Zinc therapy is normally utilized for treatment of Wilson disease (WD), an inherited condition that is characterized by increased levels of non-ceruloplasmin bound (‘free’) copper in serum and urine. A subset of patients with Alzheimer’s disease (AD) or its prodromal form, known as Mild Cognitive Impairment (MCI), fail to maintain a normal copper metabolic balance and exhibit higher than normal values of non-ceruloplasmin copper. Zinc’s action mechanism involves the induction of intestinal cell metallothionein, which blocks copper absorption from the intestinal tract, thus restoring physiological levels of non-ceruloplasmin copper in the body. On this basis, it is employed in WD. Zinc therapy has shown potential beneficial effects in preliminary AD clinical trials, even though the studies have missed their primary endpoints, since they have study design and other important weaknesses. Nevertheless, in the studied AD patients, zinc effectively decreased non-ceruloplasmin copper levels and showed potential for improved cognitive performances with no major side effects. This review discusses zinc therapy safety and the potential therapeutic effects that might be expected on a subset of individuals showing both cognitive complaints and signs of copper imbalance.

中文翻译：

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早期阿尔茨海默氏病中的锌疗法：安全性和潜在的疗效。

锌疗法通常用于治疗威尔逊病（WD），这是一种遗传性疾病，其特征是血清和尿液中非铜蓝蛋白结合（“游离”）铜的水平增加。患有轻度认知障碍（MCI）的一部分患有阿尔茨海默氏病（AD）或前驱形式的患者无法维持正常的铜代谢平衡，并且显示出高于非铜蓝蛋白的正常值。锌的作用机制涉及诱导肠细胞金属硫蛋白，从而阻止铜从肠道吸收，从而恢复体内非铜蓝蛋白的生理水平。在此基础上，将其用于WD。锌疗法已在初步的AD临床试验中显示出潜在的有益效果，即使这些研究未达到其主要终点，因为他们有研究设计和其他重要的弱点。然而，在研究的AD患者中，锌有效降低了非铜蓝蛋白铜水平，并显示出改善认知能力的潜力，而没有重大副作用。这篇综述讨论了锌治疗的安全性以及可能对表现出认知障碍和铜失衡迹象的个体子集预期的潜在治疗作用。