Renal osteodystrophy and clinical outcomes: data from the Brazilian Registry of Bone Biopsies - REBRABO / Osteodistrofia renal e desfechos clínicos: dados do Registro Brasileiro de Biópsias Ósseas - REBRABO

ABSTRACT Introduction: Mineral and bone disorders (MBD) are major complications of chronic kidney disease (CKD)-related adverse outcomes. The Brazilian Registry of Bone Biopsy (REBRABO) is an electronic database that includes renal osteodystrophy (RO) data. We aimed to describe the epidemiological profile of RO in a sample of CKD-MBD Brazilian patients and understand its relationship with outcomes. Methods: Between August 2015 and March 2018, 260 CKD-MBD stage 3-5D patients who underwent bone biopsy were followed for 12 to 30 months. Clinical-demographic, laboratory, and histological data were analyzed. Bone fractures, hospitalizations, and death were considered the primary outcomes. Results: Osteitis fibrosa, mixed uremic osteodystrophy, adynamic bone disease, osteomalacia, osteoporosis, and aluminum (Al) accumulation were detected in 85, 43, 27, 10, 77, and 65 patients, respectively. The logistic regression showed that dialysis vintage was an independent predictor of osteoporosis (OR: 1.005; CI: 1.001-1.010; p = 0.01). The multivariate logistic regression revealed that hemodialysis treatment (OR: 11.24; CI: 1.227-100; p = 0.03), previous parathyroidectomy (OR: 4.97; CI: 1.422-17.241; p = 0.01), and female gender (OR: 2.88; CI: 1.080-7.679; p = 0.03) were independent predictors of Al accumulation; 115 patients were followed for 21 ± 5 months. There were 56 hospitalizations, 14 deaths, and 7 fractures during follow-up. The COX regression revealed that none of the variable related to the RO/turnover, mineralization and volume (TMV) classification was an independent predictor of the outcomes. Conclusion: Hospitalization or death was not influenced by the type of RO, Al accumulation, or TMV classification. An elevated prevalence of osteoporosis and Al accumulation was detected.

RESUMO Introdução: Os distúrbios minerais e ósseos (DMO) são importantes complicações da doença renal crônica (DRC) associadas à desfechos adversos. O Registro Brasileiro de Biópsia Óssea (REBRABO) é um banco de dados eletrônico que inclui dados sobre osteodistrofia renal (OR). Nosso objetivo foi descrever o perfil epidemiológico da OR em uma amostra de pacientes brasileiros com DMO-DRC e entender sua associação com os desfechos. Métodos: Entre agosto de 2015 e março de 2018, 260 pacientes com DMO-DRC estágio 3-5D submetidos à biópsia óssea foram acompanhados por 12 a 30 meses. Dados clínico-demográficos, laboratoriais e histológicos foram analisados. Fraturas ósseas, hospitalizações e óbito foram considerados como desfechos primários. Resultados: Osteíte fibrosa, osteodistrofia urêmica mista, doença óssea adinâmica, osteomalácia, osteoporose e acúmulo de alumínio (Al) foram detectados em 85, 43, 27, 10, 77 e 65 pacientes, respectivamente. A regressão logística mostrou que o tempo em diálise foi um preditor independente de osteoporose (OR: 1.005; IC: 1.001-1.010; p = 0,01). A regressão logística multivariada revelou que o tratamento hemodialítico (OR: 11,24; IC: 1,227-100; p = 0,03), paratireoidectomia prévia (OR: 4,97; IC: 1,422-17,241; p = 0,01) e sexo feminino (OR: 2,88; IC: 1,080-7,679; p = 0,03) foram preditores independentes de acúmulo de Al; 115 pacientes foram acompanhados por 21 ± 5 meses. Houve 56 internações, 14 óbitos e 7 fraturas durante o seguimento. A regressão COX revelou que nenhuma das variáveis relacionadas ao tipo de OR/remodelação-mineralização-volume (classificação TMV) foi um preditor independente de desfechos. Conclusão: A hospitalização ou óbito não foram influenciadas pelo tipo de OR, acúmulo de Al ou classificação de TMV. Foi detectada uma prevalência elevada de osteoporose e acúmulo de Al.

Toxic metals in maternal blood, cord blood and meconium of newborn infants in Pakistan

Toxic metals and deficiency/excess of trace elements can have adverse effects on health. The aim of this study was to quantify toxic metals lead, cadmium and trace elements zinc, copper, aluminium [Al] and Iron [Fe] levels in pregnant women, cord blood and meconium of new-born infants from industrial zones of Karachi, Pakistan. Analytical research was performed from 2011–2012 in low socio-economic pregnant mothers and newborn infants from 20 towns near Sindh Industrial Trading Estates, Federal B industrial area and Korangi industrial areas, Karachi, where environmental pollution was anticipated. Blood samples of pregnant women [n = 416], cord blood [n = 309] and meconium [n = 309] were analyzed quantitatively for metals and trace elements. Results indicated that mothers residing in steel towns were found to have the highest levels of lead. Meconium contained high levels of toxic heavy metals and trace elements compared to cord blood and maternal blood. Maternal blood toxic metals were present in high quantities. Therefore, safety measures should be taken when industrial waste is disposed of in order to prevent population contamination

Safety and efficacy of intravesical alum for intractable hemorrhagic cystitis: a contemporary evaluation

ABSTRACT Introduction: Hemorrhagic cystitis (HC) represents a challenging clinical entity. While various intravesical agents have been utilized in this setting, limited data exist regarding safety or efficacy. Herein, then, we evaluated the effectiveness and complications associated with intravesical alum instillation for HC in a contemporary cohort. Materials and Methods: We identified 40 patients treated with intravesical alum for HC between 1997-2014. All patients had failed previous continuous bladder irrigation with normal saline and clot evacuation. Treatment success was defined as requiring no additional therapy beyond normal saline irrigation after alum instillation. Results: Median patient age was 76.5 years (IQR 69, 83). Pelvic radiation was the most common etiology for HC (n=38, 95%). Alum use decreased patient's transfusion requirement, with 82% (32/39) receiving a transfusion within 30 days before alum instillation (median 4 units) versus 59% (23/39) within 30 days after completing alum (median 3 units) (p=0.05). In total, 24 patients (60%) required no additional therapy prior to hospital discharge. Moreover, at a median follow-up of 17 months (IQR 5, 38.5), 13 patients (32.5%) remained without additional treatment for HC. Adverse effects were reported in 15 patients (38%), with bladder spasms representing the most common event (14/40; 35%). No clinical evidence of clinically significant systemic absorption was detected. Conclusion: Intravesical alum therapy is well-tolerated, with resolution of HC in approximately 60% of patients, and a durable response in approximately one-third. Given its favorable safety/efficacy profile, intravesical alum may be considered as a first-line treatment option for patients with HC.

Aluminio en pacientes con terapia de reemplazo renal crónico con hemodiálisis en dos unidades renales en Bogotá / Aluminium in chronic renal replacement therapy patients undergoing haemodialysis in two renal units in Bogotá

Objetivo Determinar las concentraciones de aluminio en suero de pacientes con terapia de reemplazo renal crónico con hemodiálisis y las concentraciones en agua de redes de distribución y diálisis en dos unidades renales en Bogotá. Material y Métodos Estudio descriptivo en 63 pacientes en hemodiálisis y 20 individuos sanos. Las concentraciones de aluminio se determinaron por espectrofotometría de absorción atómica horno de grafito con corrección de lámpara de deuterio. Resultados El promedio de las concentraciones de aluminio en suero de los pacientes fue de 26,5 µg/L (11,2 a 49,2 µg/L, DE=8,03), en individuos sanos de 8,05 µg/L (menor al Límite de Detección a 17,2 µg/L, DE=4,31), en agua de diálisis fue menor a 2 µg/L y en agua de las redes de distribución menor a 200 µg/L. Conclusiones Las concentraciones de aluminio en el agua de la red de distribución y diálisis estudiadas se encontraron por debajo de los valores establecidos internacionalmente indicando un adecuado tratamiento de las mismas. Igualmente las concentraciones de aluminio pre-HD y post-HD observadas en los pacientes se encontraron por debajo de las reportadas en la literatura. El consumo de hidróxido de aluminio aumenta significativamente la concentración de aluminio en suero. Variables como edad, género, estado civil y situación laboral no son factores de riesgo que alteren significativamente las concentraciones de aluminio en suero.

Objective Determining aluminium concentrations in the serum of patients undergoing chronic renal replacement therapy with haemodialysis and concentration in distribution network water and dialysis in two renal units in Bogotá. Material and Methods This was a descriptive study of 63 haemodialysed patients and 20 healthy subjects. Aluminium concentration was determined in water and serum using graphite furnace atomic absorption spectrometry with deuterium lamp background corrector. Results Average aluminium concentration was 26.5 µg/L in patients (ranging from 11.2 to 49.2 µg/L; 8.03 standard deviation) and 8.05 µg/L in healthy individuals (ranging from undetectable to 17.2 µg/L; 4.31 standard deviation). Aluminium concentration in dialysis water and distribution network water was below 2 µg/L and 200 µg/L, respectively. Conclusions Aluminium concentration in water and serum in this study was below international standard values, thereby indicating appropriate treatment. Additionally, aluminium concentration in pre-HD and post-HD sera was below that reported previously. Aluminium hydroxide uptake increases aluminium concentration in serum. Personal situation regarding age, gender, civil and work status were not risk factors determining aluminium concentrations in serum.

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 percent) subjects smoked crack from crushed can pipes, while 15 (21 percent) smoked from other containers. Fifty-two (73.2 percent) out of the 71 subjects presented a serum aluminum level of 2 æg/l and 13 (18.3 percent) had a serum aluminum level of 6 æg/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.

OBJETIVO: Não há informação na literatura sobre o impacto do uso de crack fumado em latas de alumínio utilizadas como cachimbos improvisados, uma forma comum de uso de crack no Brasil. Uma vez que a ingestão de alumínio está associada a dano neurológico, nós medimos alumínio sérico em usuários de crack. O objetivo deste estudo foi avaliar os níveis de alumínio em usuários de crack que fumam em cachimbos improvisados de lata de alumínio. MÉTODO: Setententa e uma usuárias de crack, com média de idade de 28,0 anos (± 7,7), forneceram informação sobre seu uso de drogas e tiveram amostras de seu sangue testadas para níveis séricos de alumínio. RESULTADOS: Cinqüenta e seis (79 por cento) sujeitos fumaram crack usando cachimbos de lata e 15 (21 por cento) fumaram em outros formatos. Cinqüenta e dois (73,2 por cento) dos 71 sujeitos apresentaram níveis de alumínio sérico de 2 æg/l e 13 (18,3 por cento) tinham níveis no ponto de corte 6 æg/l, o que está acima dos valores de referência. Quando comparados com não-usuários pareados por média de idade e do mesmo gênero, os sujeitos tiveram valores medianos e intervalos inter-quartil para níveis séricos similares [3 (2-4,6) para usuários de crack; 2,9 (1,6-4,1) para os controles], porém com médias e desvios-padrão diferentes (4,7 ± 4,9 e 2,9 ± 1,7, respectivamente). DISCUSSÃO: Usuários de crack apresentam altos níveis de alumínio sérico, mas não temos certeza disto estar associado completamente com as latas de alumínio. Mais estudos são necessários. Se tal associação se mostrar verdadeira em pesquisa no futuro, questões terão que ser debatidas a respeito deste problema, incluindo planejamento apropriado e avaliação das políticas públicas nesta área.

Aspectos importantes na determinação do nível de alumínio no sangue de pacientes em tratamento regular de hemodiálise / Aluminium level in serum analysis and its importance in hemodialysis treatment

A elevada toxicidade do alumínio para pacientes com insuficiência renal está muito bem documentada na literatura. A ação tóxica deste elemento é tão elevada que um controle anual dos níveis de alumínio sérico dos pacientes submetidos regularmente ao tratamento de hemodiálise é exigida pela Agência Nacional de Vigilância Sanitária (ANVISA). Devido à ubiquidade do aluminio, a análise requer cuidados especiais com relação à contaminação. Neste trabalho são abordados os aspectos mais importantes, desde a coleta até a quantificação do alumínio propriamente dita, para evitar fontes externas de contaminação e conduzir análise com êxito. Os cuidados necessários tornam-se relevantes devido ao baixo limite que coloca o paciente em risco. Níveis de Al acima de 30ug/L já caracterizam intoxicação, e determinam tratamento com agente quelante para redução do nível de Al sérico. Como este tratamento não é isento de efeitos colaterais, é muito importante que resultados confiáveis seja obtidos na análise do alumínio sérico.

Occupational pulmonary health effects among a group of aluminum foundry workers: a cross sectional study

Aluminum is an extremely versatile metal. Inhalation of aluminum dust and / or fumes can induce a wide range of pulmonary health effects, including airways disorders, cancer, and parenchymal diseases. This cross sectional study was conducted to determine the adverse pulmonary health effects of occupational aluminum exposure and some of the associated personal and occupational risk factors among a group of aluminum foundry workers. 33 male aluminum foundry workers, from different work sections, and 28 apparently healthy subjects, as a control group, were included in this study. All participants were interviewed using a pre-constructed questionnaire based mainly on the modified British Medical Research Council questionnaire; furthermore, they were subjected to serum aluminum level estimation, spirometry, and chest radiological examinations [chest X-ray was done for all participants, while High Resolution Computed Tomography [HRCT] was done for those with free chest X-ray films or with early parenchymal changes]. Significantly higher serum aluminum level along with significantly higher prevalence of both acute work-related symptoms and chronic respiratory symptoms were observed among the studied aluminum foundry workers compared to the control group. Moreover, spirometric examination of the studied aluminum foundry workers revealed mixed pattern of pulmonary dysfunction suggesting both obstructive ventilatory problems and restrictive parenchymal disorders. Chest X-ray films of furnace and rolling-mill workers showed excess fibrotic strands at upper and mid-zones of both lung fields; while, chest X-ray films and HRCT of the finishing aluminum foundry workers showed mild to moderate fibrotic changes. On the other hand, there were no detected abnormalities in chest X-ray films of the administrative aluminum foundry workers; while, their HRCT chest examination revealed fine reticulo-nodular opacities noticed at upper and mid-zones of both lungs. Moreover, there were no detected abnormalities in chest X-ray films and HRCT of the control group. It could be concluded that, unprotected occupational exposure to different aluminum forms can impair the pulmonary health of aluminum foundry workers. Moreover, serum aluminum can be a useful biomarker for assessing workers' exposure. Finally, HRCT was found to be more valuable than chest X-ray in early diagnosis of aluminum-induced lung fibrosis. Periodic medical examinations and biological monitoring of aluminum foundry workers along with improving working conditions are recommended

Study of serum aluminum level in hemodialysed patients and its relation to bone desity.

In this study, 70 patients with chronic liver failure [CRF] maintained on regular hemodialysis were divided into two groups according to the presence or absence of bony pains. The results showed that serum AL level was significantly higher in the group with bony pains [25.9 + 20.9 g/l and 13.88 + 5.6 g/l, respectively]; also, intact parathyroid hormone [iPTH] was significantly higher in the group with bony pains [432.77 + 244.20 pg/ml and 269.77 + 0.81 pg/l, respectively]. Bone densitometry was significantly lower in patients with bony aches [group A] than those with no bony aches [group B] in the neck of the femur and the mid radius. Hemoglobin level was significantly lower in the group with bony pains [7.4 + 1.2 g% and 11.3- 1.5 g%, respectively]; also, serum ferritin level was significantly higher in the group with bony pains [249.126.1 mg% and 714.38.7 mg%, respectively]

Renal and pulmonary functional changes in patients with silicosis

The objective of this study was to investigate the early renal and pulmonary functional changes among workers exposed to silica dust. The study was performed on the following three groups of subjects: Group I consisted of 15 healthy subjects as a control group, group II consisted of 15 workers exposed to silica dust without a manifestation suggestive of silicosis [chronic cough and expectoration, dyspnea, fatigability, normal spirometric data and normal chest radiographic appearance] and group III consisted of 15 workers exposed to silica dust with manifestations suggestive of silicosis, clinical [chronic cough and expectoration, dyspnea and fatigability], physiological [abnormal spirometric data] and chest radiographic appearance. The study concluded that patients suffering from silicosis showed significant changes in the renal functions together with mild combined obstructive and restrictive ventilatory defect compared with the healthy silica exposed workers and the healthy nonexposed ones. It was recommended that kidney function tests should be routinely done, especially those which detect the early dysfunction as B2-microglobulins, even if chest X-ray and simple pulmonary functions were normal

study of neuropsychological disorders - among aluminum foundry workers

For 63 aluminum foundry workers and 58 matched construction workers, aluminum concentrations in plasma and urine were measured. The exposed workers were classified into low-exposure and high-exposure groups according to ambient aluminum dust concentrations. For referents, low exposure and high exposure groups, the mean plasma aluminum levels were 4.1, 29.5, 48.4 micro g/L respectively, and the corresponding values for urinary aluminum being 10.1, 46.3, 70.8 micro g/L, respectively. In the exposed group, there was a statistically significant linear correlation between aluminum concentrations in the plasma and urine [r = 0.95]. Central nervous system functions were assessed with a neuropsychological symptoms questionnaire, and a neuropsychological test battery. There was an exposure-related increase in memory and concentration problems, tremors, fatigue and dizziness as well as impairment of the results of manual and finger dexterity test and attention test. The correlation between aluminum exposure indices and the used neuropsychological test performance could indicate effects from exposure to aluminum

Determinación histoquímica y espectrofotométrica de aliminio óseo en niños con osteodistrofia renal / Histochemical and spectrophotometric aliminium bone determinations in children with renal osteodystrophy

Introducción. El papel biológico del aluminio (Al) no está claro y no hay valores óseos de referencia en niños, aún cuando se ha asociado a lesiones óseas en pacientes con insuficiencia renal crónica terminal (IRTC). El propósito de este trabajo fue el de establecer los valores cuantitativos e histoquímicos del Al en la biopsias óseas de un grupo de niños con IRCT bajo diálisis, precisar el espectro histomorfométrico y compararlas con tejido óseo obtenido de niños sin alteraciones óseas metabólicas. Material y métodos. El presente es un estudio retrospectivo, transversal y descriptivo que se realizó en 2 instituciones de referencia, en 20 niños con IRCT a los que se cuantificó Al sérico, biopsia ósea después de doble marcaje con tetraciclina, histomorfometría e histoquímica para Al y cuantificación espectrofotométrica de Al óseo; como testigo, se obtuvo hueso de 10 autopsias de niños sin alteraciones metabólicas óseas. Resultados. Los pacientes tenían entre 9 y 18 años de edad; 11 eran mujeres; 15 tuvieron diálisis peritoneal por 9.6 ñ 5.9 meses en promedio y 5 con diálisis peritoneal y hemodiálisis por 29.4 ñ 7 meses; ninguno recibió hidróxido de Al ni presentaron alteraciones neurológicas; 11 tuvieron anemia microcítica y el Al sérico promedió 45.32 ñ 26.88 µg/L, la fracción carboxílica de la hormona paratiroidea (PTHc) fue de 6.12 ñ 2.99 ng/dL. Histoquímicamente se encontraron depósitos de Al en el frente de mineralización de 92.3 por ciento de los casos, en 10 fue menor de 25 por ciento. Bioquímicamente los niveles de Al óseo fueron de 30.04 ñ 19.5 µg/g; en los testigos se encontró 11.51 ñ 2.63 µg/g de tejido de Al. La sobrecarga de Al en suero y en el tejido óseo observado en esto niños, no alcanz-o niveles tóxicos clínicos aparentes. El estudio histomorgométrico de la biopsias óaseas (n=15) reveló 5 pacientes con osteitis fibrosa, 2 con enfermedad moderada, 7 con adinamia y 1 con ostomolacia. Conclusiones: los valores bioquímicos de referencia para el Al en tejido óseo fueron de 11.5 ñ 2.63 µg/g. En la mayoría de los pacientes se encontraron depósitos óseos de Al y bioquímicamente valores 3 veces por arriba de los controles, aunque no se acompañó de toxicidad clínica. La adinamia ósea es una lesión frecuente en paicentes bajo tratamiento de diálisis peritoneal

The spectrum of bone disease in 200 chronic hemodialysis patients: a correlation between clinical, biochemical and histologic findings

Introduction: Renal osteodystrophy includes the complete range of mineral metabolism disordes that affect the skeleton in patients with chronic renal failure. Patients and Methods: 200 patients with end-stage renal disease and on dialysis were investigated regarding the clinical, biochemical and histological findings of bone disease. Results: The spectrum of renal osteodystrophy consisted mainly of high turnover bone lesions (74.5 percent), including osteitis fibrosa in 57.5 percent. Patients with mild bone disease were on dialysis for shorter periods of time and were mostly asymptomatic. Patients with aluminum-related bone disease (16.5 percent) had the greatest aluminum exposure, either orally or parenterally, and together with patients with high turnover mixed disease, were the most symptomatic. Although on a non-regular basis, the vast majority of the patients (82.5 percent) had been receiving vitamin D. The incidence of adynamic bone disease was high (n=8) among parathyroidectomized patients (n=12). Significantly higher serum levels of alkaline phosphatase were observed in osteitis fibrosa. Conclusions: The use calcitriol and phosphate-binding agents on a non-regular basis seems to be the reason for the apparent reduced response to the treatment of secondary hyperparathyroidism. Alkaline phosphatase has been shown to be a fair marker for bone turnover in patients with osteitis fiborsa. The severity of the clinical manifestations of bone disease correlates with the histological features of bone lesion and to the time spent on dialysis.

Dosagem de alumínio no soro de indivíduos sadios e em pacientes com insuficiência renal crônica mantidos ou näo em tratamento dialítico / Serum aluminium measurement in healthy people and in patients with chronic kidney failure with or without dialysis

Este trabalho descreve um método para a quantificaçao de alumínio por espectrofotometria de absorçao atômica, com forno de grafite. Amostras de soro de indivíduos normais e de pacientes com insuficiência renal crônica com e sem tratamento dialítico foram analisadas com a finalidade de quantificar o alumínio presente. Em todos os 26 indivíduos normais, a concentraçao sérica de alumínio estava abaixo de 10 mug/l. Trinta e três por cento dos pacientes com insuficiência renal sem tratamento dialítico apresentavam alumínio sérico entre 11 e 17 mug/l. Entre os pacientes mantidos em diálise, somente 2 (4 por cento) tinham níveis abaixo de 10 mug/1,21 (46 por cento) entre 11 e 30 mug/l, 16 (35 por cento) entre 31 e 60 mug/l e 7 (15 por cento) acima de 60 mug/l. Nao foi observada correlaçao significativa entre o nível sérico de alumínio e a creatinina sérica ou o tempo de tratamento dialítico. A metodologia apresentada permite adequada identificaçao dos pacientes com níveis elevados de alumínio no soro.

Efeito do aluminio em plaquetas humanas / Effect of aluminium in human platelets

O efeito do aluminio foi avaliado em plaquetas humanas de individuos clinicamente saudaveis atraves de estudos de agregacao, peroxidacao e fosforilacao de proteinas em residuo de tirosina com os inibidores plaquetarios "in vitro" (Trolox, AAS, NDGA, EDTA E DFO). Os resultados obtidos demonstraram que o aluminio foi capaz de promover peroxidacao lipidica com ativacao de proteina tirosina quinase (PTK) e agregacao plaquetaria. A ativacao plaquetaria pelo aluminio independe da formacao de metabolitos do acido araquidonico via ciclooxigenase. por outro lado, os eventos de agregacao e fosforilacao de PTK foram dependentes de peroxidacao enzimatica mediada preferencialmente por hidrolise de acido araquidonico, via ativacao de lipoxigenases

Inhibition of bovine brain acetylcholinesterase by aluminum

We report the in vitro inhibitory effect of very low concentrations of aluminum salts (IC50 = 4.1 x 10-12M) on bovine brain acetylcholinesterase (AChE). The enzymatic assays were performed using acetylcholine bromide in a buffered pH 7.4 solution at 37§C. The relevant enzyme interacting species is the Al3+ ion, whose concentrations were fixed at pM levels by a citrate metal ion buffer system. The IC50 demonstrates that Al3+ is a potent inhibitor of AChE

Characteristics of spermidine oxidase from sera of schizophrenic and normal subjects

Spermidine [spd] oxidase was initially purified from sera of schizophrenic and normal subjects by anion exchange chromatography. This purified the spd oxidase 105 and 128 folds, relative to the crude sera of schizophrenics and normals respectively. The specific activities of purified Spd oxidase were 231.3 and 135.2 nkat/mg protein, for schizophrenic and normal respectively. Spermidine oxidase activity was found to be linearly proportional to the amount of protein up to 900 micro g and with time of reaction up to about 50 sec. The enzyme showed a maximum activity at PH 4.5 for both schizophrenic and normal subjects. Spermidine oxidase was found to be highly activated by Ca++, ospexin and to a lesser extent, by Al+++ and folic acid. While the activity of this enzyme was found to be inhibited highly by pyrazole, antipyrine, iodoacetamide, glutathione and Inderal