Aluminum chelation principles and recent advances

Acute Al toxicity is not common. Toxicity from prolonged Al exposure has become much less common, but still occurs occasionally. The potential contribution of Al to Alzheimer's disease and related disorders is not resolved. Diagnosis of Al accumulation and treatment of Al toxicity can be achieved with chelators. The biology and chemistry of Al relevant to its chelation are reviewed. The approaches that have been used to assess potential Al chelators are summarized. The chemistry of desferrioxamine and the hydroxypyridinones in relation to Al chelation and the results of the more recent studies with these agents are reviewed. There is very little clinical experience with the hydroxypyridin ones as Al chelators. The results of chemical and animal studies suggest they have potential to replace desferrioxamine, as orally effective Al chelators. However, adverse effects associated with the use of 1,2-dimethyl-3,4-hydroxypyridinone (deferiprone) dampen enthusiasm for the hydroxypyridinones as Al chelators. The uses of Al chelators to enhance Al removal, concentration, detection and speciation are reviewed. The role of Al chelators in the environment and their production by plants to reduce Al toxicity is summarized. (C) 2002 Elsevier Science B.V. All rights reserved.