Zinc supplementation in reducing myeloperoxidase level in chronic suppurative otitis media without cholesteatoma

Context: The pathogenesis of chronic suppurative otitis media (CSOM) remains unclear, but it has been reported that myeloperoxidase (MPO) contributes significantly to chronic CSOM processes. Given the role of MPO in CSOM pathogenesis, antioxidant therapy such as zinc is believed to be an adjunctive therapy to the existing standard therapy for optimal treatment. Aims: To analyze the effect of zinc on MPO in patients with CSOM without cholesteatoma. Methods: This research was conducted at the ENT Clinic of Dr. Moewardi Hospital, Indonesia, using a pretest-post-test control group design. Samples in the investigation were divided into two treatment groups: zinc supplementation and placebo for 30 days. Furthermore, to determine the effectiveness of zinc supplementation, MPO serum levels were measured using an MPO ELISA kit. Results: The mean level of MPO decreased significantly from 3.17 ± 1.47 ng/mL to 0.65 ± 0.48 ng/mL (p=0.001) after intervention with zinc supplementation, meanwhile after the intervention with placebo, the mean level of MPO also lowered insignificantly from 3.08 ± 1.05 ng/mL to 2.45 ± 0.78 ng/mL (p=0.082). A significant difference was also found in MPO level changes within the zinc group compared to the placebo group (0.63 ± 1.13 ng/mL vs. 2.51 ± 1.24 ng/mL) (p=0.001). Conclusion: Zinc has a modulator effect in the inflammation cascade, which can decrease MPO levels in CSOM without cholesteatoma. This opens the possibility of using zinc supplementation as an additional therapy to the existing standard of CSOM therapy.