Zinc as an adjunct in radiation-based therapies: Evidences of radioprotection and mechanistic insights

Background Radiation-based therapies are a progressive modality for managing life-threatening diseases such as cancer. However, these treatments often inflict damage on non-target tissues, necessitating the development of effective radioprotective agents. Zinc, known for its diversified role under various pathological conditions, has emerged as a potential protective agent against radiation-induced injuries due to its antioxidant, anti-inflammatory and immune-regulating properties. Aim This review aims to evaluate the potential of zinc in mitigating the adverse effects associated with radiation-based therapies, focusing on its protective role in normal tissue injury. Methods A comprehensive literature review was conducted using multiple databases, including PubMed, NCBI, SciFinder, Google Scholar and Science Direct. Relevant studies assessing the radioprotective effects of zinc were identified and analysed to summarise its efficacy and potential benefits in radiation therapy. Results The review highlights the beneficial effects of zinc in managing radiation-induced adverse effects, such as oral mucositis, skin injury, dermatitis, xerostomia, dysgeusia, dysosmia, bone marrow regeneration and oxidative stress reduction. Zinc's role as an antioxidant and anti-inflammatory agent, along with its ability to regulate immune system homeostasis, underpins these protective effects. Conclusions Zinc shows promising potential as a radioprotective agent in mitigating the adverse effects of radiation-based therapies. Despite the positive preclinical and clinical findings, further randomised trials with larger sample sizes and rigorous methodologies are needed to confirm zinc's efficacy. Additionally, further research is warranted to explore zinc's potential in addressing other radiation-induced events, ultimately contributing to improved patient care during radiation therapy.