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Aluminum Is a Potential Environmental Factor for Crohn's Disease Induction

Extended Hypothesis



    1. Pediatric Gastroenterology and Nutrition Unit, Carmel Medical Center, Pappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Address for correspondence: Aaron Lerner, M.D., M.H.A., Pediatric Gastroenterology and Nutrition Unit, Carmel Medical Center, 7 Michal St, Haifa 34362, Israel. Voice: 972-4-8250-527; fax: 972-4-8250-919.


Abstract: Aluminum (Al) is a common environmental compound with immune-adjuvant activity and granulomatous inflammation inducer. Al exposure in food, additives, air, pharmaceuticals, and water pollution is ubiquitous in Western culture. Crohn's disease (CD) is a chronic relapsing intestinal inflammation in genetically susceptible individuals and is influenced by yet unidentified environmental factors. It is hypothesized, in the present review, that Al is a potential factor for induction or maintaining the inflammation in CD. Epidemiologically, CD incidence is higher in urban areas, where microparticle pollution is prevalent. Al immune activities share many characteristics with the immune pathology of CD: increased antigen presentation and APCs activation, many luminal bacterial or dietary compounds can be adsorbed to the metal and induce Th1 profile activity, promotion of humoral and cellular immune responses, proinflammatory, apoptotic, oxidative activity, and stress-related molecule expression enhancement, affecting intestinal bacterial composition and virulence, granuloma formation, colitis induction in an animal model of CD, and terminal ileum uptake. The Al–bacterial interaction, the microparticles homing the intestine together with the extensive immune activity, put Al as a potential environmental candidate for CD induction and maintenance.

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