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Aluminum is unquestionably neurotoxic:encephalopathy develops in some patients on long-term renal dialysis with aluminum-rich dialysate.The aetiological role of aluminum in Alzheimer's disease is much more speculative;although the detailed pathological manifestations of the disease differ from those of dialysis encephalopathy,aluminum has been identified within diseased neurons and,co-localised with silicon as amorphous aluminosilicates,has been found as a"consistent feature"at the core of senile plaques.The presence of aluminum at these sites-whether as cause or consequence of disease-raises questions about the mode of its absorption and the mechanism by which it is transported within the physiological environment.The intake of aluminum is 20mg/day(range 1-100) via the gastrointestinal tract and 3-15 ug/day(range 2-100)via inhalation, leading to a median plasma level of 7 ug/1(range 1.5-15).7 If aluminum is a causal agent in Alzheimer's disease it must be transported to and bound at a key site;another requirement is a process for amplification of biochemical damage so that profound changes are brought about by extremely small concentrations.We now draw attention to aspects of the chemistry of aluminum that may throw light on such issues. |
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