Copper, wound healing

Trace elements are essential cofactors for numerous biochemical processes. Trace elements that are added routinely to PN include zinc, selenium, copper, manganese, and chromium. There are various commercial parenteral trace element formulations that can be added to PN admixtures (e.g., MTE-5 ). Zinc is important for wound healing, and patients with high-output fistulas, diarrhea, burns, and large open wounds may require additional zinc supplementation. Patients may lose as much as 12 to 17 mg zinc per liter of gastrointestinal (GI) output (e.g., from diarrhea or enterocutaneous fistula losses) however, others have demonstrated that 12 mg/day may be adequate to maintain these patients in positive zinc balance.18 Patients with chronic diarrhea, malabsorption, and short-gut syndrome may have increased selenium losses and may require additional selenium supplementation. Patients with severe cholestasis should have copper and manganese... 

Polyphenol oxidase occurs within certain mammalian tissues as well as both lower (46,47) and higher (48-55) plants. In mammalian systems, the enzyme as tyrosinase (56) plays a significant role in melanin synthesis. The PPO complex of higher plants consists of a cresolase, a cate-cholase and a laccase. These copper metalloproteins catalyze the one and two electron oxidations of phenols to quinones at the expense of 02. Polyphenol oxidase also occurs in certain fungi where it is involved in the metabolism of certain tree-synthesized phenolic compounds that have been implicated in disease resistance, wound healing, and anti-nutrative modification of plant proteins to discourage herbivory (53,55). This protocol presents the Triton X-114-mediated solubilization of Vida faba chloroplast polyphenol oxidase as performed by Hutcheson and Buchanan (57). 

Zinc helps in wound healing and maintaining taste and smell. Zinc stimulates enzymes involved in the production of insulin, sperm, DNA synthesis, and the immune system. Zinc supplements larger than 150 mg can result in decreased high-density lipoprotein (HDL) cholesterol and copper deficiency, and can weaken the immune response. Zinc supplements should not be taken with antibiotics because it inhibits tetracycline (antibiotic) absorption. Wait 2 hours after taking any antibiotic before taking zinc. 

Reduces conversion of hypoxantine and xantine to uric acid, resulting in development of xantine renal calculi deficiency state may be potentiated by high copper intake Delayed wound healing impaired taste sensitivity retarded growth and sexual development dwarfism... 

Copper occurs in many foods particularly good sources are liver, kidney, shellfish, nuts, raisins, and dried legumes. Copper deficiency due to diet is rare except in malnutrition and in children with chronic diarrhea. It occurs in total parenteral nutrition with fluids low in copper, particularly following intestinal resection and in patients who receive large amounts of zinc to improve wound healing or for management of sickle cell anemia. Copper is often removed from prepared foods to increase their shelf life. 

Zinc Dermatitis, hypogeusia, alopecia, diarrhea, apathy, depression, growth retardation, impaired wound healing, immunosuppression Acute gastric distress, nausea, dizziness, death with large intravenous doses Chronic immunosuppression, decreased HDL, copper deficiency Decreased infection, hypoalbuminemia, corticosteroids, pregnancy, burns, stress, inflammation Increased tissue injury, hemolysis, contaminated collection tube... 

A number of new copper complexes have also been found to have antiinflammatory activity. Copper(II)(j8-oxo-2-thiophenepropionitrile) is effective in treating rat polyarthritis [175]. The copper complex of glycyl-L-histidyl-L-lysine, Cu(II)(GHL), is claimed to have anti-inflammatory activity and increase the rate of wound healing [176, 177] consistent with earlier reports of increased gastric wound healing rates associated with Cu(II)(aspirinate)4 and Cu(II)(tryptophanate)2 treatment [178]. Copper(II)(L-histidinate)2, Cu(II)-... 

Overexposure to zinc by food, water, and air commonly poses no risk to the general population. Long-term administration of zinc (100-150 mg per day) to patients to promote wound healing is usually well tolerated, but anemia may be induced in case of low copper status. This effect is readily reversible, however. Using a safety factor of 10 this means that an additional zinc intake of 10-15 mg per day does not constitute a health hazard (US ERA 1980). The provisional maximum tolerable daily intake for man has been estimated at 0.3 to 1.0 mg Znkg body weight (WHO 1983). 

For a wound to be healed, it has to be fed by either using the body s own resources, which in many cases are inadequate because of vascular damage, or by using supplements, which may be applied directly at the site of the wound, rather than rely on supplementation that is dependent on the circulation. Supplements like vitamins A, C and E, as well as zinc and copper are important in the wound healing process. 

Microbial cellulose is found to be an optimal material for skin tissue repair due to its ability to provide a moist environment for wound healing and pain free dress changing. Unfortrmately, microbial cellulose itself has no antimicrobial activity to prevent wound infection. However the lack of antimicrobial activity of microbial cellulose is the main issue to be tackled. To improve the antimicrobial activity of microbial cellulose, researchers have introduced different materials such as benzalkonium chloride, chitosan and metallic nanoparticles into microbial cellulose. Among them metallic nanoparticles such as copper, silver [56] and ZnO [57] have been recently reported as excellent antimicrobial agents. Due to the electron-rich oxygen atoms in the microbial cellulose macromolecules and the large surface area of nanoporous microbial cellulose effective as nanoreactor, the in-situ metallization technique was successfully applied to the synthesis of Ag and microbial cellulose nanocomposite, which could in turn serve as antimicrobial skin tissue repair material. 

Related to these effects of essential metals are the antibacterial effects of some copper compounds [55] and the wound-healing properties of zinc salts [56]. 

The rationale for the use of zinc is that serum zinc levels are lowered in arthritis sufferers, zinc promotes wound healing, and that zinc is necessary for maintenance of some immune responses [107—109]. Some benefit has been observed but with no dramatic improvements, and efficacy is unconfirmed. Despite the logic of the arguments used for zinc, it has been classed as of unlikely benefit , along with other attempts such as acupuncture and prayer [110]. In this respect, taking heart from the traditional use of copper bracelets, we can say that the use of metals probably outdates that of prayer. 

A number of metal ions, such as iron, zinc, copper, magnesium, and selenium, play important roles in cellular activities. Deficiency in any metal ion delays wound healing. Apart from systemic intake of these metal ions in the diet, they can be administered through the topical use of appropriate wound dressings. 

Cangul IT, Gul NY, Topal A, et al. Evaluation of the effects of topical tripeptide-copper complex and zinc oxide on open-wound healing in rabbits. Vet Dermatol 2006 17 417-23. 

Zinc oxide is a very old technological material. Already in the Bronze Age it was produced as a byproduct of copper ore smelting and used for healing of wounds. Early in history it was also used for the production of brass (Cu-Zn alloy). This was the major application of ZnO for many centuries before metallic zinc replaced the oxide [149]. With the start of the industrial age in the middle of the nineteenth century, ZnO was used in white paints (chinese white), in rubber for the activation of the vulcanization process and in porcelain enamels. In the following a number of existing and emerging electronic applications of ZnO are briefly described. 

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