with high IR. In the patients with low IR, the VAT ZAG expression was greater than that in SAT. ZAG expression correlated between SAT and VAT. VAT ZAG expression was mainly predicted by insulin, HOMA-IR, plasma adiponectin and expression of adiponectin and ACSS2. SAT ZAG expression was only predicted by expression of ATGL.  As a conclusion, we can said that the plasma zinc level and ZAG level not only correlated to insulin resistance (IR) but they also affect the metabolisms of lipids in adipose tissues. Thus, the future treatments for obesity and problems like diabetes should target on the modulation of zinc and ZAG levels.
After reading through these reputable journals on CYP450, Metallothioneins, and Biochemistry of Zincs, I had learnt to appreciate the affords done by these researchers. I also learnt to become humble as I realized that there are still a lot of things outside the world that I am still not aware of. The techniques, methods and findings written in these journals had inspired me a lot especially in the aspect of drugs developments. After reading through these journals and articles I had been acknowledged with the current trends in drugs discovery and also the new treatments approaches, thus I will keep reading these kinds of journals in the future! Readings journals like this are definitely useful especially in my career!




REFERENCES
1.      Wikipedia Group. Cytochrome P450 Enzyme.[internet].2010[updated on 2012.Cited on cited on 2012 April 1  ].Available from http://en.wikipedia.org/wiki/Cytochrome_P450.
2.      W Steimer1, B Müller1, S Leucht.et.al.Prevalence of Cytochrome P450 2D6 (CYP2D6) and Serotonin Transporter(5-HTT) Polymorphisms in depressed Inpatients compared to a Control Group. AACC, San Francisco.Vol. 1.[Journal].2000 July 23[cited on 2012 April 1 ].Vol.1.pp11
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