Zinc is an essential trace element critical for surgical recovery and cognitive resilience due to its multifaceted role in enzyme activation, immune modulation, neuroprotection, and tissue repair. It supports over 50 enzymatic reactions spanning all six enzyme classes, facilitates collagen synthesis, and promotes cellular proliferation. Zinc also mitigates inflammation and oxidative stress, enhances mucosal barrier function, and supports cognitive function through its action on neurotransmitters and long-term potentiation (LTP). Deficiency in zinc is associated with delayed wound healing, impaired immune defense, and increased neuroinflammation—key concerns in the perioperative period.

Mechanisms of Action and Benefits

1. Enzymatic Activation and Protein Synthesis
Zinc supports over 50 metalloenzymes and structural proteins essential for cellular replication, protein synthesis, and DNA repair. This enzymatic support is foundational to immune competence and surgical tissue regeneration【1】.

2. Collagen Formation and Wound Healing
Zinc catalyzes key steps in collagen biosynthesis, enhancing epithelialization and fibroblast function. It is essential for wound healing by increasing tensile strength and promoting infection resistance in surgical wounds【1】.

3. Antioxidant Defense via Metallothionein Induction
Zinc induces the expression of metallothioneins, which sequester reactive oxygen species and reduce oxidative damage. This enhances antioxidant capacity during surgical stress and supports tissue repair【1】.

4. Inflammation Reduction and Immune Modulation
Zinc down regulates inflammatory markers such as C-reactive protein and modulates the function of macrophages, neutrophils, and natural killer (NK) cells. These actions reduce the risk of postoperative infection and systemic inflammation【1】.

5. Neuroprotection and Cognitive Function
Zinc regulates neurotransmitter signaling and facilitates long-term potentiation (LTP), a critical mechanism underlying memory and learning. Deficiency is associated with impaired cognition and heightened vulnerability to postoperative cognitive dysfunction【2,3】.

6. Apoptosis Inhibition
Zinc inhibits caspase-mediated apoptotic pathways, protecting cells from programmed death during metabolic and surgical stress, and preserving tissue viability【3】.

7. Mucosal Barrier Support
Zinc strengthens epithelial barriers by stabilizing tight junction proteins, helping to maintain gut integrity and reduce the risk of bacterial translocation and postoperative complications【1】.

References

1. https://lpi.oregonstate.edu/mic/minerals/zinc. Accessed October 2024.
   
2. https://lpi.oregonstate.edu/mic/health-disease/cognitive-function#zinc-deficiency. Accessed October 2024.
   
3. J Neurosci. 2011;31(45):16076–16085. doi:10.1523/JNEUROSCI.3454-11.2011