Aluminum intake from non-prescription drugs and sucralfate

Long INterspersed element-1 mobility as a sensor of environmental stresses

Long INterspersed element (LINE-1, L1) retrotransposons are the most abundant transposable elements in the human genome, constituting approximately 17%. They move by a "copy-paste" mechanism, involving reverse transcription of an RNA intermediate and insertion of its cDNA copy at a new site in the genome. L1 retrotransposition (L1-RTP) can cause insertional mutations, alter gene expression, transduce exons, and induce epigenetic dysregulation. L1-RTP is generally repressed; however, a number of observations collected over about 15 years revealed that it can occur in response to environmental stresses. Moreover, emerging evidence indicates that L1-RTP can play a role in the onset of several neurological and oncological diseases in humans. In recent years, great attention has been paid to the exposome paradigm, which proposes that health effects of an environmental factor should be evaluated considering both cumulative environmental exposures and the endogenous processes resulting from the biological response. L1-RTP could be an endogenous process considered for this application. Here, we summarize the current understanding of environmental factors that can affect the retrotransposition of human L1 elements. Evidence indicates that L1-RTP alteration is triggered by numerous and various environmental stressors, such as chemical agents (heavy metals, carcinogens, oxidants, and drugs), physical agents (ionizing and non-ionizing radiations), and experiential factors (voluntary exercise, social isolation, maternal care, and environmental light/dark cycles). These data come from in vitro studies on cell lines and in vivo studies on transgenic animals: future investigations should be focused on physiologically relevant models to gain a better understanding of this topic.

A Green Sequential Injection Spectrophotometric Approach Using Natural Reagent Extracts from Heartwood of Ceasalpinia sappan Linn. for Determination of Aluminium

A cost-effective and environmentally friendly approach using a simple sequential injection spectrophotometric system with a non-synthetic reagent from plant extracts was proposed for a green analytical-chemistry methodology. The crude aqueous extracts from heartwood of Ceasalpinia sappan Linn. in acetate buffer pH 5.5 were utilized as an alternative natural reagent for the quantification of aluminium. The extracts contained homoisoflavonoid compounds, brazilin, and brazilein, which reacted with Al(3+) to form reddish complexes with the maximum absorption wavelength at 530 nm. The optimum conditions for the sequential injection parameters, such as sequential profile, sample and reagent volumes, and the pH effect, were investigated. Under the optimum conditions, a linear calibration graph in the range of 0.075 - 1.0 mg L(-1) Al(3+) was obtained with limits of detection and quantification of 0.021 and 0.072 mg L(-1) Al(3+), respectively. Relative standard deviations of 3.2 and 2.4% for 0.1 and 0.25 mg L(-1) Al(3+) (n = 11), respectively, and sampling rate of 128 injections h(-1) were achieved. The developed system was successfully applied to pharmaceutical preparations, water, and beverage samples. The results agreed well with those obtained from the ICP-AES method. Good recoveries between 87 and 104% were obtained.

Highly sensitive and selective chemosensors for Cu2+and Al3+based on photoinduced electron transfer (PET) mechanism

Two new fluorescent PET chemosensors were synthesised from an acridine core. The sensors can be used to monitor Cu²⁺and Al³⁺in CH₃CN. The detection limits for7a–Cu²⁺and7b–Al³⁺were calculated to be 2.8 × 10⁻⁷M and 5.8 × 10⁻⁷M, respectively.

A water soluble Al3+ selective colorimetric and fluorescent turn-on chemosensor and its application in living cell imaging

An efficient water soluble fluorescent Al(3+) receptor, 1-[[(2-furanylmethyl)imino]methyl]-2-naphthol (1-H) was synthesized and characterized by physico-chemical and spectroscopic tools along with single crystal X-ray crystallography. High selectivity and affinity of 1-H towards Al(3+) in HEPES buffer (DMSO/water: 1/100) of pH 7.4 at 25 °C showed it to be suitable for detection of intracellular Al(3+) by fluorescence microscopy. Metal ions, viz. alkali (Na(+), K(+)), alkaline earth (Mg(2+), Ca(2+)), and transition-metal ions (Ni(2+), Zn(2+), Cd(2+), Co(2+), Cu(2+), Fe(3+), Cr(3+/6+), Hg(2+)) and Pb(2+), Ag(+) did not interfere. The lowest detection limit for Al(3+) was calculated to be 6.03 × 10(-7) M in 100 mM HEPES buffer (DMSO/water: 1/100). Theoretical calculations have also been included in support of the configuration of the probe-aluminium complex.

Dietary and other sources of aluminium intake

Aluminium in the food supply comes from natural sources including water, food additives, and contamination by aluminium utensils and containers. Most unprocessed foods, except for certain herbs and tea leaves, contain low (< 5 micrograms Al/g) levels of aluminium. Thus most adults consume 1-10 mg aluminium daily from natural sources. Cooking in aluminium containers often results in statistically significant, but not practically important, increases in the aluminium content of foods. Intake of aluminium from food additives varies greatly (0 to 95 mg Al daily) among residents in North America, with the median intake for adults being about 24 mg daily. Generally, the intake of aluminium from foods is less than 1% of that consumed by individuals using aluminium-containing pharmaceuticals. Currently the real scientific question is not the amount of aluminium in foods but the availability of the aluminium in foods and the sensitivity of some population groups to aluminium. Several dietary factors, including citrate, may affect the absorption of aluminium. Aluminium contamination of soy-based formulae when fed to premature infants with impaired kidney function and aluminium contamination of components of parenteral solutions (i.e. albumin, calcium and phosphorus salts) are of concern.

Aluminum-induced maternal and developmental toxicity and oxidative stress in rat brain: Response to combined administration of Tiron and glutathione

The current study was performed to assess the potential of 4,5-dihydroxy 1,3-benzene disulfonic acid di sodium salt (Tiron) and glutathione (GSH) either individually or in combination against aluminum (Al)-induced developmental toxicity in fetuses and sucklings of Wistar rats. Female rats were exposed to aluminum chloride at a dose of 345 mg/(kg day) oral from days 0 to 16 of gestation and 0 to 16 of post-partum (P.P.). Tiron and GSH were administered at a dose of 471 mg/(kg day) i.p. and 100 mg/(kg day) oral, respectively, on days 5, 7, 9, 11, 13, 15 and 17 of gestation and post-partum. Al caused reduction in number of corpora lutea, number of implantation sites, placental and fetal weight and stunted growth. Skeletal malformations were also observed in fetuses. Maternal toxicity was demonstrated by reduction in body weight gain. Induction of oxidative stress was also recorded in the brain of mother as well as in fetuses and sucklings after Al exposure. Significant decrease was recorded in reduced glutathione, glutathione reductase (GR), glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD), acetyl cholinesterase (AChE) and increase was observed in TBARS and glutathione-S-transferase (GST) in brain of pregnant mothers, fetuses and sucklings. Most of the above parameters responded positively with individual therapy with Tiron, but more pronounced beneficial effects on the above-described parameters were observed when Tiron was administered in combination with GSH. Inductively coupled plasma-atomic emission spectroscopy (ICP-AES) studies also showed significantly high concentration of Al in suckling's brain and maternal blood, brain, placenta and fetal brain. Treatment with Tiron individually or in combination with glutathione, reduced the accumulation of the Al in almost all the organs studied. It is concluded that chelating agents reduced the Al-induced toxicity and Tiron was more effective in reducing blood Al concentration than glutathione when given individually.

Use of sucralfate in renal failure

OBJECTIVE

To assess the potential for the development of aluminum toxicity in patients with renal insufficiency or chronic renal failure who are taking sucralfate.

DATA SOURCES

Clinical literature accessed through MEDLINE (1966-December 1999) and International Pharmaceutical Abstracts (1970-December 1999). Key search terms included sucralfate, renal failure, renal insufficiency, and end-stage renal disease.

DATA SYNTHESIS

Urinary excretion is an important route of elimination for systemically absorbed aluminum. Accumulation of aluminum in patients with impaired renal function may lead to significant toxicity. A potential source of aluminum is the antiulcer medication sucralfate. Studies and case reports evaluating the use and toxicity of sucralfate in patients with normal renal function, as well as those with renal failure or renal insufficiency, were reviewed.

CONCLUSIONS

Aluminum accumulation and toxicity have been reported with the use of sucralfate in patients with compromised renal function. The risk of toxicity most likely represents a long-term complication of sucralfate use in this patient population. Toxicity may be enhanced by concurrent use of other aluminum-containing medications, such as phosphate binders or antidiarrheal preparations. These medications, in addition to sucralfate, should be avoided if possible in patients with end-stage renal disease. Patients with renal failure or renal insufficiency who are undergoing prolonged sucralfate therapy should be monitored for potential signs of aluminum toxicity.

Safety evaluation of dietary aluminum

Aluminum is a nonessential metal to which humans are frequently exposed. Aluminum in the food supply comes from natural sources, water used in food preparation, food ingredients, and utensils used during food preparations. The amount of aluminum in the diet is small, compared with the amount of aluminum in antacids and some buffered analgesics. The healthy human body has effective barriers (skin, lungs, gastrointestinal tract) to reduce the systemic absorption of aluminum ingested from water, foods, drugs, and air. The small amount of aluminum (<1%) that is systemically absorbed is excreted principally in the urine and, to a lesser extent, in the feces. No reports of dietary aluminum toxicity to healthy individuals exist in the literature. Aluminum can be neurotoxic, when injected directly into the brains of animals and when accidentally introduced into human brains (by dialysis or shrapnel). A study from Canada reports cognitive and other neurological deficits among groups of workers occupationally exposed to dust containing high levels of aluminum. While the precise pathogenic role of aluminum in Alzheimer's disease (AD) remains to be defined, present data do not support a causative role for aluminum in AD. High intake of aluminum from antacid for gastrointestinal ailments has not been reported to cause any adverse effects and has not been correlated with neurotoxicity or AD. Foods and food ingredients are generally the major dietary sources of aluminum in the United States. Cooking in aluminum utensils often results in statistically significant, but relatively small, increases in aluminum content of food. Common aluminum-containing food ingredients are used mainly as preservatives, coloring agents, leavening agents, anticaking agents, etc. Safety evaluation and approval of these ingredients by the Food and Drug Administration indicate that these aluminum-containing compounds are safe for use in foods.

Kinetics of aluminum disposition after ingestion of low to moderate pharmacological doses of aluminum

We assessed the kinetics of aluminum uptake and elimination by tissues of Sprague Dawley rats following a single gavage dose of 0, 0.25, 0.5, or 1 mmol Al/kg body weight (b.w.) in 1 ml of 16% citrate (equivalent to 0-650 mg Al to a 70-kg human). Serum, liver, kidney, and tibia aluminum concentrations were measured 15, 30, 60, 120, 270, and 360 min after dosing. Serum aluminum concentrations were proportional to dose in rats dosed with 0.25 or 0.5 mmol Al/kg b.w. but were not proportional to dose for rats dosed with 1 mmol Al/kg b.w. Elimination half-lives of serum aluminum were similar for all treatments (102-119 min) which suggests that the non-linear aluminum kinetics in serum reflected a difference in absorption of the highest dose. Although fasted rats dosed with 0.25 or 1 mmol Al/kg b.w. with citrate absorbed aluminum with similar efficiency (4.2% of dose), the length of the absorptive period was prolonged in the rats given the highest does. Total absorbed aluminum mass in rats dosed with 0.25 and 0.5 mmol vs. 1 mmol Al/kg b.w. reached a plateau at 120 vs. 270 min after dosing, respectively. The kinetics of aluminum in liver, bone, and kidney were generally dose-independent. Elimination half-lives of liver aluminum were similar for all aluminum treatments (267-465 min); elimination half-lives could not be estimated in bone and kidney because of turnover exceeded the 6 h collection period.

Aluminum exposure and metabolism

Aluminum (Al) is a nonessential, toxic metal to which humans are frequently exposed. Oral exposure to aluminum occurs through ingestion of aluminum-containing pharmaceuticals and to a lesser extent foods and water. Parenteral exposure to aluminum can occur via contaminated total parenteral nutrition (TPN), intravenous (i.v.) solutions, or contaminated dialysates. Inhalation exposure may be important in some occupational settings. The gut is the most effective organ in preventing tissue aluminum accumulation after oral exposure. Typically gastrointestinal absorption of aluminum from diets is < 1%. Although the mechanisms of aluminum absorption have not been elucidated, both passive and active transcellular processes and paracellular transport are believed to occur. Aluminum and calcium may share some absorptive pathways. Aluminum absorption is also affected by the speciation of aluminum and a variety of other substances, including citrate, in the gut milieu. Not all absorbed or parenterally delivered aluminum is excreted in urine. Low glomerular filtration of aluminum reflects that most aluminum in plasma is nonfiltrable because of complexation to proteins, predominantly transferrin. The importance of biliary secretion of aluminum is debatable and the mechanism(s) is poorly understood and appears to be saturable by fairly low oral doses of aluminum.

Effects of aluminium on the mineral metabolism of rats in relation to age

The present study was conducted to assess in rats the effects of chronic aluminium (Al) exposure on calcium (Ca), magnesium (Mg), manganese (Mn), copper (Cu), zinc (Zn) and iron (Fe) accumulation and urinary excretion in relation to the age of the animals. Male young (21 day old), adult (8 months), and old (16 months) rats were orally exposed to 0, 50, or 100 mg Al/kg/day for a period of 6.5 months. Urinary levels of essential elements were determined after 3 and 6.5 months of exposure, whereas tissue Ca, Mg, Mn, Cu, Zn and Fe concentrations were examined after 6.5 months of Al administration. A number of age-related changes in tissue accumulation and urinary excretion of essential elements following chronic exposure to Al were found. Concentrations of essential elements in most tissues of young Al-exposed rats were generally lower than those of adult and old rats. The highest levels of essential elements were found in old animals. Liver, testes and spleen were the tissues that showed the most remarkable increases in relation to the levels found in those tissues of young rats. Adult rats showed a pattern comparable to that of old animals for mineral metabolism in brain, whereas in bone and testes the pattern of accumulation was closer to that of young rats. While the urinary levels of Ca were generally reduced in the Al-exposed groups, no Al-associated changes were noted for Mg, Mn, Cu and Zn. In turn, after 6.5 months of Al administration Fe excretion was increased in Al-treated adult and old rats. The results of this study suggest that early stages of life cycle should be of special concern for Al-induced changes in the metabolism of essential elements.

Bile is an important route of elimination of ingested aluminum by conscious male Sprague-Dawley rats

We assessed the importance of bile as an excretory route for ingested aluminum (AI). Bile dusts in 30 male Sprague-Dawley rats were cannulated to allow both bile collection and reinfusion of bile acids. Five days after surgery, rats (average weight = 191 +/- 4 g) were given a single oral dose of aluminum (0, 0.2, 0.4, or 0.8 mmol) as aluminum lactate in 1 ml of 16% citrate by gavage. Bile was collected 1-7 h after dosing from unanesthetized rats. Biliary aluminum secretion was highest during the first hour of bile collection. All rats dosed with aluminum secreted significantly greater amounts of aluminum in bile than control rats. However, biliary aluminum secretion did not vary among animals given the different aluminum doses suggesting that biliary secretion of aluminum was saturated at these doses. Rats dosed with 0.8 mmol A1 retained significantly greater amounts of aluminum in soft tissues than those given 0.2 or 0.4 mmol A1. This result suggests that physiological were unable to prevent tissue aluminum accumulation in the rats given the highest dose.

Evaluation of the developmental neuroendocrine and reproductive toxicology of aluminium

Two experiments evaluating functional endpoints pertaining to the developmental neuroendocrine effects of aluminum in the rat are reported. A total of 31 timed mated dams were fed by daily gastric gavage 0, 5, 25, 50, 250, 500 or 1000 mg/kg body weight/day aluminum as a solution of aluminum lactate in distilled water from days 5 to 15 of gestation. The 390 offspring were evaluated for morphological and physiological parameters of reproductive functioning, including birth weight, anogenital distance (AGD), timing of vaginal opening, regularly of oestrous cycles, duration of pseudopregnancy (PSP), number of superovulated oocytes, and gonadal weight. No consistent or reproducible findings suggestive of toxic effect were found in the parameters of birth weight, AGD, timing of vaginal opening, duration of PSP, number of superovulated oocytes, and adult gonadal weight. A temporary increase in the proportion of aberrant oestrous cycles was detected during the first four cycles after vaginal opening, in the 250 mg/body weight/day group, with none by the fifth consecutive oestrous cycle. These results suggest that, apart from a transient disturbance of oestrous cycle regularity, aluminum does not have a developmental reproductive toxic effect.

Pharmacokinetic study of zeolite A, sodium aluminosilicate, magnesium silicate, and aluminum hydroxide in dogs

Zeolite A is a synthetic zeolite which may have therapeutic utility in osteoporotic individuals because of its ability to stimulate bone formation. A study of Zeolite A (30 mg/kg), sodium aluminosilicate (16 mg/kg), magnesium trisilicate (20 mg/kg), and aluminum hydroxide (675 mg) was designed in beagle dogs. The purpose of this study was to compare the oral bioavailability of silicon and aluminum from Zeolite A, sodium aluminosilicate, magnesium trisilicate, and aluminum hydroxide in dogs. Twelve female dogs received each compound as a single dose separated by one week in a randomized, 4-way, crossover design. Plasma samples were drawn at time 0 and for 24 hours after dosing. The concentrations of silicon and aluminum were determined by graphite furnace atomic absorption. The mean plasma silicon AUC values (+/- S.D.) were 9.5 +/- 4.5, 7.7 +/- 1.6, 8.8 +/- 3.0, 6.1 +/- 1.9 mg.hr/L and the mean plasma silicon Cmax values (+/- S.D.) were 1.07 +/- 1.06, 0.67 +/- 0.27, 0.75 +/- 0.31, 0.44 +/- 0.17 mg/L for Zeolite A, sodium aluminosilicate, magnesium trisilicate, and aluminum hydroxide respectively. Although mean silicon AUC and Cmax values were elevated when compared to baseline after administration of the silicon containing compounds, only the AUC from Zeolite A reached statistical significance (p = 0.041). The mean plasma silicon Tmax values (+/- S.D.) were 7.9 +/- 6.4, 5.8 +/- 4.6, 6.9 +/- 6.3 and 8.5 +/- 3.4 hrs for Zeolite A, sodium aluminosilicate, magnesium trisilicate and aluminum Hydroxide respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

A single-dose comparison of the bioavailability of aluminium from two formulations of sucralphate in normal volunteers

The oral bioavailability of aluminium was compared after administration of 1 g sucralphate as either a tablet or a suspension (1 g/5 ml) in a crossover study in 16 healthy volunteers. Aluminium levels were detectable in all subjects pre-dose (21.4 +/- 8.8 micrograms l-1 before tablet; 21.4 +/- 7.4 micrograms l-1 before suspension) and there was a measurable increase in the plasma concentrations of aluminium in all subjects after administration of the suspension, and in 14 of the subjects after administration of the tablet formulation, with Cmax reached within the first 8 h in most subjects. Plasma levels were still elevated 72 h after dosing. The variability in plasma levels of aluminium was significantly higher after administration of the suspension (CV 39-53%) than after administration of the tablet (CV 29-44%), reflecting greater absorption of aluminium from the suspension formulation in three subjects. Similarly, the variance of the Cmax, AUC(0-72 h), and AUC(0-infinity) (for both the raw data and the baseline adjusted data) were all higher for the suspension than for the tablet. A point estimate of the difference of the pharmacokinetic parameters (determined from the median of the arithmetic Walsh averages) indicated little or no difference in Cmax, Tmax, or AUC(0-infinity) in the two formulations. In summary, the performance of the suspension formulation of sucralphate is more variable than the tablet formulation in vivo and some patients may therefore have higher circulating levels of aluminium on therapy with the suspension formulation.

Aluminum absorption and excretion following sucralfate therapy in chronic renal insufficiency

PURPOSE

To measure serum aluminum levels and urinary aluminum excretion in patients with chronic renal insufficiency (CRF) receiving therapeutic doses of sucralfate.

PATIENTS

Six patients with CRF were enrolled in the study. Creatinine clearances ranged from 0.2 to 0.9 mL/second (mean +/- SD 0.40 +/- 0.25 mL/second). Seven subjects with normal renal function were also studied.

METHODS

Each subject received sucralfate 1 g four times daily for 21 days. Serum and urine samples (serum only) were collected on baseline and on Days 2, (3), 8, 15, 22, (23, 24), 29, and 36. Samples were assayed by graphite furnace atomic absorption spectrophotometry.

RESULTS

In CRF, serum aluminum levels (mumol/L) increased by Day 2 and remained elevated to Day 24. Urinary aluminum excretion (mumol/day) was elevated throughout the study. The elimination half-life of serum aluminum after therapeutic dosing of sucralfate was 13.1 +/- 3.1 days. In subjects with normal renal function, baseline serum aluminum levels were similar to those in CRF (0.12 +/- 0.12 versus 0.11 +/- 0.12 mumol/L), but serum aluminum levels were higher at the end of the study in CRF (Day 22, 0.24 +/- 0.17 versus 0.83 +/- 0.48 mumol/L).

CONCLUSIONS

After therapeutic doses of sucralfate, significant elevations of serum aluminum levels occurred in CRF. Serum aluminum levels were higher in patients with CRF than in normal subjects. Long courses of sucralfate should be used with caution or avoided in CRF.

Kinetics of aluminum in rats. III: Effect of route of administration

Male Fischer rats received 0.1 mg/kg (bolus) of elemental aluminum as the sulfate salt via the portal (n = 4) or systemic (n = 4) route of administration. Blood and bile were serially sampled over an 8-h period, postadministration. Aluminum was determined by flameless atomic absorption spectrophotometry. Blood aluminum concentrations declined in a monoexponential fashion, with half-lives of 0.7 h (portal) and 1.08 h (systemic) (p less than 0.05). The corresponding systemic clearances were 48.9 +/- 10.6 and 35.1 +/- 3.64 mL/(h.kg) (p less than 0.05). The systemic availability following portal administration was 0.66, indicating a significant "first-pass" effect. Biliary aluminum recovery (% dose) was negligible following both routes [0.83 +/- 0.062% (portal) versus 1.3 +/- 0.22% (systemic), p less than 0.05]. Bile flow decreased approximately 40% (p less than 0.05) immediately upon injection of aluminum via the portal route only; flow remained suppressed throughout the study. This decrease in bile flow was most likely responsible for the lower biliary recovery with this route. In contrast, liver recovery of aluminum at 8-h postadministration was higher with the portal route (65.4 +/- 4.1 versus 39.4 +/- 2.52%). These results show that reported values for oral "bioavailability" of aluminum, often calculated by the standard AUC ratio method, underestimate the true extent of absorption. One mechanism of aluminum-related jaundice observed clinically may be due to cholestasis.

Influence of renal impairment, chemical form, and serum protein binding on intravenous and oral aluminum kinetics in the rabbit

The influence of renal impairment on the intravenous kinetics of aluminum (Al) lactate and the oral absorption of eight representative Al forms was determined. The serum protein binding of Al was assessed. Creatinine clearance in renally impaired rabbits was 23% of controls. Systemic clearance of Al was less in renally impaired rabbits (39 vs. 53 ml/hr/kg), as were the steady-state volume of distribution (516 vs. 1175 ml/kg), the half-life of elimination (14 vs. 27 hr), and the mean residence time of Al (14 vs. 25 hr). The shorter Al half-life and mean residence time in renally impaired rabbits were due to a diminished volume of Al distribution. Oral bioavailability of Al in renally intact rabbits ranged from 0.3 to 2.2% (Al borate less than glycinate less than hydroxide less than chloride less than sucralfate less than lactate less than nitrate less than citrate). Renal impairment had little influence on oral bioavailability of most Al forms, although it increased Al citrate absorption to 4.6%. In vitro and in vivo determination of Al ultrafilterability (less than 30,000 D) as an estimate of serum protein binding suggested a greater percentage of ultrafilterable Al species in renally impaired rabbit serum than in control rabbit serum. The increase in ultrafilterable Al species produced the less than expected reduction in Al clearance in renally impaired rabbits. The ultrafilterability of various Al concentrations was greater for citrate greater than lactate greater than nitrate greater than chloride, perhaps partially explaining the similar rank order of oral absorption of these Al forms. The physicochemistry of the eight Al forms was further characterized by determination of their octanol/water partitioning coefficients and their water solubility. There was a significant correlation between the percentage absorbed and the log of the octanol/water partition coefficient. Knowledge of the physicochemistry of Al aids in the understanding of Al pharmacokinetics.

Elevation of serum aluminum in humans on a two-day sucralfate regimen

Serum aluminum concentrations were determined in ten healthy subjects treated with phenytoin 500 mg and with sucralfate and phenytoin in a crossover fashion. Each subject received four 1,000-mg sucralfate tablets between 8 AM and 10 PM one day before the study, and this was repeated during the study day. A total of eight doses of sucralfate was administered over the two-day period. Serum samples were drawn at 0, 2, 4, 8, 12, 24, 32, and 48 hours after administration. The areas under the serum aluminum concentration-time curves before and after sucralfate (mean +/- SD) were 496.0 +/- 80.9 and 770.9 +/- 146.6 hr-ng/mL, respectively. This increase is statistically significant (P less than .01), indicating that serum aluminum levels are elevated even after two days of treatment with sucralfate. The results from this study are not in agreement with the only other report on this subject.

Retention of aluminium in the tissues of rats after the discontinuation of oral exposure to aluminium

Two studies were conducted to determine whether the aluminium deposited in the bones, muscles and kidneys of young growing rats fed diets supplemented with A1(OH)3 (989 or 1070 micrograms A1/g diet) for 16 days was retained after the A1(OH)3 was removed from the diets. A1 levels in the tissues of test rats decreased significantly (P less than 0.01) 3 days after withdrawal of the A1(OH)3 from the diet, and 7 days after withdrawal the tissue concentrations of A1 were similar in the test and control animals. Ingestion of A1 had no effect on tissue levels of phosphorus, calcium, magnesium, zinc or iron.

Aluminum impairs glucose utilization and cholinergic activity in rat brain in vitro

The effects of AlCl3 on the production of 14CO2 from [U-14C]glucose and high affinity choline transport in rat brain synaptosomes, and on carbachol-stimulated hydrolysis of phosphoinositides in cortical slices were studied. In buffer containing either high K+ (50 mM) or low K+ (4.9 mM), 1 mM AlCl3 significantly depressed the synaptosomal production of 14CO2 from [U-14C]glucose to 54% and 44% of control rates, respectively. At a concentration of 0.1 mM, AlCl3 depressed the evolution of 14CO2 from [U-14C]glucose from synaptosomes incubated in the high K+ buffer, but did not significantly change 14CO2 production from synaptosomes in the low K+ buffer. Aluminum chloride also inhibited high affinity choline transport in synaptosomes prepared from rat cortex and from hippocampus with an IC50 of approximately 0.5 mM. In brain slices the carbachol-stimulated hydrolysis of phosphoinositides was inhibited by AlCl3 in a dose-dependent manner. One millimolar, 0.5 mM and 0.1 mM AlCl3 inhibited the carbachol-stimulated release of inositol phosphates by 75%, 44% and 33%, respectively. These same concentrations of AlCl3 inhibited the incorporation of [3H]inositol into phospholipids. This inhibitory effect was not dose-dependent as all 3 concentrations of AlCl3 inhibited phospholipid labelling to the same extent (27-37%). These results are discussed in relation to the in vivo neurotoxicity of aluminum.

Absorption and disposition of aluminum in the rat

The kinetics of aluminum were determined in the rat. Intravenous bolus and oral doses of 8.1-mg/kg of aluminum as the chloride salt were administered to six rats. Serial blood samples and total urine and feces were collected and assayed for aluminum by atomic absorption spectrophotometry. The fraction absorbed orally (mean +/- SEM) was 0.27 +/- 0.03; the half-life was 5.29 +/- 0.47 h; the steady-state volume of distribution was 38.4 +/- 6.4 mL/kg, and the clearance was 8.87 +/- 1.76 mL X h-1 X kg-1. It was found that aluminum did not significantly penetrate the cellular components of blood. Plasma protein binding was determined to be approximately 98%. Sixty percent of the intravenous dose was excreted in the urine and the remaining 40% was excreted in the feces.