The relationship of plasma aluminum to oxidant-antioxidant and inflammation status in asthma patients

Aluminum (Al) is a non-essential mineral which human beings are exposed to on day-to-day life. The purpose of this study was to assess the concentrations of plasma Al and the relationship of those levels with risk factors for asthma. In total, 27 allergic asthmatics and 30 healthy volunteers were enrolled. Plasma Al and selected blood parameters were measured, and a pulmonary function test was performed. Higher Al concentrations were found in the asthmatics than the healthy controls. Increased immunoglobulin E, high-sensitivity C-reactive protein, lipid peroxidation products, and pro-inflammatory cytokines (tumor necrosis factor-α and interleukin [IL]-4) were observed, but IL-10 and overall antioxidant and enzyme activities were lower. Associations between oxidative-antioxidant status and inflammatory markers with plasma Al levels in asthmatics were noted. Al status was also linked to cytokine concentrations and pulmonary function. In conclusion, abnormal Al distribution may further precipitate oxidative stress and inflammation, alter Th1/Th2 lymphocyte balance, and therefore contribute to the development of asthma.

Iron and aluminum in Alzheimer's disease

In this case presentation, a woman with high serum levels of aluminum was treated with chelation therapy with deferoxamine and ascorbic acid. This patient was initially bedridden and the clinical situation was complicated by epileptic seizures. After the chelation therapy, the clinical condition was ameliorated and the therapy continued without the correlation to aluminum serum levels. The role of metals in neurodegenerative disorders and the correlation between iron metabolism and amyloid beta peptide are described. This case suggests chelation therapy could represent a promising therapeutic option for this dramatic disease.

Application of Zeeman graphite furnace atomic absorption spectrometry with high-frequency modulation polarization for the direct determination of aluminum, beryllium, cadmium, chromium, mercury, manganese, nickel, lead, and thallium in human blood

Determination of aluminum (Al), beryllium (Be), cadmium (Cd), chromium (Cr), mercury (Hg), manganese (Mn), nickel (Ni), lead (Pb), and thallium (Tl) concentrations in human blood using high-frequency modulation polarization Zeeman graphite furnace atomic absorption spectrometry (GFAAS) was performed. No sample digestion was used in the current study. Blood samples were diluted with deionized water or 0.1 % (m/v) Triton X-100 solution for Tl. Dilution factors ranged from 1/5 per volume for Be and Tl to 1/20 per volume for Cd and Pb. For Tl, Cd, and Hg, noble metals (gold, platinum, rhodium, etc.) were applied as surface modifiers. To mitigate chloride interference, 2 % (m/v) solution of NH(4)NO(3) was used as matrix modifier for Tl and Ni assessment. The use of Pd(NO(3))(2) as oxidative modifier was necessary for blood Hg and Tl measurement. Validation of the methods was performed by analyzing two-level reference material Seronorm. The precision of the designed methods as relative SD was between 4 and 12 % (middle of a dynamic range) depending on the element. For additional validation, spiked blood samples were analyzed. Limits of detection (LoDs, 3σ, n = 10) for undiluted blood samples were 2.0 μg L(-1) for Al, 0.08 μg L(-1) for Be, 0.10 μg L(-1) for Cd, 2.2 μg L(-1) for Cr, 7 μg L(-1) for Hg, 0.4 μg L(-1) for Mn, 2.3 μg L(-1) for Ni, 3.4 μg L(-1) for Pb, and 0.5 μg L(-1) for Tl. The LoDs achieved allowed determination of Al, Cd, Cr, Mn, Ni, and Pb at both toxic and background levels. Be, Hg, and Tl could be reliably measured at toxic levels only. The methods developed are used for clinical diagnostics and biological monitoring of work-related exposure.

Particle-induced X-ray emission analysis of elements in plasma from wild and captive sea turtles (Eretmochelys imbricata, Chelonia mydas, and Caretta caretta) in Okinawa, Japan

The aim of this study was to evaluate the reliability of direct determination of trace and major element concentrations in plasma samples from wild (six hawksbill, nine green, and nine loggerhead) and captive sea turtles (25 howksbill, five green, and three loggerhead) in Okinawa, Japan. The particle induced X-ray emission method allowed detection of 23 trace and major elements (Al, As, Br, Ca, Cl, Cr, Cu, Fe, Hg, K, Mg, Mn, Mo, Ni, P, Pb, S, Se, Si, Sr, Ti, Y, and Zn). The wild sea turtles were found to have high concentrations of As and Pb in plasma compared with captive, but there were no significant changes in the Al and Hg concentrations. Loggerhead sea turtles were found to have significantly higher accumulation of As and Pb in plasma in comparison to other species. These findings may be useful when adjusting environmental and species-related factors in severely polluted marine ecosystems. Our results indicate that measuring the plasma As and Pb concentrations in wild sea turtles might be of help to assess the level of pollution in marine ecosystems, keeping in mind that loggerhead sea turtles had been shown to have higher levels of As and Pb in plasma.

The relationship between plasma aluminum content, lymphocyte DNA damage, and oxidative status in persons using aluminum containers and utensils daily

OBJECTIVES

The aim of this study was to explore the in vivo effect of the plasma aluminum content on lymphocyte DNA damage, the plasma protein carbonyl (PC) content, and malondialdehyde (MDA) and total antioxidative capacity (TAC) levels in aluminum exposed and non-exposed humans.

DESIGN AND METHODS

Peripheral blood samples were collected from in vivo aluminum exposed and non-exposed humans and the above parameters were measured.

RESULTS

The mean values of lymphocyte DNA damage, plasma MDA, PC levels, and aluminum concentrations were found to be significantly higher in the aluminum exposed group than within the control group (p<0.01). On the other hand, plasma TAC levels were found to be significantly lower in the aluminum exposed group than in the control group (p<0.001). Significant positive correlations were found to exist between lymphocyte DNA damage and the aluminum concentration (r=0.643, p<0.001), DNA damage and MDA (r=0.491, p<0.001), and DNA damage and PC (r=0.548, p<0.01). A negative correlation was found between TAC and DNA damage (r=-0.600 p<0.001) in the aluminum exposed group.

CONCLUSION

Findings from the study revealed that an increased plasma aluminum concentration was associated with increased oxidative stress and increased DNA damage in aluminum exposed humans.

CITRATE ANTICOAGULATION AND ADVERSE EVENTS

Several patients with heparin intolerance were dialysed with tri-sodium citrate as anticoagulant without acute clinical problems (good tolerance). After some weeks however problems arose. In all patients an alkalosis developed: the pre dialysis bicarbonate level rose progressively from 27 mmol/l to 40 mmol/l. This could be tempered by lowering the dialysis fluid bicarbonate concentration from 37 mmol/l to 25 mmol/l. A second problem was a progressive rise in pre dialysis sodium level from a mean of 136 mmol/l to 150 mmol/l. Adapting the dialysis fluid sodium concentration from 140 mmol/l towards 132 mmol/l could solve this. The third problem was a progressive rise in serum aluminium level in patients from 3 microg/l to 38 microg/l. After excluding water, concentrate, dialysis fluid, drug intake, etc... as possible sources, we controlled the aluminium level in the glass bottle containing tri-sodium citrate. We noted the very high value of 35,300 microg/l. After replacing the glass bottles with polyvinylchloride bags with a negligible aluminium content, the serum aluminium levels returned back to normal. It is known that citrate chelates the aluminium present in the glass of bottles or vials.

Effects of subchronic aluminum exposure on the reproductive function in female rats

The aim of this study was to investigate the effects of aluminum (Al) exposure on the reproductive function in female rats. Forty female Wistar (5 weeks old) rats, weighing 110-120 g, were divided randomly into four groups. They were orally administrated with 0, 64.18, 128.36, and 256.72 mg aluminum chloride (AlCl(3)) per kilogram body weight in drinking water for 120 days. Levels of Al, estrogen (E(2)), progestogen (P), testosterone (T), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in serum were measured at the end of experiment. The results showed that levels of E(2), P, FSH, and LH were significantly lower and Al concentration was significantly higher in all three Al-treated groups than those in the control group (GC). The level of T was significantly higher in the low- and medium-dose groups (GL and GM) (P < 0.05) but not in high-dose group (GH) compared with GC. The results suggest that the reproductive function of female rats is inhibited under long-term Al exposure in an Al dose-dependent manner.

Normal concentrations of heavy metals in autistic spectrum disorders

AIM

Autism is a neurological-psychiatric disease. In the last 20 years we witnessed a strong increase of autism diagnoses. To explain this increase, some scientists put forward the hypothesis that heavy metal intoxication may be one of the causes of autism. The origin of such an intoxication was hypothesised to be vaccines containing thimerosal as antimicrobic preservative. This preservative is mainly made up of mercury. The aim of our research was to investigate the correlation between autism and high biological concentrations of heavy metals.

METHODS

Seventeen autistic patients, between 6 and 16 years old (average: 11.52 DS: 3.20) (15 males and 2 females), were investigated, as well as 20 non autistic subjects from neuropsychiatric service between 6 and 16 years (average: 10.41 DS: 3.20) (15 males and 2 females). In both groups blood, urine and hair samples were analysed trough means of a semiquantitative analysis of heavy metal dosing. The metals analysed were Lead, mercury, cadmium and aluminium, since their build-up may give both neurological and psychiatric symptoms.

RESULTS

The comparison of the mean values of the concentrations between the groups, performed with ANOVA test, has shown no statistically relevant differences.

CONCLUSION

There wasn't correlation between autism and heavy metal concentration.

Circulating levels of metals are related to carotid atherosclerosis in elderly

The aim of this study was to investigate if blood levels of trace and/or heavy metals are related to atherosclerosis in a cross-sectional study in elderly. In the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (1016 subjects, all aged 70), the prevalence of carotid artery plaques was recorded by ultrasound. The numbers of carotid arteries with plaques (0, 1 or 2) were recorded. Also the thickness (IMT) and gray scale (IM-GSM) of the intima-media complex were measured together with plaque echogenicity. Eleven heavy metals and trace elements were analyzed in whole blood, using inductively coupled plasma-sector field mass spectrometry. Nickel levels were related to the number of carotid arteries with plaques in an inverted U-shaped manner after multiple adjustment for gender, waist circumference, body mass index, fasting blood glucose, systolic and diastolic blood pressure, HDL and LDL cholesterol, serum triglycerides, smoking, antihypertensive treatment and statin use (p=0.026). IM-GSM and plaque echogenicity were both inversely related to chromium in a linear fashion, and to aluminum in an inverted U-shaped manner (both p<0.0001 for IM-GSM). The relationships between metals and IMT were modest. Circulating levels of some metals, like nickel, aluminum and chromium, were related to atherosclerotic plaques or the echogenicity of the IM-GSM and overt plaques independently of cardiovascular risk factors, including lipids.

Effects of aluminum exposure on the adherence, chemotaxis, and phagocytosis capacity of peritoneal macrophages in rats

To investigate the effects of aluminum (Al) exposure on peritoneal macrophages of Wistar rats, four groups of ten rats each were orally exposed to 0, 13, 26, and 52 mg kg(-1) Al(3+) in form of aluminum trichloride (AlCl(3)) in drinking water for 120 days. At the end of the experimental period, the Al concentration in serum, the adherence, chemotaxis, and phagocytosis capacity of peritoneal macrophages were determined. The results showed that the Al concentration in serum significantly increased in a dose-dependent manner; the adherence, chemotaxis, and phagocytosis capacity of peritoneal macrophages decreased with the increase of Al dose, and present a dose-effective relationship. Further, they were significantly lower in the high-dose groups (P < 0.01) compared with the control group. It indicates that Al was toxic to peritoneal macrophages of rats, and the adherence, chemotaxis, and phagocytosis capacity of peritoneal macrophages in rats were significantly suppressed by exposure to 52 mg kg(-1) day Al(3+).

Trace elements in obese Turkish children

The quality of the diet of obese children is poor. Eating habits may alter micronutrient status in obese patients. In this study, we determined the serum levels of selenium, zinc, vanadium, molybdenum, iron, copper, beryllium, boron, chromium, manganese, cobalt, silver, barium, aluminum, nickel, cadmium, mercury, and lead in obese Turkish children. Thirty-four obese and 33 healthy control subjects were enrolled in the study. Serum vanadium and cobalt levels of obese children were significantly lower than those of the control group (0.244 ± 0.0179 vs. 0.261 ± 0.012 μg/l, p < 0.001, and 0.14 ± 0.13 vs. 0.24 ± 0.15 μg/l, p = 0.011, respectively). There was no significant difference between groups regarding the other serum trace element levels. In conclusion, there may be alterations in the serum levels of trace elements in obese children and these alterations may have a role in the pathogenesis of obesity.

Effects of in-feed inclusion of clinoptilolite on blood serum concentrations of aluminium and inorganic phosphorus and on ruminal pH and volatile fatty acid concentrations in dairy cows

The experiment investigated the effects of the dietary inclusion of 200 g of the natural zeolite, clinoptilolite on the blood serum concentrations of aluminium (Al) and inorganic phosphorus (P) as well as on the ruminal pH and the ruminal concentrations of Al and P and of certain volatile fatty acids. Sixteen Holstein cows with a rumen fistula were randomly assigned to one of two groups. Group A cows (n = 8) were fed the basal ration supplemented with 200 g of clinoptilolite per day, and group B cows (n = 8) were fed the basal ration and served as controls. Blood and rumen fluid samples were collected at the same day of each week and at the same time (5 h after morning feeding) for 12 weeks. Clinoptilolite supplementation had no significant effect on ruminal and blood serum concentrations of Al and P. However, clinoptilolite significantly increased ruminal pH and acetate, and decreased ruminal propionate and valerate.

Serum-cobalt levels with metal-on-metal bearings in the cement-free total hip arthroplasty results covering two years; prospective study

PURPOSE OF THE STUDY

Total hip arthroplasty increases the use of alternate bearings to prevent polyethylene wear as the number of younger and more active patients has drastically risen. We carried out a prospective randomized study, to assess and compare clinical results and radiological changes, serum-cobalt- and serum-aluminium-levels when metal-on-metal and ceramic-on-ceramic bearings are applicated.

MATERIAL AND METHODS

After giving informed consent 80 consecutive patients were included in this prospective randomized study. They were randomly assigned to receive either a metal-on-metal or a ceramic-on-ceramic bearing in their total hip replacement. Eligible were patients with a primary coxarthrosis or an avascular necrosis of the head of femur. Of the 80 patients 54 were females and 26 males. 42 patients were randomized to a metal-on-metal bearing and 38 patients were randomized to a ceramic-on-ceramic bearing. The average patient-age was 65,8 years and the mean body mass index was 27,7 at the time of operation. Surgery was performed through a transgluteal approach in supine position under general or spinal anaesthesia. A forged conical threaded acetabular component made of titanium-aluminium-niobium alloy was used in all patients. The metal inlays and the 28 mm metal heads were made of Co-28Cr-6Mo alloy with a carbon content of 0,2%. The ceramic inlays and the 28 mm ceramic heads are Al2O3 implants. We used as femoral component a conical rectangular stem of a titanium-aluminium-niobium alloy. Cup and stem werde implanted cementfree. Clinical data werde obtained at a follow up at a minimum of two years after implantation. Patients were assessed with the Harris Hip Score and the University of California at Los Angeles activity scale. 72 of the 80 patients could be explored clinically and radiologically.

RESULTS

The 2 year follow up check showed clinically and radiologically no difference between the two groups. The median Harris HipScore was above 90 points and the UCLA score was about 7 points. The medium serum-cobalt level was in the metal-on-metal group about 1.2μg/L and in the ceramic-on-ceramic group below the detection limit. The medium serum aluminium level showed values of 1.2 respectively 1.3 μg/L. The luminescencies in the metal-on-metal group were increased, but all components of the prosthesis could be regarded as stable.

DISCUSSION

It was the goal of our prospective study to compare clinical and radiological results of hip arthroplasty in metal-on-metal and ceramic-on-ceramic bearings and assess the serum-cobalt and the serum-aluminium levels. The socalled "biocorrosion" is still a high risk element for loosening of implants because of aseptic osteolysis. A higher release of polyethylene and metal particles is triggered, which leads to a slow but continuous process of inflammation. Apart from the debris also metal ions in a higher concentration are released, so that we could detect after some years in patients with artificial implants a higher level of metal in blood and urine. So far we did not recognize any carcinogenity or the appearance of renal disorders, or other mutagene effects in our patients. We could also not observe any fractures in ceramic implants. We are convinced that short time and intermediate reports are necessary, although final judgement can only be based on long term data.

CONCLUSION

Our prospective randomized study showed after two years no difference clinically between the two groups of metal-on-metal and ceramic-on-ceramic bearings with total endoprostheses of the hip. Although medium serum-cobalt level in the metal-on-metal group with 1,2u/L is a significant higher value, whereas it lies in the ceramic-on-ceramic group below the detectable limit.

Effects of multivitamin/mineral supplementation on trace element levels in serum and follicular fluid of women undergoing in vitro fertilization (IVF)

We investigated effects of multivitamin/mineral supplementation on element levels in serum and follicular fluid of women undergoing IVF. We used three groups in this study. The first group was used as an age-matched and nonpregnant control (n = 13). Group 2 (n = 30) constituted the IVF group and women in the third group who were undergoing IVF also received a multivitamin/mineral tablet daily for 45 days. Follicular fluid and serum selenium and zinc levels and follicular fluid copper levels were lower in IVF patients than in controls although follicular fluid aluminum and iron levels were higher in IVF patients than in controls. However, follicular fluid and serum aluminum, copper, zinc and selenium levels, and serum magnesium levels were higher in the multivitamin/mineral group than in the IVF group although follicular fluid iron levels were lower in the multivitamin/mineral group than in the IVF group. In conclusion, we observed that copper, zinc, and selenium in serum and follicular fluid decreased in women undergoing IVF. Multivitamin/mineral supplementation in serum and follicular fluid of women undergoing IVF normalized the trace element levels.

Health risk assessment of workers exposed to metals from an aluminium production plant

OBJECTIVE

Foundry is an industry involved various kinds of metals and chemicals. Workers who work in foundry industry are at risk of exposure to these metals and chemicals. Objective of this study was to conduct quantitative health risk assessment for workers who exposed to metals from an aluminium production industry.

MATERIAL AND METHOD

The U.S. National Academy of Sciences' four steps of health risk assessment were used to conduct quantitative health risk assessment in this study.

RESULTS

This study showed that there were 6 types of metals involved in the aluminium foundry in this study. These metals could cause various health effects but not cancers. Workers were mostly exposed to these metals by inhalation. Calculated reference dose (RfD) for inhalation of aluminium used in this assessment was 0.000015 mg/kg/day. Calculated RID for inhalation of manganese used in this assessment was 0.000002 mg/kg/day. Calculated RfD for inhalation of copper used in this assessment was 0.000028 mg/kg/day. Calculated RID for inhalation of zinc used in this assessment was 0.000083 mg/ kg/day. Calculated RID for inhalation of magnesium used in this assessment was 0.949833 mg/kg/day. Calculated RID for inhalation of iron used in this assessment was 10.6219 mg/kg/day. Maximum daily doses (MDDs) for workers who exposed to metals measured in this foundry were 0, 0, 0.000463, 0.0000927, 0.000162 and 0 mg/kg/day for manganese, zinc, aluminium, iron, magnesium and copper, respectively. Finally, risk characterization for workers exposed to metals in this aluminium foundry showed that workers in this foundry had 31 times higher risk of developing diseases from aluminium than persons who were not exposed to aluminium. These workers had the same risk of developing diseases from other metals and chemicals as persons who were not exposed to those metals and chemicals.

CONCLUSION

Workers who exposed to aluminium in this aluminium production plant had 31 times risk of developing non-carcinogenic effects from aluminium compared with normal persons. Therefore, appropriate preventive measures should be applied to protect workers.

Differences in metal ion release following cobalt-chromium and oxidized zirconium total knee arthroplasty

Ions are released from all metals after implantation in the body through processes of corrosive and mechanical wear. The aim of this study was to investigate whether serum metal ion levels are raised in patients following total knee arthroplasty. Serum levels of chromium, cobalt, aluminium, molybdenum and zirconium were measured in two groups of patients at a minimum of 3 years after knee arthroplasty. Twenty three patients had a cobalt-chromium femoral component and 14 patients had an oxidized zirconium femoral component, acting as a control group as this femoral component is free from cobalt and chromium. All patients had the same titanium tibial base plates, and no patellae were resurfaced. Despite the lack of cobalt and chromium in the prostheses used in the control group, no statistically significant differences in serum cobalt and chromium ion levels were found between the groups. On the basis of these results there does not appear to be any significant rise in serum metal ion levels following total knee arthroplasty several years after implantation.

Environmental exposure to lead, but not other neurotoxic metals, relates to core elements of ADHD in Romanian children: performance and questionnaire data

Neurobehavioral measures of attention, and clinical features of the attention-deficit hyperactivity disorder (ADHD) have been studied in pediatric environmental lead research. However rarely, if ever, have performance measures of attention or executive functions and questionnaire-based quantitative ADHD-observations been studied in the same subjects. We examined associations between pediatric blood lead concentrations (PbB), as well as those of mercury (Hg), and aluminum (Al), and performance in four different attention tasks, as well as behavioral ratings from an ICD-10 (hyperactivity) and DSM-IV-coded (attention deficit) German questionnaire (FBB-ADHS). Asymptomatic, 8-12 year old children from two Romanian cities were studied, namely Bucharest and Pantelimon, a city near a metal-processing plant. Blood was analyzed for Pb, Al, and Hg. Data from 83 children were available for final analysis. We assessed attention performance by means of four tasks of the computer-based ADHD-taylored German KITAP-battery. We also received questionnaire ratings from parents and teachers covering three ADHD-dimensions. Multiple linear regression analysis was used to estimate associations between the three neurotoxic trace metals in blood and the different ADHD features. After adjusting for eleven potentially confounding variables we found consistent borderline to significant associations between Pb, but not other metals, in blood and various performance- and questionnaire data. False alarm responses (FAR) in the KITAP subtests rather than response latencies exhibited positive associations with PbB. Questionnaire ratings for ADHD dimensions also revealed PbB-related adversity. With any two-fold increase of PbB outcome changed markedly, namely up to 35%. Restriction to children with PbBs<10mug/dl had only a marginal influence on outcome.The converging evidence from performance- and questionnaire data confirms that core elements of ADHD are adversely affected by low environmental PbB even below 10mug/dl, but not by other neurotoxic trace metals. Observed effect-sizes are considerably larger than those typically found for lead-related IQ-deficit, thus suggesting that attention deficit could be the more basic adverse effect of lead in children. This is the first study from Central and Eastern Europe dealing with links between environmental exposure of children to neurotoxic metals and ADHD.

Effect of high aluminum concentration in water resources on human health, case study: Biga Peninsula, northwest part of Turkey

Widespread and intense zones of silicified, propylitic, and argillic alteration exist as outcrop around the Biga Peninsula, NW Turkey. Most of the springs in the study area surface out from these altered volcanic rocks. The concentrations of aluminum (Al) in these springs ranged from 13.17 to 15.70 ppm in this region. These high levels of Al were found to exceed the maximum allowable limits (0.2 ppm) depicted in national and international standards of drinking water quality. Therefore, the effect of high Al in water resources on human health was evaluated in this research. A total of 273 people aged above 18 years and living in the Kirazli region (whose water supply is from springs emerging from these alteration zones) and in the Ciplak-Halileli region (whose water supply is provided from an alluvium aquifer) were selected as the research group. For this group, a questionnaire was completed that contained questions on descriptive characteristics of humans and a Mini-Mental State Examination (MMSE) was administered by the authors using the face-to-face interview technique. A neurological examination was then performed by the neurology specialist as a second-stage investigation. Finally, 10 ml of venous blood samples were obtained from these people as a third-stage analysis to determine the serum Al levels together with vitamin B(12), folic acid, and thyroid-stimulating hormone parameters. The result typically revealed that the MMSE score was less in 31.9% and there was no statistically significant difference between the two regions. However, the result also showed that neuropathy in the history (including a careful past medical history) was significantly higher in the Kirazli region.

Evaluation of bone remodeling in hemodialysis patients: serum biochemistry, circulating cytokines and bone histomorphometry

BACKGROUND

To optimize the noninvasive evaluation of bone remodeling, we evaluated, besides routine serum markers, serum levels of several cytokines involved in bone turnover.

METHODS

A transiliac bone biopsy was performed in 47 hemodialysis patients. Serum levels of intact parathyroid hormone (iPTH; 1-84), total alkaline phosphatases (tAP), calcium, phosphate and aluminum (Al) were measured. Circulating levels of interleukin-6 (IL-6), IL-1 receptor antagonist (IL-1Ra) and soluble IL-6 receptor (sIL-6r) were determined using ELISA. Circulating IL-1beta, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor-alpha (TNF-alpha) were simultaneously quantified by flow cytometric immunoassay.

RESULTS

Patients with low/normal bone formation rate (L/N-BFR) had significantly lower serum iPTH (p<0.001) and tAP (p<0.008) and significantly higher Al (p<0.025) than patients with high BFR. Serum calcium and phosphorus, however, did not differ (p=NS). An iPTH >300 pg/mL in association with tAP >120 U/L showed low sensitivity (58.8%) and low negative predictive value (44.0%) for the diagnosis of high BFR disease. An iPTH <300 pg/mL in association with normal or low tAP, <120 U/L, was associated with low sensitivity (66.7%) but high specificity (97.1%) for the diagnosis of L/N-BFR. Serum IL-1, IL-6, IL-12p70 and TNF-alpha were positively correlated with BFR, serum IL1-Ra and IL-10 with bone area, and by multiple regression analysis, tAP and IL-6 were independently predictive of BFR.

CONCLUSIONS

Significant associations were found between several circulating cytokines and bone histomorphometry in dialysis patients. The usefulness of these determinations in the noninvasive evaluation of bone remodeling needs to be confirmed in larger dialysis populations.

Physiology-based modelling in radiation research: the biokinetics of plutonium

For many years, the biokinetics of radioactive substances was calculated on the basis of mathematical criteria only. Biokinetic compartments in most cases did not correspond to anatomically defined distribution areas in an organism but were operational values. However, the quality of the resulting models depends on how accurately their assumptions reflect reality. Ideally, a biokinetic model develops which reproduces reality. In the past few years, this need has resulted increasingly in physiological operational sequences being modelled in realistic anatomical structures of the body along with physicochemical parameters. In this study, an estimate of the biokinetic operational sequence after an incorporation of plutonium is made similar to the pharmacokinetics of a substance showing comparable chemical and physiological behaviours in the body. These behaviours are found for metals, iron and aluminium. Thus, comparison of the biokinetics of plutonium with the pharmacokinetics of aluminium results in some commonalities and some differences. A new model with physiological compartments for plutonium is presented on the basis of the biokinetics of aluminium.

Serum aluminum level correlates with arterial stiffness in haemodialysis patients

BACKGROUND

In addition to pulse wave velocity (PWV), serum aluminum level is predictive of mortality in haemodialysis (HD) patients. This cross-sectional study evaluated the correlations between serum aluminum and brachial-ankle PWV (baPWV).

METHODS

One hundred twenty-seven HD patients (average age 58.46 +/- 9.95 years) were enrolled. Medical data were obtained via chart reviews and hospital database. Associations between biomarker levels and baPWV were analysed by multiple linear regression.

RESULTS

Serum aluminum, high sensitivity C-reactive protein (hsCRP), age, pulse pressure (PP), mean arterial pressure (MAP) and diabetes mellitus (DM) are important correlates of baPWV.

CONCLUSION

Further, hsCRP, PP, age and DM are positively related to arterial stiffness in HD patients.

The interactions between the chronic exposure to Aluminum and liver regeneration on bile flow and organic anion transport in rats

The chronic exposure to Aluminum (Al) may compromise different liver functions, mainly during the hepatic regeneration. The aim of this study is to investigate the interactions between the chronic i.p. exposure to Al and hepatic regeneration (HR) on bile flow and organic anion transport in experimental animals. For this purpose, we studied bile flow and fractional transfer rates for the transport of hepatic organic anions (hepatic uptake, sinusoidal efflux, and canalicular excretion), as well as parameters related with the oxidative stress (OS), on rats chronically treated with Al at 0 and 2 days of HR. The Al treatment and time of HR caused a decrease in the biliary flow and in the hepatic uptake and canalicular excretion constants. In addition, Al and HR increased the lipoperoxidation associated with a reduction of the glutathione content and glutathione peroxidase and catalase enzyme's activities. Since the effects of Al and HR on biliary flow and transport systems were additive, but not on the oxidative status, different mechanisms might be involved on these alterations. Even though the OS may play a key role on the hepatic deleterious effects, there is no unique cause-effect relationship between OS and liver dysfunction in this experimental animal model.

Concentrations of selected essential and non-essential elements in blood of harbor seal (Phoca vitulina) pups of the German North Sea

This study on harbor seal (Phoca vitulina) pups of the North Sea evaluated concentrations of 14 essential and non-essential elements (Al, As, Be, Ca, Cd, Cr, Fe, Mn, Mo, Ni, Pb, Se, Sn, and Zn) in whole blood samples. The essential elements are analyzed to give references for health status determinations of pups. The measurement of classic toxic metals, like Pb or Cd, and other elements that may be in toxic concentrations in blood, is important due to their influence on health, particularly on the immune system. Blood samples of six seal pups found on the German Wadden Sea coast of Schleswig-Holstein in 2004 and transported to the Seal Centre Friedrichskoog, Germany were collected. The blood sampling was performed three times, immediately after collection of the newborns, after 1.5 months, and after 2 months before their release back into the wild. Inductively coupled plasma mass spectrometry and total reflection X-ray fluorescence spectrometry were used to determine the element concentrations. We found higher concentrations of Al, As, Fe, Mo, and Zn in blood samples of newborns compared to samples collected later, probably due to transplacental and lactational transfer from mother to fetus. Furthermore, there is a high need for, in particular, Fe and Zn in the developing organism, which may cause reduced values after some month. In contrast, the concentrations of Be, Cd, Ca, Cr, Pb, Mn, Ni, Se, and Sn, which were low in newborns and increased during the study, may be due to the fish fed to infant pups. Compared to free-ranging adults, in pups, the concentrations of Al, Ni, and Pb were higher in contrast to lower concentrations of As, Mn, and Mo. This case study is the first report on element levels in harbor seal pups of the North Sea.

Aluminum Toxicity Following IV Use of Oral Methadone Solution

BACKGROUND

Aluminum toxicity has been reported in renal failure patients exposed to aluminum-contaminated dialysate and oral phosphate binders. We report a case of significant aluminum toxicity in a non-hemodialysis patient.

CASE REPORT

A 43-year-old male IV drug user presented to the hospital with a seizure disorder of recent onset, progressive cognitive decline, ataxia, and dysarthria. The serum aluminum concentration was 180 micrograms/L (6.65 micromol/L). For 3 to 4 years prior, the patient had injected 'cooked' oral methadone. The methadone solution was heated in an aluminum pot to reduce the volume and then injected intravenously (IV). He was treated with IV deferoxamine over 9 months until he failed to return. Serum aluminum level after 9 months of treatment was 64.5 microgram/L (2.39 micromol/L). Neurological symptoms were partially improved.

CONCLUSION

Chronic IV injection of oral methadone solution heated in an aluminum-based cooking utensil may result in significant aluminum toxicity.

The Effects Of Sucralfate Ingestion On Serum And Specific Tissue Aluminum Concentration In Normal Rats

The effects of sucralfate ingestion on serum and specific tissue aluminum (Al) accumulation were studied in normal rats fed either a control diet or the same diet supplemented with sucralfate. Although serum Al concentrations were not significantly different between the groups, animals fed sucralfate for 8 weeks had significantly higher bone but not brain or liver Al concentrations when compared with controls. This study indicates that 8 weeks exposure to Al in sucralfate leads to an increase in bone Al concentrations, without changes in serum Al concentrations, suggesting that serum Al concentration may be a poor predictor of gastrointestinal absorption and specific tissue retention of Al.

[Apoptosis and micro- and macroelement composition of lymphocytes in patients with pulmonary tuberculosis]

The paper describes the results of comparatively analyzing the parameters of apoptosis, micro- and macroelement spectrum of peripheral blood lymphocytes in healthy donors and in patients with chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis. In drug-responsive and drug-resistant pulmonary tuberculosis, unidirectional pretreatment changes were generally recorded in the activity of apoptosis and the spectrum of chemical elements of peripheral blood lymphocytes, which were most pronounced after completion of a phase of intensive antituberculosis chemotherapy. After termination of a complete course of the therapy, apoptotic activity lowered with the cationic composition of cells being normalized. The parameters differentiating pulmonary tuberculosis from COPD were ascertained, these included increases in the count of apoptotic cells and the cell concentrations of Ca2+, Zn2+, and Mg2+.

Exposure to environmental factors in drinking water: risk of islet autoimmunity and type 1 diabetes--the BABYDIAB study

Type 1 diabetes (T1D) is characterized by autoimmunity against pancreatic islets, and autoantibodies may be present for years before diagnosis. Environmental factors during early life, including drinking water, may play a role in pathogenesis of T1D. The German BABYDIAB study is a prospective observational study that followed newborn offspring of mothers or fathers with T1D from birth to 17 years of age. The present study was a nested case-control analysis, where subjects with islet autoimmunity were defined as cases (n=95), those without as controls (n=139). Drinking water quality was obtained from the German Water Supply Authorities for the participating families for the first year of the child's life. There was no significant association between water acidity or drinking water quality (concentration of minerals and elements) and islet autoimmunity risk. Increased progression to diabetes in islet autoantibody-positive children was associated with exposure to water with lower pH values (less than cohort median, 7.62; odds ratio [OR]: 2.5; 95% confidence interval [CI]: 1.1-5.7; p=0.03) but was not significant after correction for multiple comparisons. Concentrations of nitrate, nitrite, iron, aluminum, and manganese were not associated with risk of T1D progression. This is the first prospective study with water quality measured before the onset of islet autoimmunity and T1D. Consistent with a previous cross-sectional case-control study, we found an association between drinking water pH and the rate of T1D development in at-risk children. The association is marginal and requires validation in other prospective cohorts.

Centers for Disease Control and Prevention (CDC). Elevated serum aluminum levels in hemodialysis patients associated with use of electric pumps--Wyoming, 2007

Aluminum toxicity can cause osteomalacia, anemia, and dementia in hemodialysis patients and has historically been associated with exposure to contaminated water or dialysate preparations or ingestion of aluminum-containing phosphate binders. Since 2002, improvements in water treatment methods and use of non-aluminum-containing phosphate binders have resulted in low prevalence (<1%) of aluminum toxicity among hemodialysis patients. In the United States, reported cases of aluminum toxicosis are rare, and no outbreak has been reported since 1992. This report describes 10 patients treated at a hemodialysis unit in a Wyoming hospital (hospital A) in 2007 who had elevated serum aluminum levels that were detected through routine serum aluminum screening. An investigation was conducted by the Wyoming Department of Health, which determined that the source of exposure was dialysate acid concentrate that became contaminated with aluminum as it passed through two electric drum pumps. The drum pumps had been used to transfer dialysate acid concentrate from 55-gallon storage drums to 1-gallon jugs for use on individual hemodialysis machines. Removal of the pumps from service resulted in a rapid reduction in patient serum aluminum levels. The findings suggest that regular assessment of machine compatibility with dialysate fluid is needed.

Serum calcium, phosphate, parathyroid hormone, albumin, aluminium and cholesterol achievement on replacement therapy (chapter 9)

In the UK, there is a continuing year-on-year trend towards improvement in serum phosphate control in dialysis patients although overall it still remains poor. The Renal Association (RA) target (<1.8 mmol/l) was achieved in 65% of patients overall, (71% of peritoneal dialysis (PD) patients, 63% of haemo dialysis (HD) patients). Seventy-six percent of UK dialysis patients achieve a corrected calcium concentration within the RA target range. As with serum phosphate, there is a trend of continuing year-on-year improvement. Nearly two-thirds (69%) of patients achieve a calcium x phosphate product within the KDOQI guidelines (<4.4 mmol(2)/l(2)): again, achievement seems to have improved year-on-year. Control was better in PD patients compared with HD patients (73% vs 67% achieving the standard). There remains large between-centre variation in the ability of renal centres to achieve the UK RA target for plasma parathyroid hormone (PTH). As seen in previous years, overall achievement was poor (median 63%, range 47-92% compliance with the standard). Most transplant patients achieve good phosphate and calcium control (99%, range 95-100%) and the percentage of patients achieving serum calcium concentrations within the target range was 84% (range 43-97%). Nearly all (99%) of transplant patients achieved calcium x phosphate product concentrations within the KDOQI target range. There would appear to be wide variation in clinical practice with respect to aluminium monitoring with a suggestion that few centres are following current UK, RA guidelines. Overall in the UK, 83% of HD, 70% of PD and 62% of transplant patients achieve a total cholesterol concentration <5 mmol/l. The percentage of patients with cholesterol <5 mmol/l has increased significantly year-on-year in all three modalities.

[Influence of hemodialysis on changes of trace metals concentrations in blood of patients with end-stage renal failure]

This study on blood levels of trace metals in hemodialysis patients was carried out with an aim to clarify the impact of hemodialysis therapy on the trace metals status in such patients. Two hundred sixty six hemodialysis patients were enrolled. All patients underwent standard hemodialysis. Blood was collected before and after hemodialysis sessions. Atomic absorption spectrophotometry was applied to measure blood levels of aluminum, lead, cadmium, mercury as well as plasma levels of copper, and zinc. Aluminum, lead, mercury, and cadmium level in blood significant by increased after hemodialysis. The patients treated with acetate hemodialysis had significantly higher blood aluminum levels than the patients treated with bicarbonate hemodialysis (38.4+/-44.6 versus 25.9+/-43.5 microg/l, p=0.03). We observed negative correlation between copper concentration (n=60) in plasma and ultrafiltration (r=-0.4, p=0.003). The zinc and cadmium level increased with dialysis duration (r=0.2, p<0.001; r=0.2, p<0.02). Low plasma zinc levels, that is, <800 microg/l, was more often found in patients with <12 hour/week and <12 months hemodialysis duration. After 3 years of dialysis treatment blood lead, cadmium level (n=30) increased and plasma copper level decreased.

[Aluminum concentration in blood of hemodialysis patients and its clinical importance]

A multicenter study was performed to investigate the prevalence of abnormal blood contents of aluminum in hemodialysis patients and to clarify the impact of aluminum level on the clinical status of such patients.

MATERIAL AND METHODS

Two hundred sixty five patients with end-stage renal disease from 7 dialysis centers were enrolled in this study. All patients had undergone standard hemodialysis. Venous blood samples were collected from hemodialysis patients before hemodialysis sessions. Atomic absorption spectrophotometry was applied to measure blood levels of aluminum.

RESULTS

Out of hemodialysis patients 24.9% had high blood aluminum (>30 microg/l), and the mean was 27.4+/-43.8 microg/l in all subjects. The aluminum containing phosphate binder users had significantly higher blood aluminum levels (45.1+/-102.0 versus 15.4+/-18.9 microg/l, p<0.04). The hemodialysis subjects had low parathyroid hormone level more frequently when blood aluminum concentration was high (>30 microg/l).

Trace element levels in adult patients with proteinuria

AIM

Trace elements are involved in many metabolic processes. They circulate prevalently bound to protein. In literature few studies deal with metal metabolism in adult patients with proteinuria, so we decided to further investigate metal metabolism in proteinuric patients.

METHODS

We studied 27 patients (14 male, 13 female), mean age 61.6+/-17 years with different degrees of renal function, serum albumin and proteinuria. Metal concentrations of copper (Cu), zinc (Zn) and aluminum (Al) were measured in serum and urine. No patient had environmental exposure to these metals.

RESULTS

The serum Zn level was below the normal range in 11 patients. The serum Cu level was reduced in 5 patients. The Al serum level was elevated in 4 patients. Six patients had reduced and 6 patients had elevated Zn excretion. The urinary Cu excretion was elevated in 6 patients. The urinary Al excretion was elevated in 1 patient. Trace metal concentrations were related neither to renal function nor to total serum protein or albumin levels. Serum zinc was directly correlated with proteinuria and urinary zinc and negatively correlated with testosterone levels in both sexes.

CONCLUSION

Adult patients with proteinuria have several modification of trace metal concentration in serum and urine. Serum concentration of metals did not depend on renal function or serum protein levels. Urinary Zn excretion was directly related to proteinuria and serum Zn levels. A negative correlation between serum Zn levels and testosterone was found in both sexes. Renal failure reduced urinary excretion of Cu and Al.

Effects of acute exposure to aluminum on cognition in humans

There is epidemiological evidence suggesting an association between aluminum in drinking water and Alzheimer's disease (AD), and between aluminum in dialysate and dialysis dementia. The exact role of aluminum in the pathogenesis of these and other dementias is not clear. This study examined the acute effects of aluminum on cognitive function in patients with AD and related dementias and in age-matched and younger volunteers with normal cognitive function. Whether individuals with AD and/or the APOE epsilon4 genotype had enhanced gastrointestinal absorption of aluminum was tested, and whether individuals with elevated blood aluminum concentrations exhibited acute cognitive effects was determined. Subjects were randomized to receive a single dose of aluminum orally (Amphojel plus citrate) for 3 d followed by a 3-wk washout, and then 3 d of matched placebo administration, or vice versa. Serum aluminum levels were measured and the daily dose of Amphojel was adjusted to a target aluminum level between 50 and 150 microg/L. Neuropsychological tests were administered at baseline and 90 min after the third dose of Amphojel or placebo. There was a large interindividual variation in aluminum serum levels in all study groups after the same initial dose of Amphojel. There were no significant differences in neuropsychological test scores after aluminum ingestion in normal volunteers or in patients with cognitive impairment. There was no association between APOE epsilon4 genotype and aluminum absorption. The results did not support the hypothesis that aluminum ingested at these doses produces acute effects on cognition or adverse effects, nor did they reveal that AD patients are more vulnerable to such outcomes. Further inquiry is required to explore any possible association between aluminum and cognition, but controlled trials may be limited by safety concerns.

Speciation of Al in human serum by convective-interaction media fast-monolithic chromatography with inductively coupled plasma mass spectrometric detection

A new analytical procedure using anion-exchange separation support based on convective-interaction media (CIM) was developed for the speciation of Al in human serum. The separation of proteins was performed on a weak anion-exchange CIM diethylamine (DEAE) fast-monolithic disk. To prevent co-elution of low molecular mass (LMM) Al species with high molecular mass (HMM) Al compounds on CIM disk serum proteins were first separated from LMM-Al species by the use of size exclusion chromatography (SEC). For this purpose 1 mL of serum was injected onto SEC (Superdex 75 HR 10/30) column. Isocratic elution using 0.05 M TRIS-HCl+0.03 M NaHCO(3) was applied and separation of proteins was followed by UV detection at 278 nm. It was experimentally proven that proteins were eluted in 5.5 mL peak that was collected into a polyethylene cup. A 0.1 mL of the sample aliquot was then injected onto the CIM DEAE disk. The separation of serum proteins was obtained in 10 min by applying linear gradient elution from 100% buffer A (0.05 M TRIS-HCl+0.03 M NaHCO(3)) to 100% buffer B (A+1M NH(4)Cl) and followed by UV detection at 278 nm. Separated Al species were detected on-line by inductively coupled plasma mass spectrometry (ICP-MS). Well-resolved protein peaks were obtained. It was experimentally proven that 90+/-3% of Al in spiked serum of renal patient was eluted under the transferrin peak. The proposed speciation procedure removes LMM-Al species and enables reliable determination of the concentration and composition of Al bound to proteins by CIM DEAE-ICP-MS when the concentration of Al in serum is higher than 5 ng mL(-1). In comparison to chromatographic columns CIM disks enable faster separation and simpler manipulation during cleaning procedure and coupling to ICP-MS.

A systems biology approach to the blood–aluminium problem: The application and testing of a computational model

Transport and distribution of systemic aluminium are influenced by its interaction with blood. Current understanding is centred upon the role played by the iron transport protein transferrin which has been shown to bind up to 90% of serum total aluminium. We have coined what we have called the blood-aluminium problem which states that the proportion of serum aluminium which, at any one moment in time, is bound by transferrin is more heavily influenced by kinetic constraints than thermodynamic equilibria with the result that the role played by transferrin in the transport and distribution of aluminium is likely to have been over estimated. To begin to solve the blood-aluminium problem and therewith provide a numerical solution to the aforementioned kinetic constraints we have applied and tested a simple computational model of the time-dependency of a putative transferrin ligand (L) binding aluminium to form an Al-L complex with a probability of existence, K(E), between 0% (no complex) and 100% (complex will not dissociate). The model is based upon the principles of a lattice-gas automaton which when ran for K(E) in the range 0.1-98.0% demonstrated the emergence of complex behaviour which could be defined in the terms of a set of parameters (equilibrium value, E(V), equilibrium time, E(T), peak value, P(V), peak time, P(T), area under curve, AUC) the values of which varied in a predictable way with K(E). When K(E) was set to 98% the model predicted that ca. 90% of the total aluminium would be bound by transferrin within ca. 350 simulation timesteps. We have used a systems biology approach to develop a simple model of the time-dependency of the binding of aluminium by transferrin. To use this approach to begin to solve the blood-aluminium problem we shall need to increase the complexity of the model to better reflect the heterogeneity of a biological system such as the blood.

Role of beer as a possible protective factor in preventing Alzheimer's disease

Aluminium (Al), a neurotoxin, has lately been implicated as one of the possible causal factors contributing to Alzheimer's disease. Because silicon (Si) intake can affect the bioavailability of aluminium, the object of the present study was to assess whether moderate beer consumption might, as a source of dietary Si, affect the toxicokinetics of Al and thereby limit that element's neurotoxicity. The results obtained confirmed that at moderately high levels of beer intake the Si present in the beer was able to reduce Al uptake in the digestive tract and thus was able to slow the accumulation of this metal in the body, brain tissue included. In consequence, moderate beer consumption, due to its content in bioavailability silicon, possibly affording a protective factor for preventing Alzheimer's disease, could perhaps be taken into account as a component of the dietary habits of the population.

Human erythrocyte δ-aminolevulinate dehydratase activity and oxidative stress in hemodialysis patients

BACKGROUND

Oxidative stress is a complicating factor in chronic renal failure, especially in hemodialysis (HD) patients. Also, aluminum intoxication may occur during hemodialysis treatment. Aluminum has been shown to inhibit the sulfhydryl-containing enzyme delta-aminolevulinate dehydratase (ALA-D). Thus, the involvement of -SH oxidation in ALA-D inhibition and its relationship with serum Al levels and lipid peroxidation in HD patients were evaluated.

METHODS

Blood ALA-D activity, plasma thiobarbituric acid reactive substances (TBARS), and serum aluminum levels were measured in HD patients (n=37) and healthy controls (n=20).

RESULTS

TBARS and Al levels were higher in HD patients than in controls (p<0.01), while ALA-D activity was lower (p<0.05). The sulfhydryl-reducing agent dithiothreitol (DTT) reactivated ALA-D of HD patients, but activity was still lower than that of controls. ALA-D activity was negatively correlated with TBARS (r=-0.63, p<0.01) and aluminum levels (r=-0.31, p<0.05).

CONCLUSIONS

Reduced ALA-D activity in HD patients was found to be related to the oxidation of -SH groups essential for enzyme activity. Our results suggest that increased oxidative stress may have contributed to enzyme inhibition in HD patients.

Selenium status indices, laboratory data, and selected biochemical parameters in end-stage renal disease patients

We investigated the relations between selenium status (SeS) parameters, indexes of nutrition, erythropoiesis, and uremic toxemia, serum electrolytes, and other biochemical markers in end-stage renal disease (ESRD) patients, as no multivariate statistical analysis concerning all of these parameters was performed so far. SeS was evaluated by plasma Se concentration (plSe) and glutathione peroxidase (plGSHPx) activity in 69 uremic patients treated with hemodialysis (HD) and 40 healthy controls. The hierarchical multivariate partial least squares model (PLS2) was employed to establish data structure and correlations between parameters investigated. plSe and plGSHPx activity were significantly lower in patients when compared with controls (p=0.000). plSe was positively associated with indexes of erythropoiesis and nutritional status, as well as serum electrolytes and parameters of uremic toxemia. plGSHPx was inversely dependent on the pair of parameters: intact parathyroid hormone (iPTH) and aluminum plasma concentration (Al). We conclude that (1) ESRD strongly decreases selenium status and (2) the PLS2 approach revealed the existence of significant interactions among plSe, plGSHPx, and selected biochemical parameters or groups of such parameters; some of these associations need further studies to be clarified.

Brazilian female crack users show elevated serum aluminum levels

OBJECTIVE: There is no information in the literature on the impact of crack smoking using crushed aluminum cans as makeshift pipes, a common form of crack use in Brazil. Since aluminum intake is associated with neurological damage, we measured serum aluminum levels in crack smokers. The objective of this study was to ascertain the levels of aluminum in crack users who smoke on makeshift aluminum pipes. METHOD: 71 female crack smokers, their mean age being 28.0 (± 7.7), provided information about their drug use, and had blood samples tested for serum aluminum level. RESULTS: 56 (79%) subjects smoked crack from crushed can pipes, while 15 (21%) smoked from other containers. Fifty-two (73.2%) out of the 71 subjects presented a serum aluminum level of 2 µg/l and 13 (18.3%) had a serum aluminum level of 6 µg/l cut-off point, which is above the reference value. When compared to non-drug users matched by their mean age and gender, they had similar median values and interquartile ranges for serum aluminum level [3 (2-4.6) for crack smokers; 2.9 (1.6-4.1) for controls], but with different means and standard deviations (4.7 ± 4.9 and 2.9 ± 1.7, respectively). DISCUSSION: Crack smokers have high serum aluminum level, but we are unsure of its complete association with aluminum cans. Further studies are needed. If such association is proven true in future research, further issues will be raised in dealing with this important disorder, including proper planning and evaluation of public health policies in this area.

Lipid peroxidation in workers exposed to aluminium, gallium, indium, arsenic, and antimony in the optoelectronic industry

OBJECTIVE

The objective of this study was to investigate whether exposure to aluminum, gallium, indium, arsenic, and antimony induces lipid peroxidation in humans.

METHODS

Whole blood and urine levels of 103 exposed electronic industry workers and 67 referents were analyzed by use of inductively coupled plasma mass spectrometry. Malondialdehyde (MDA), the product of lipid peroxidation, was determined by high-performance liquid chromatography.

RESULTS

The mean plasma MDA level in the 103 workers was significantly higher than that in 67 referents. The levels of MDA in the exposed workers were correlated significantly with the levels of urinary gallium and arsenic.

CONCLUSIONS

Malondialdehyde as an index of lipid peroxidation can be induced by gallium and arsenic exposure. By reducing exposure to these metals, biologic effects such as lipid peroxidation may also be diminished.

Potential Ototoxicity of Aluminum in Hemodialysis Patients

OBJECTIVES/HYPOTHESIS

Aluminum (Al) is a neurotoxin in both human and animal models. Al accumulation is usually observed in patients with end-stage renal disease (ESRD). To clarify whether Al also exhibits toxic effects on the specified neural organ of inner ear, we recruited hemodialysis (HD) patients to investigate the effect of serum Al level on the auditory physiology.

STUDY DESIGN

Forty patients in maintenance HD as well as 40 age-matched healthy subjects without hearing complaints were enrolled. The auditory function tests, including pure-tone audiometry (PTA), distortion-product otoacoustic emissions (DPOAEs), and auditory brainstem response (ABR) were performed in all subjects. The serum Al levels determined within 3 months of auditory tests were used for analysis.

RESULTS

High-frequency hearing impairment was the predominant auditory dysfunction in HD patients who showed worse high-tone hearing level on PTA and diminished amplitudes of DPOAEs at 3 K and 4 K as compared with the controls (P < .001). Age was a significant factor determining the auditory dysfunction in both HD patients and control subjects. After age correction, serum Al level correlated reversely with the amplitude of DPOAEs-2 K (P = .002), but not with amplitudes of DPOAEs-3 K, -4 K, hearing levels on PTA, or wave latencies on ABR.

CONCLUSION

High-frequency hearing impairment is a common presentation in HD patients. Serum Al level correlates reversely with the amplitude of DPOAEs-2 K but not those of DPOAEs-3 K, -4 K, hearing levels on PTA, and wave latencies on ABR. Possibly, the correlation between the Al level and the high-frequency OAE results was obscured by the significantly diminished amplitudes of DPOAEs-3 K, -4 K in ESRD patients. These results implicate that the effect of Al is mainly of cochlear origin rather than of retrocochlear origin.

Experimental design optimization for the ICP-AES determination of Li, Na, K, Al, Fe, Mn and Zn in human serum

A chemometric approach based on experimental design and desirability functions was used to develop and validated a method for the determination of some metals of biological concern by a fast sequential ICP-AES. The elements considered are Al, Fe, Mn, Zn, Li, Na and K. The experimental design was used to investigate the effects of three instrumental most crucial parameters, such as sheath gas flow rate, pump speed and auxiliary gas flow rate. In order to improve the multielemental analysis speed, although a sequential instrument allows the use of a separate parameter set for each wavelength, regression models and desirability functions were applied to find the experimental conditions providing the highest global sensitivity. Validation was performed in terms of limits of detection (LOD), limits of quantitation (LOQ), linearity, precision and recovery. By using the 167.02 nm wavelength, aluminium LOD was 0.5 microg L(-1) while the highest LOD was found for K (65 microg L(-1)). A linear range of at least three orders of magnitude was statistically demonstrated for each element. Precision was evaluated by testing two concentration levels, and good results in terms of intra-day repeatability were obtained, with R.S.D. values lower than 4.1% at the lowest concentration level. Lacking a suitable certified reference material, trueness was estimated using the recovery rate on fortified samples. The validated method was then used in the quantification of the elements considered in a serum sample.

Serum aluminium and cobalt levels after ceramic-on-ceramic and metal-on-metal total hip replacement

In a randomised study, 28 patients with a mean age of 62.2 years (32 to 81) with osteoarthritis or avascular necrosis of the hip received either a ceramic-on-ceramic or a metal-on-metal total hip replacement. Apart from the liners the acetabular and femoral components were made of Ti-Al-Nb alloy. The serum aluminium and cobalt levels were measured before, and at one year after surgery. The 15 patients in the ceramic-on-ceramic group had a median pre-operative aluminium level of 1.3 microg/l (0.25 to 8.4) and a cobalt level below the detection limit. At one year the aluminium level was 1.1 microg/l (0.25 to 2.3) and the cobalt level was 0.4 microg/l (0.15 to 0.7). The 13 patients in the metal-on-metal group had a median pre-operative aluminium level of 1.9 microg/l (0.25 to 4.4) and a cobalt level below the detection limit. At one year the median aluminium level was 0.9 microg/l (0.25 to 3.9) whereas the cobalt level was 1.4 microg/l (0.5 to 10.5). This increase in the cobalt level at one year was significant (p < 0.001). Our findings indicate that ceramic-on-ceramic bearings do not cause elevated levels of serum aluminium in the first post-operative year.