title: Aluminum and bone: Review of new clinical circumstances associated with Al(3+) deposition in the calcified matrix of bone.
abstract: Several decades ago, aluminum encephalopathy associated with osteomalacia has been recognized as the major complication of chronic renal failure in dialyzed patients. Removal of aluminum from the dialysate has led to a disappearance of the disease. However, aluminum deposit occurs in the hydroxyapatite of the bone matrix in some clinical circumstances that are presented in this review. We have encountered aluminum in bone in patients with an increased intestinal permeability (coeliac disease), or in the case of prolonged administration of aluminum anti-acid drugs. A colocalisation of aluminum with iron was also noted in cases of hemochromatosis and sickle cell anemia. Aluminium was also identified in a series of patients with exostosis, a frequent benign bone tumor. Corrosion of prosthetic implants composed of grade V titanium (TA6V is an alloy containing 6% aluminum and 4% vanadium) was also observed in a series of hip or knee revisions. Aluminum can be identified in undecalcified bone matrix stained by solochrome azurine, a highly specific stain allowing the detection of 0.03 atomic %. Colocalization of aluminum and iron does not seem to be the fruit of chance but the cellular and molecular mechanisms are still poorly understood. Histochemistry is superior to spectroscopic analyses (EDS and WDS in scanning electron microscopy).
authors.affiliation: Groupe études remodelage osseux et biomatériaux (GEROM), LHEA, IRIS-IBS institut de biologie en santé, CHU d'Angers, LUNAM université Nantes Angers Le Mans, 49933 Angers cedex, France; Service commun d'imagerie et analyses microscopiques (SCIAM), IRIS-IBS institut de biologie en santé, CHU d'Angers, LUNAM université, 49933 Angers cedex, France. Electronic address: daniel.chappard@univ-angers.fr.
authors.forename: D
authors.initials: D
authors.lastname: Chappard
authors.affiliation: Département de chirurgie osseuse, CHU d'Angers, 49933 Angers cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Bizot
authors.affiliation: Groupe études remodelage osseux et biomatériaux (GEROM), LHEA, IRIS-IBS institut de biologie en santé, CHU d'Angers, LUNAM université Nantes Angers Le Mans, 49933 Angers cedex, France; Service commun d'imagerie et analyses microscopiques (SCIAM), IRIS-IBS institut de biologie en santé, CHU d'Angers, LUNAM université, 49933 Angers cedex, France.
authors.forename: G
authors.initials: G
authors.lastname: Mabilleau
authors.affiliation: Département de chirurgie osseuse, CHU d'Angers, 49933 Angers cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Hubert
mesh_terms: D000535:Aluminum / Q000737:chemistry / Q000494:pharmacology / Q000633:toxicity*; D017607:Aluminum Compounds / Q000737:chemistry / Q000494:pharmacology / Q000633:toxicity*; D000863:Antacids / Q000009:adverse effects / Q000737:chemistry; D001672:Biocompatible Materials / Q000009:adverse effects / Q000737:chemistry; D001857:Bone Matrix / Q000737:chemistry / Q000187:drug effects* / Q000473:pathology / Q000648:ultrastructure; D016723:Bone Remodeling / Q000187:drug effects; D001927:Brain Diseases / Q000139:chemically induced; D002113:Calcification, Physiologic / Q000187:drug effects; D002118:Calcium / Q000378:metabolism; D002446:Celiac Disease / Q000150:complications; D004396:Coloring Agents; D005096:Exostoses / Q000139:chemically induced*; D006432:Hemochromatosis / Q000378:metabolism; D006801:Humans; D007501:Iron / Q000378:metabolism*; D007668:Kidney / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D010018:Osteomalacia / Q000139:chemically induced*; D019736:Prostheses and Implants / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects; D013194:Staining and Labeling
chemical_list: D017607:Aluminum Compounds; D000863:Antacids; D001672:Biocompatible Materials; D004396:Coloring Agents; D000535:Aluminum; D007501:Iron; D002118:Calcium
keywords: Aluminium; Aluminum; Biomaterial; Biomatériaux; Bone; Exostose; Exostosis; Metal oxidation; Metal toxicity; Mineralization; Minéralisation; Oxydation métallique; TA6V; Tissu osseux; Titane; Titanium; Toxicité des métaux