Serum zinc levels and Alzheimer's disease.

Concentrations of zinc in postmortem serum and four brain regions were measured by flame atomic absorption spectrometry and instrumental neutron activation analysis, respectively, in nine Alzheimer's disease (AD) and eight control subjects. A statistically significant elevation of zinc serum was observed in AD subjects (136.4+/-66.8 microg/dL) compared with age-matched control subjects (71.1+/-35.0 microg/dL). No significant differences were observed between AD and control zinc concentrations in the amygdala, hippocampus, cerebellum, and superior and middle temporal gryi.

Alzheimer's disease, dental amalgam and mercury.

BACKGROUND: Mercury, or Hg, is a neurotoxin that has been speculated to play a role in the pathogenesis of Alzheimer's disease, or AD. Dental amalgam releases low levels of Hg vapor and is a potential source of Hg for a large segment of the adult population. METHODS: The authors studied 68 subjects with AD and 33 control subjects without AD to determine Hg levels in multiple brain regions at autopsy and to ascertain the subjects' dental amalgam status and history. The subjects were from central Kentucky and Elm Grove, Wis. The authors conducted dental amalgam assessments during the lives of the majority of subjects and in some subjects at the time of autopsy only. The authors also determined three dental amalgam index scores--Event (placement, repair or removal of amalgam), Location and Time In Mouth--in addition to the numbers of and surface area of occlusal amalgam restorations. The authors determined Hg levels in multiple brain regions and performed full neuropathologic evaluations to confirm the normal status of the brain or the presence of AD. RESULTS: The authors found no significant association of AD with the number, surface area or history of having dental amalgam restorations. They also found no statistically significant differences in brain Hg level between subjects with AD and control subjects. CONCLUSIONS: Hg in dental amalgam restorations does not appear to be a neurotoxic factor in the pathogenesis of AD. The authors found that brain Hg levels are not associated with dental amalgam, either from existing amalgam restorations or according to subjects' dental amalgam restoration history. CLINICAL IMPLICATIONS: Dental amalgam restorations, regardless of number, occlusal surface area or time, do not relate to brain Hg levels.

Imbalances of trace elements related to oxidative damage in Alzheimer's disease brain.

Four elements that have been implicated in free-radical-induced oxidative stress in Alzheimer's disease (AD) were measured by instrumental neutron activation analysis (INAA) in seven brain regions from 58 AD patients and 21 control subjects. A statistically significant elevation of iron and zinc was observed in multiple regions of AD brain, compared with controls. Mercury was elevated in AD in most regions studied, but the high variability of mercury levels in both AD and control subjects prevented the AD-control difference from reaching significance. Selenium, a protective agent against mercury toxicity, was significantly elevated only in AD amygdala. The elevation of iron and zinc in AD brain has the potential of augmenting neuron degeneration through free radical processes.

Trace elements in Alzheimer's disease pituitary glands.

Levels of mercury (Hg), selenium (Se), iron (Fe), rubidium (Rb), and zinc (Zn) were measured in the pituitary gland to assess the possibility of a potential difference in the environmental Hg exposure of Alzheimer's disease (AD) patients and control subjects and levels of other elements of interest in AD. The pituitary gland has been established as a good predictor of environmental Hg exposure. Neutron activation analysis was utilized to determine levels of these elements in pituitary glands of 43 AD subjects and 15 control subjects. No significant differences were observed between the AD and control means for these five elements. The sole significant Pearson's correlation involving Hg was the established correlation with Se, indicative of the detoxification of Hg. The absence of a statistical difference between AD and control pituitary gland Hg levels suggests AD patients do not have an excessive environmental exposure to Hg compared to controls.

Elevated 4-hydroxynonenal in ventricular fluid in Alzheimer's disease.

4-Hydroxynonenal (4-HNE), an aldehyde by-product of the peroxidation of fatty acids, has been shown to have toxic properties for neurons in culture. In light of increasing evidence that oxidative stress contributes to the neurodegenerative process in Alzheimer's disease (AD), we quantified levels of free and protein-bound 4-HNE in the ventricular fluid from 19 AD subjects and 13 control subjects by high-pressure liquid chromatography and dot-blot immunoassay. Free 4-HNE levels were found to be significantly elevated in the ventricular fluid of AD subjects compared with control subjects (p = 0.0096). These results demonstrate increased lipid peroxidation in AD brain and suggest a role for 4-HNE in the neurodegenerative process.

Copper, iron, and zinc imbalances in severely degenerated brain regions in Alzheimer's disease: possible relation to oxidative stress.

Copper (Cu), iron (Fe), and zinc (Zn) levels in five different brain regions (amygdala, hippocampus, inferior parietal lobule, superior and middle temporal gyri, and cerebellum) were determined by instrumental neutron activation analysis (INAA) in samples from Alzheimer's disease (AD) patients and age-matched control subjects. A significant decrease in Cu, and significant increases in Zn and Fe were found in AD hippocampus and amygdala, areas showing severe histopathologic alterations in AD. None of these elements were significantly imbalanced in the cerebellum which is minimally affected in AD.

Standardization in biological analyses of aluminum: what are the needs?

A review of the literature of aluminum (Al) levels in biological samples, particularly Alzheimer's disease (AD) brain, reveals a lack of interlaboratory agreement at both the bulk and microprobe levels. One possible reason for this controversy may be the methods chosen for quantitation and standardization. Currently, the major problem affecting quantitation of Al at the bulk level is the lack of low-Al-concentration, matrix-matched certified standards. Although a number of certified aluminum bulk standards are available, most do not match well in matrix with the samples of interest. A similar situation exists for micro-probe standards in which commercially available pure metal foils and thin films of materials, such as metal oxides, are available but again do not match well in matrix. A review of the current status of quantitation of Al levels in biological analyses at the bulk and microprobe level is presented. Future directions to develop standards include the submission of currently used microprobe standards to a central laboratory for critical analysis and selection of the optimum standard, followed by establishment of interlaboratory and intertechnique comparisons. Other future directions include the adaptation of a standard protocol for the selection of tissue for analysis and criteria for data rejection, as well as the development of a standard system for data normalization and reporting.

Neutron activation analysis of trace elements in motor neuron disease spinal cord.

Levels of 10 trace elements were analysed in autopsied lumbar spinal cords of 38 motor neuron disease patients and 22 control subjects using instrumental neutron activation analysis. Statistically significant elevations of iron, selenium and zinc, and depletions of mercury and cesium were found in the spinal cords of motor neuron disease patients compared with control subjects. No significant correlations were found between disease duration, clinical severity or lumbar motor neuron counts and iron and selenium levels, suggesting that accumulation of these elements occur early as well as late in the disease process and therefore are not a consequence of end stage pathology. Increased iron in motor neuron disease spinal cord could act to enhance formation of reactive oxygen species. Our study supports the free radical hypothesis of neuron degeneration in motor neuron disease.

Elevated thiobarbituric acid-reactive substances and antioxidant enzyme activity in the brain in Alzheimer's disease.

We determined levels of thiobarbituric acid-reactive substances (TBARS), a measure of lipid peroxidation, and the activity of the antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GSSG-R), and catalase (CAT) in the amygdala, hippocampus, pyriform cortex, superior and middle temporal gyri, inferior parietal lobule, middle frontal gyrus, occipital pole, and cerebellum of 13 Alzheimer's disease (AD) and 10 control brains. Levels of TBARS were elevated in all AD brain regions except the middle frontal gyrus, and elevation levels reached statistical significance in the hippocampus and pyriform cortex and marginal significance in the amygdala of AD subjects compared with age-matched controls. Significant elevation of GSH-Px activity was present in AD hippocampus compared with control. Moderate but statistically insignificant elevations of GSH-Px activity also were present in the amygdala and pyriform cortex in AD. GSSG-R activity was significantly elevated in the amygdala and hippocampus in AD subjects compared with controls. CAT activity was significantly elevated in AD hippocampus and superior and middle temporal gyri. SOD levels were elevated in all brain regions in AD patients compared with controls, although none of these elevations reached statistical significance. Antioxidant enzyme activities were significantly elevated where lipid peroxidation was most pronounced, suggesting a compensatory rise in antioxidant activity in response to increased free radical formation. This study supports the concept that the brain in AD is under increased oxidative stress and demonstrates that the oxidative changes are most pronounced in the medial temporal lobe, where histopathologic alterations are most severe.

Elemental imbalances in the olfactory pathway in Alzheimer's disease.

Concentrations of 11 trace elements were determined in 56 control and 98 Alzheimer's disease (AD) olfactory bulb, olfactory tract, olfactory trigone, piriform cortex and amygdala specimens by instrumental neutron activation analysis. Iron and zinc were significantly elevated and bromine was significantly depleted in olfactory regions of AD patients, compared with normal age-matched control subjects. Elevated iron could possibly play a role in neuronal degeneration in AD by enhancing reactive free radical formation.

Aluminum, calcium, and iron in the spinal cord of patients with sporadic amyotrophic lateral sclerosis using laser microprobe mass spectroscopy: a preliminary study.

We measured aluminum (Al), calcium (Ca), and iron (Fe) levels in neuronal cytoplasm and nucleus, capillaries, and neuropil in samples of ventral cervical spinal cord from 5 patients with sporadic amyotrophic lateral sclerosis (ALS) and 5 age-matched controls using laser microprobe mass spectrometry (LMMS). The concentration of Al was not altered in any area in the ALS samples. In contrast, Fe and Ca were increased 1.5-2-fold in the nucleus and cytoplasm of ALS neurons but not in capillaries and neuropil. These findings do not support the hypothesis that Al is enriched in spinal cord of sporadic ALS as has been reported for Guamanian ALS/Parkinson's dementia. The elevations of Fe in spinal neurons are consistent with reports of increased Fe in bulk samples of ALS spinal cord. The presence of increased Fe within spinal neurons may be significant in the pathogenesis of motor neuron degeneration by catalyzing the generation of reactive oxygen species within specific cells.

Iron, selenium and glutathione peroxidase activity are elevated in sporadic motor neuron disease.

Oxygen free radical damage is strongly implicated in the pathogenesis of familial motor neuron disease (MND) associated with mutation of the Cu/Zn superoxide dismutase gene, and may be relevant in sporadic MND. Selenium (Se) and iron (Fe) have important roles in free radical metabolism. Using neutron activation analysis we have demonstrated significant elevation of Se and Fe in lumbar spinal cord in MND cases (38) compared to controls (22). Analysis of enzymes involved in free radical scavenging showed a significant and specific increase in the activity of the selenoprotein enzyme glutathione peroxidase in MND spinal cord.

Comparison of the effects of elevated intracellular aluminum and calcium levels on neuronal survival and tau immunoreactivity.

Both calcium and aluminum have been implicated in the cell damage and death that occurs in several neurodegenerative disorders including Alzheimer's disease (AD). We examined the effects of experimentally elevated intraneuronal levels of aluminum ([Al]i) and/or calcium ([Ca2+]i) on neuronal degeneration and antigenic alterations in the microtubule-associated protein tau in cell cultures of rat hippocampus and human cerebral cortex. Exposure of cultures to Al3+ alone (200 microM) for up to 6 d did not result in neuronal degeneration. Neurons exposed to the divalent cation ionophore A23187 degenerated within 4 h when Ca2+ was present in the culture medium whether or not Al3+ was present. Measurements of [Ca2+]i using the calcium indicator dye fura-2 demonstrated a direct relationship between increased [Ca2+]i and neuronal degeneration. In contrast, neurons did not degenerate when exposed to A23187 in the presence of Al3+ and the absence of Ca2+, despite a 10-fold elevation in [Al]i as measured by laser microprobe mass spectrometry. Calcium influx, but not aluminum influx, elicited antigenic changes in tau similar to those seen in AD neurofibrillary tangles. Neurons exposed to glutamate in the presence of Al3+ but in the absence of Ca2+ were not vulnerable to injury. Finally, increased [Al]i occurred in neurons that degenerated as the result of exposure to glutamate indicating that aluminum associates with degenerating neurons. Taken together these data indicate that, in contrast to increased [Ca2+]i, elevated [Al]i may not induce degeneration or antigenic changes in tau.

Laser microprobe analysis of brain aluminum in Alzheimer's disease.

Aluminum (Al) levels were measured in the cytoplasm and nucleus of 241 neurofibrillary tangle (NFT)-bearing neurons, in 217 NFT-free neurons and adjacent neuropil from 7 autopsy-confirmed Alzheimer's disease (AD) patients, and in 316 normal neurons from 5 control subjects, by laser microprobe mass spectrometry. Grand mean Al levels (dry weight basis) in AD samples were 2.93 +/- 1.24 micrograms/gm for NFT-bearing neuron cytoplasm, 3.54 +/- 1.39 micrograms/gm for NFT-bearing neuron nuclei, 2.31 +/- 1.09 micrograms/gm for NFT-free neuron cytoplasm, and 3.23 +/- 1.09 micrograms/gm for NFT-free neuron nuclei. Control values were 1.85 +/- 0.78 micrograms/gm for cytoplasm and 2.01 +/- 0.93 micrograms/gm for nuclei. The differences between corresponding regions of AD NFT-bearing, AD NFT-free, and control neurons were not significant (p > 0.05, analysis of variance). Al levels in neuropil were identical for AD and control samples at 2.16 +/- 0.93 micrograms/gm. In contrast to some literature reports, we found very few (< 2.5%) extremely high Al values (> 20 micrograms/gm, dry weight) on a cellular basis in AD samples. AD neurons did exhibit a higher number of Al values (9.6-14.3%) that were > 3 sigma above the corresponding control means, than did control neurons (1.3-1.6%), indicating that small elevations of Al may exist in patients with AD. Our data suggest that any Al accumulation in patients with AD is small and generalized in both NFT-free and NFT-bearing neurons and that analyses of large bulk brain samples are likely to have AD/control differences masked by the large amount of unaffected neuropil sampled.

Brain aluminum in Alzheimer's disease using an improved GFAAS method.

Aluminum (Al) has been determined in autopsy brain samples (20 mg, dry weight) from 10 histologically verified Alzheimer's disease (AD) patients and 10 neurologically normal controls using an improved graphite furnace atomic absorption method. The method makes use of a potassium dichromate matrix modifier to circumvent interferences to the Al determination by the high levels of phosphorus and alkali metals in brain tissue. Brain regions studied included middle frontal gyrus, hippocampus, inferior parietal lobule, and the superior and middle temporal gyri. Small, but significant (p < 0.05) elevations of Al were observed in AD hippocampus, inferior parietal lobule and superior and middle temporal gyri, compared to corresponding control tissues. In contrast to other reports in the literature, no extremely high Al levels (> 20 micrograms/g, dry weight) were observed in our samples. Our highest value for Al in AD brain was 8.0 micrograms/g. These results suggest that there is a small focal increase of Al in specific regions of AD brain compared to age-matched controls. The fact that the increase is small, coupled with the analytical difficulties of accurate bulk sample Al determinations by any technique in the brain matrix, may account for the discordant literature reports for Al in AD brain.

Trace element imbalances in isolated subcellular fractions of Alzheimer's disease brains.

Concentrations of 13 trace elements (Ag, Br, Co, Cr, Cs, Fe, Hg, K, Na, Rb, Sc, Se, Zn) in isolated subcellular fractions (whole brain, nuclei, mitochondria, microsomes) of temporal lobe from autopsied Alzheimer's disease (AD) patients and normal controls were determined utilizing instrumental neutron activation analysis. Comparison of AD and controls revealed elevated Br (whole brain) and Hg (microsomes) and diminished Rb (whole brain, nuclear and microsomes), Se (microsomes) and Zn (nuclear) in AD. The elevated Br and Hg and diminished Rb are consistent with our previous studies in AD bulk brain specimens. Comparison of element ratios revealed increased Hg/Se, Hg/Zn and Zn/Se mass ratios in AD. Se and Zn play a protective role against Hg toxicity and our data suggest that they are utilized to detoxify Hg in the AD brain. Overall our studies suggest that Hg could be an important toxic element in AD. Whether Hg deposition in AD is a primary or secondary event remains to be determined.

A search for longitudinal variations in trace element levels in nails of Alzheimer's disease patients.

Levels of Br, Hg, K, and Zn were determined by INAA in the nails of Alzheimer's disease (AD) patients at 6-mo intervals for up to 3 yr. These elements have been shown to be imbalanced in AD nail. Bromine showed no trends. Mercury tended to decrease in nail with increasing age of patient, and with the duration and severity of the dementia. Potassium and Zn tended to increase with these same factors. Hence, progressive changes in trace-element levels do occur in AD nail, although imbalances are detected even in the earliest sampled stages of the disease.

Trace element imbalances in amyotrophic lateral sclerosis.

Concentrations of 15 elements were determined by instrumental neutron activation analysis in brain, spinal cord, blood cells, serum and nails of Amyotrophic Lateral Sclerosis (ALS) patients and appropriately matched control subjects. Several significant imbalances were detected in trace element levels in ALS samples compared to control samples. Some of these changes are probably secondary to the loss of tissue mass, especially in spinal cord. However the widespread changes observed in Hg and Se levels in ALS tissues deserve special attention. The significance of these alterations in trace element levels in relation to the pathogenesis of ALS is discussed.