Aluminum Homeostasis in Man

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Abstract
Aluminum is the most prevalent metal found in nature and represents the third most abundant element of the earth's crust. In light of man's wide exposure to aluminum compounds, a review of the literature was undertaken to determine the extent of the available literature concerning the absorption, distribution, excretion, and metabolism of aluminum in man. In relative terms, the gastrointestinal tract is the major portal of entry for aluminum. The lungs play only a minor role, and there is no evidence to suggest that the dermal absorption of aluminum occurs. The gastrointestinal tract is only very slightly permeable to aluminum and provides a relatively effective barrier to its absorption. In the blood, aluminum is primarily bound to serum proteins (80%); however, a sufficient concentration of dialyziable or “free” (20%) aluminum exists to provide for its distribution. Aluminum can be found in every tissue and a normal body content of aluminum for reference man can now be calculated at 0.295 g. Present data suggest that bone may offer a major site of aluminum deposition. Urine provides at least one mechanism of aluminum excretion. However, aluminum's low renal clearance rate (2 ml/min) clearly suggests that other more efficient mechanisms for excretion exist. In fact, preliminary data indicate that bile may play some as yet undefined role in the removal process. The lack of a biologically convenient radiolabeled form of aluminum has severely handicapped the elucidation of aluminum metabolism. The chemical form of aluminum in blood, urine, or the tissues remains unknown. The liver is believed to play some role in aluminum metabolism, but no direct proof of this is available at present.