Influence of dietary constituents on intestinal absorption of aluminum

Orally-ingested aluminum compounds have been implicated in the development of dialysis encephalopathy, osteomalacic dialysis osteodystrophy and other disorders in both hemodialyzed and nonhemodialyzed patients suffering from chronic renal failure [1–10]. Both dialysate aluminum content [7, 11, 12] and aluminum-containing phosphate binding agents [12–15] have been identified as contributing to hyperaluminemia in uremic patients. The health threat from dialysate fluids has been reduced by the recommendation that the dialysate contains less than 10 µg/liter of aluminum [16]. Alternative phosphate-binding agents which do not contain aluminum are available but these agents are not free of problems [17], and uremic patients continue to ingest significant doses of aluminum-containing phosphate binding agents.Aluminum is the most common metal in the biosphere of humans but, aside from uremic patients, causes no widespread toxicity. This may be as a result of the extremely limited solubility of aluminum at the pH range of the small intestine and blood [18]. Advances in analytical chemistry have made it possible to measure picogram quantities of aluminum in body fluids, thus enabling accurate determination of plasma aluminum levels in the part per billion (µg/liter) range. These analytical techniques have shown that orally ingested aluminum-containing antacids elevate plasma aluminum levels in man [13]. Balance studies monitoring aluminum absorption and elimination revealed an average positive balance from 23 to 313mg of aluminum per day when diets were supplemented with 1 to 3g of aluminum per day [15]. These studies show that a small fraction of the ingested aluminum is absorbed. This absorption presents potential toxic effects to uremic patients whose ability to eliminate aluminum is impaired.In addition, Slanina et al [19] have shown that addition of citric acid to aluminum-supplemented dietary regimens results in blood aluminum levels that are significantly higher than those found in subjects treated with aluminum-supplemented dietary regimens alone. This result suggests that dietary factors may contribute to aluminum absorption.This study was undertaken to determine if the form of aluminum present in the intestinal lumen significantly affects the absorption of aluminum following oral ingestion

Formulation of a killed whole cell pneumococcus vaccine - effect of aluminum adjuvants on the antibody and IL-17 response

Background Streptococcus pneumoniae causes widespread morbidity and mortality. Current vaccines contain free polysaccharides or protein-polysaccharide conjugates, and do not induce protection against serotypes that are not included in the vaccines. An affordable and broadly protective vaccine is very desirable. The goal of this study was to determine the optimal formulation of a killed whole cell pneumococcal vaccine with aluminum-containing adjuvants for intramuscular injection. Methods Four aluminium-containing adjuvants were prepared with different levels of surface phosphate groups resulting in different adsorptive capacities and affinities for the vaccine antigens. Mice were immunized three times and the antigen-specific antibody titers and IL-17 responses in blood were analyzed. Results Although all adjuvants induced significantly higher antibody titers than antigen without adjuvant, the vaccine containing aluminum phosphate adjuvant (AP) produced the highest antibody response when low doses of antigen were used. Aluminum hydroxide adjuvant (AH) induced an equal or better antibody response at high doses compared with AP. Vaccines formulated with AH, but not with AP, induced an IL-17 response. The vaccine formulated with AH was stable and retained full immunogenicity when stored at 4°C for 4 months. Conclusions Antibodies are important for protection against systemic streptococcal disease and IL-17 is critical in the prevention of nasopharyngeal colonization by S. pneumoniae in the mouse model. The formulation of the whole killed bacterial cells with AH resulted in a stable vaccine that induced both antibodies and an IL-17 response. These experiments underscore the importance of formulation studies with aluminium containing adjuvants for the development of stable and effective vaccines

Cytogerontology since 1881: A reappraisal of August Weismann and a review of modern progress

Cytogerontology, the science of cellular ageing, originated in 1881 with the prediction by August Weismann that the somatic cells of higher animals have limited division potential. Weismann's prediction was derived by considering the role of natural selection in regulating the duration of an organism's life. For various reasons, Weismann's ideas on ageing fell into neglect following his death in 1914, and cytogerontology has only reappeared as a major research area following the demonstration by Hayflick and Moorhead in the early 1960s that diploid human fibroblasts are restricted to a finite number of divisions in vitro. In this review we give a detailed account of Weismann's theory, and we reveal that his ideas were both more extensive in their scope and more pertinent to current research than is generally recognised. We also appraise the progress which has been made over the past hundred years in investigating the causes of ageing, with particular emphasis being given to (i) the evolution of ageing, and (ii) ageing at the cellular level. We critically assess the current state of knowledge in these areas and recommend a series of points as primary targets for future research

Action sharpens sensory representations of expected outcomes

When we produce actions we predict their likely consequences. Dominant models of action control suggest that these predictions are used to ‘cancel’ perceptual processing of expected outcomes. However, normative Bayesian models of sensory cognition developed outside of action propose that expected sensory signals are represented with greater fidelity (sharpened), not cancelled. We distinguished between these models in an fMRI experiment where participants executed hand actions (index vs little finger movement) while observing movements of an avatar hand. Consistent with the sharpening account, visual representations of hand movements (index vs little finger) could be read out more accurately when they were congruent with action and these decoding enhancements were accompanied by suppressed activity in voxels tuned away from, not towards, the expected stimulus. Therefore, inconsistent with dominant action control models, these data show that sensorimotor prediction sharpens expected sensory representations, facilitating veridical perception of action outcomes in an uncertain sensory world

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Water-vapor adsorption and surface area measurement of poorly crystalline boehmite

Water-vapor adsorption on poorly crystalline boehmite (PCB) was studied using a gravimetric FTIR apparatus that measured FTIR spectra and water adsorption isotherms simultaneously. The intensity of the δ(HOH) band of adsorbed water changed linearly with water content and this linear relationship was used to determine the dry mass of the sample. Adsorption and desorption isotherms of PCB showed a Type IV isotherm. The BETH2O surface area of PCB was 514 ± 36 m2/g. The mean crystallite dimensions of PCB were estimated to be 4.5× 2.2× 10.0 nm (dimensions along the a, b, and c axes, respectively) based on application of the Scherrer equation to powder diffraction data of PCB. A surface area value of 504 ± 45 m2/g calculated using the mean crystallite dimensions was in good agreement with the BETH2O surface area. This work also demonstrated a method to determine surface areas for materials with minimal perturbation of their surface structure. In addition, the FTIR spectra of PCB were influenced by changes in water content. The δ(AlOH) band at 835 cm−1 observed under dry conditions was assigned to the non-H-bonded surface OH groups. As the amount of adsorbed water increased, the intensity at 835 cm−1 decreased and that at 890 and 965 cm−1 increased. The 890- and 965-cm−1 bands are assigned to surface OH groups H-bonded with adsorbed water

Distribution of adsorbed antigen in mono-valent and combination vaccines

The distribution of alpha-casein, bovine serum albumin (BSA), myoglobin and recombinant protective antigen (rPA) in mono-valent and combination vaccines containing aluminum hydroxide adjuvant was studied by fluorescence microscopy and flow cytometry. Green and red fluorescent probes were conjugated to the antigens. Adsorption isotherms of the fluorescently labeled proteins to aluminum hydroxide adjuvant demonstrated that incorporation of the fluorescent probe did not significantly affect the adsorption. In mono-valent vaccine systems, antigen adsorption occurred within one minute and uniform surface coverage of the adjuvant aggregates was observed within 1 h. Content uniformity was achieved through a cycle of de-aggregation and re-aggregation of the aluminum hydroxide adjuvant aggregates caused by mixing. For combination vaccines, two antigens were adsorbed separately to the aluminum hydroxide adjuvant prior to combination. Following combination, cycles of de-aggregation and re-aggregation occurred due to mixing, which led to uniform distribution of both antigens. The results of this study indicate that content uniformity should not be an issue during the production of mono-valent or combination vaccines as long as adequate mixing procedures are followed