However, as I'm trying to understand more of the role aluminum toxicity plays in Alzheimers, I'm wondering specifically if anesthesia, other medications, blood transfusions, etc. involve any forms of aluminum or other chemicals that play a part in increased aluminum uptake resulting in post-surgical dementia?
Blood transfusions involve citrates which are known to facilitate the absorption of aluminum -- and antacids (especially if injected) may include easily absorbed aluminum (if I understand that correctly). But would either of those have an immediate impact?
Other threads on this forum touch on risks of general surgery for APOE4s and the potential benefits of IV anesthetics vs inhalation anesthetics. And it may not be significant, but it's notable to me that inhalation anesthetics may be stored in lined aluminum containers.
I'm way out of my league here, but I wondered what the scientists and researchers among us might have come across in your work? Are there any other aluminum-related issues in surgery? It's a rabbit trail that's over my head, but I'm curious.
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On Aluminum:
"Like the APOE-4 gene, aluminum also causes increased beta-amyloid in the brain. Aluminum also binds to oligomers of beta-amyloid to make droplets that are more neurotoxic than beta-amyloid. Aluminum accumulates in the brain with age due to increased gastrointestinal absorption of aluminum over age 70 and weakening of the blood-brain barrier in those, like my mother, with vascular disease. A meta-analysis of studies involving 1,208 participants including 613 AD patients revealed aluminum is higher than normal in brains, serum, and cerebrospinal fluid of AD patients compared with non-AD patients." - Increasing IQ, Cognition and COVID-19 Cure Rate with Essential Nutrients by Dennis N. Crouse, PhD (footnotes removed) (to read more including footnotes, see: https://prevent-alzheimers-autism-strok ... ci-and-ad/)
Oral aluminium bioavailability is increased by citrate, acidic pH, and uraemia and may be decreased by silicon-containing compounds. ...Increased oral aluminium absorption has been suggested in Alzheimer’s disease (AD) and Down’s subjects. Hman Health Risk Assessment for Aluminum, Aluminum Oxide, and Aluminum Hydroxide
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782734/
On Related Issues:
- An article on citrates in blood transfusions:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483798/
- A response from Laurie on the impact of citrate and aluminum absorption:
(EDIT: Laurie’s husband has reconsidered the issue above & determined that citrate dextrose will not increase aluminum absorption.)laurie wrote: ↑Tue Jan 11, 2022 5:11 pm [RE: platelet donation & the anticoagulant used in the platelet collection process: acid citrate dextrose (ACD)]
You should be concerned. This is a mixture of citric acid and dextrose and it will facilitate the absorption of aluminum. I asked Dennis Crouse my husband who is a chemist for this answer.
- A patent for aluminum housing of inhaled anesthetics:
- A mention by Stavia of surgery w/out gas with a good outcome utilizing propofol (yayyy!):the interior of the aluminum container is provided with an inert lining comprising an epoxyphenolic resin, and the inhalation anesthetic is selected from the group consisting of sevoflurane, desflurane, isoflurane, enflurane, methoxyflurane and halothane
https://patents.google.com/patent/US20110284418A1/en
- Common anesthetics:
(including propofol, ketamine, thiopental, methohexital, & etomidate, among others)
https://www.drugs.com/drug-class/genera ... terSection
- Common medications given before, during, or after surgery :
(including anticoagulants, antacids, antibiotics, sedatives, opioids, paralytic drugs, acetylcholinesterase inhibitors, etc.)
https://navinurses.com/8-most-common-su ... dications/
https://www.verywellhealth.com/drugs-us ... ry-3156830
https://www.verywellhealth.com/paralyti ... ed-3157132
- An article on surgery performed under propofol anesthesia inducing cognitive impairment and amyloid pathology in ApoE4 knock-in mouse model:
- Papers on cognitive disfunction and APOE4 (which Orangeblossom posted about several years ago), (FC also brought up the second article last year):Conclusion: "Propofol anesthesia followed by surgery induced persistent changes in cognition, and pathological hippocampal changes in pre-symptomatic, but vulnerable AD mice. It would be appropriate to explore whether preclinical AD patients are more vulnerable to POCD development."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107235/
Orangeblossom wrote: ↑Thu Jan 18, 2018 9:10 am I read this useful paper which was helpful. In particular that there is cognitive disfunction which improves. I was told it was related to cortisol and stress, mainly at the time, and the lack of sleep in the time before the op, in combination. https://www.omicsonline.org/does-genera ... p?aid=4796
and this one more specific to APOE4
http://anesthesiology.pubs.asahq.org/ar ... id=1933714
"These results provide the direct evidence for a strong association between the ApoE4 and transient postoperative cognitive dysfunction in patients undergoing inhalation anesthesia. In contrast, presence of the ApoE ε4 allele did not correlate with reduced MMSE scores in the intravenous anesthesia group"
Conclusions
"There is a strong association between ApoE4 and transient POCD in patients undergoing inhalation anesthesia. Compared with inhalation anesthesia, TIVA is more suitable for elderly patients because it has no observable effect on cognitive function of elderly patients after surgery, especially those carrying the ApoE ε4 allele."
Intersting. So it may be more about the type of anaesthetic. I had laughing gas as a child, for a minor op, but think it is mainly IV in the UK. I am unsure about the other type. these articles may be of use to read for anyone considering surgery.
- And link posted on this forum (& FB) regarding the relationship between surgery and Alzheimer's disease:Fc1345linville wrote: ↑Thu Feb 11, 2021 8:39 am https://pubs.asahq.org/anesthesiology/a ... ein-E4-and
TheresaB wrote: ↑Wed Apr 14, 2021 11:51 am In addition to this website, we (ApoE4.info) has a Facebook page where articles on current research are posted. Here are the top 10 links posted that generated the most interest during the first quarter (Jan – Mar) of this year.
...9. Posted Jan 26, 2021
Study Shows the Relationship Between Surgery and Alzheimer’s Disease
For goodness sake, if you need major surgery, have major surgery. But this may be something you'd wish to discuss with your doctor. This new study published in the Journal of Alzheimer’s Disease carried out by researchers at the Marqués de Valdecilla-IDIVAL University Hospital, in collaboration with researchers at the University of Bonn Medical Center, proposes that major surgery is a promoter or accelerator of Alzheimer’s disease (AD).
Direct Link: https://neurosciencenews.com/alzheimers ... ZFZNBnIBIM