Efficacy of zinc against common cold viruses: an overview.
OBJECTIVE
To review the laboratory and clinical evidence of the medicinal value of zinc for the treatment of the common cold.


METHODS
Published articles identified through Medline (1980-2003) using the search terms zinc, rhinovirus, and other pertinent subject headings. Additional sources were identified from the bibliographies of the retrieved articles.


METHODS
By the author.


METHODS
By the author.


RESULTS
Human rhinoviruses, by attaching to the nasal epithelium via the intracellular adhesion molecule-1 (ICAM-1) receptor, cause most colds. Ionic zinc, based on its electrical charge, also has an affinity for ICAM-1 receptor sites and may exert an antiviral effect by attaching to the ICAM-1 receptors in the rhinovirus structure and nasal epithelial cells. Clinical tests of zinc for treatment of common colds have been inconsistent, primarily because of study design, blinding, and lozenge contents. Early formulations of lozenges also were unpalatable. In three trials with similar study designs, methodologies, and efficacy assessments, zinc effectively and significantly shortened the duration of the common cold when it was administered within 24 hours of the onset of symptoms. Recent reports of trials with zinc gluconate administered as a nasal gel have supported these findings; in addition, they have shown that treatment with zinc nasal gel is effective in reducing the duration and severity of common cold symptoms in patients with established illness.


CONCLUSIONS
Clinical trial data support the value of zinc in reducing the duration and severity of symptoms of the common cold when administered within 24 hours of the onset of common cold symptoms. Additional clinical and laboratory evaluations are warranted to further define the role of ionic zinc for the prevention and treatment of the common cold and to elucidate the biochemical mechanisms through which zinc exerts its symptom-relieving effects.
Hulisz
Darrell
D
School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. dth4@cwru.edu
D002626:Chemistry, Pharmaceutical; D003139:Common Cold / Q000188:drug therapy*; D005942:Gluconates / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D012229:Rhinovirus / Q000187:drug effects* / Q000472:pathogenicity; D016896:Treatment Outcome; D019345:Zinc Acetate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D005942:Gluconates; D018799:Intercellular Adhesion Molecule-1; D019345:Zinc Acetate