As pediatric asthma and allergic rhinitis continue to rise globally, researchers are turning their attention to an often-overlooked micronutrient — zinc. The comprehensive review, “The Role of Zinc in Pediatric Asthma and Allergic Rhinitis: Mechanisms and Clinical Implications,” highlights zinc’s multifaceted role in immune regulation, oxidative stress control and epithelial barrier maintenance, suggesting it may be a powerful ally in managing allergic airway diseases in children. The review was published in the Multidisciplinary Digital Publishing Institute (MDPI) journal.
According to the review, children are disproportionately impacted by asthma. Allergic rhinitis, often co-occurring with asthma, adds to the burden, especially in urbanized and industrialized regions. Traditional treatments, such as corticosteroids, antihistamines and allergen avoidance, offer symptomatic relief but fall short for many patients. This has sparked interest in nutritional interventions, particularly trace elements like zinc, researchers said.
Additionally, the review said zinc is the second most abundant trace metal in the human body and is essential for more than 300 enzymatic reactions. In the immune system, it supports T-cell development, regulates Th1/Th2 balance and maintains mucosal integrity. Zinc deficiency, which affects up to 20% of the global population, has been linked to increased airway inflammation, oxidative stress and poor asthma control.
The review noted that previous studies and meta-analyses have shown that children with asthma often have lower circulating zinc levels. These deficiencies correlate with worse symptom control, reduced lung function and increased inflammatory markers. Interventional trials suggest that zinc supplementation may improve clinical outcomes, including reduced wheezing and enhanced pulmonary function, especially in children with documented deficiency.
In allergic rhinitis, zinc levels present a paradox, according to the review. While systemic zinc may decrease during active inflammation, local zinc concentrations in nasal secretions often rise. This redistribution may reflect the body’s attempt to combat oxidative stress and repair epithelial damage. However, tissue-level zinc depletion has been linked to eosinophilic infiltration and impaired collagen synthesis, contributing to chronic inflammation and tissue remodeling.
The review further noted zinc’s therapeutic effects are rooted in its ability to:
- Suppress oxidative stress via Cu/Zn superoxide dismutase.
- Regulate Th2-driven inflammation by modulating cytokine production.
- Maintain epithelial barrier integrity through tight junction stabilization.
- Support tissue repair and reduce apoptosis via metallothionein induction.
Animal studies further support zinc’s role, showing that supplementation can reduce allergic symptoms and inflammatory markers, partly by downregulating the p38 MAPK pathway.
Given its safety, affordability and biological relevance, the review suggested that zinc supplementation could become a valuable adjunct in pediatric allergy care. However, current evidence is limited by study heterogeneity, small sample sizes and inconsistent methodologies. The review called for large-scale, randomized controlled trials to establish standardized dosing, identify responder subgroups and evaluate long-term outcomes.
Additionally, the review encouraged a personalized medicine approach, integrating zinc status assessments into routine care, especially for children with severe or poorly controlled asthma or rhinitis. Combining zinc with other micronutrients like selenium and vitamin D may further enhance therapeutic effects.
