Side Effects of aluminum hydroxide: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Main Research Findings

Aluminum hydroxide is a widely used adjuvant in vaccines and other medical applications. It is known to enhance immune responses by stimulating the immune system. However, there are concerns regarding its safety, with several studies pointing to potential side effects. 6 , 27 , 8 , 15 , 28 , 24 , and 7 are among the studies that highlight both the benefits and potential risks of aluminum hydroxide.

For instance, 27 found that aluminum hydroxide exhibited toxicity to the splenic melanomacrophage centers in fish, while 5 demonstrated that aluminum hydroxide induced apoptosis in liver cells.

Reason for Side Effects

The side effects associated with aluminum hydroxide are likely due to its immune-enhancing properties. Aluminum hydroxide activates immune cells, boosting the immune response and promoting inflammation. However, this heightened immune response can have adverse effects on the body if it becomes excessive.

Common Side Effects

Injection Site Reactions

Vaccines containing aluminum hydroxide can cause injection site reactions such as pain, swelling, and redness. 25 , 16 , 23 , and 15 reported injection site reactions following vaccination with aluminum hydroxide-containing adjuvants.

Systemic Reactions

Systemic reactions such as fever, fatigue, and headache can also occur after vaccination with aluminum hydroxide-containing vaccines. 25 , 16 , and 23 have documented these systemic reactions.

Allergic Reactions

Aluminum hydroxide can trigger allergic reactions in some individuals. These reactions can range from mild to severe, including hives, difficulty breathing, and anaphylactic shock. 10 and 26 reported instances of allergic reactions to aluminum hydroxide.

Other Side Effects

Long-term use of aluminum hydroxide has been linked to other potential side effects, including bone accumulation, nerve damage, and kidney problems. 11 , 2 , 18 , 14 , 4 , and 22 provided evidence of these long-term effects.

Countermeasures for Side Effects

Injection Site Reactions

To minimize injection site reactions, applying cold compresses and resting can be helpful. Over-the-counter pain relievers can also be used.

Systemic Reactions

If systemic reactions occur, consult a doctor for guidance. They may prescribe fever reducers or pain relievers as needed.

Allergic Reactions

In case of an allergic reaction, seek medical attention immediately. Allergic reactions can be life-threatening, so prompt medical care is crucial.

Other Side Effects

If you have concerns about potential long-term side effects from aluminum hydroxide, consult your doctor for advice.

Comparison Between Studies

Common Points

A recurring theme in many studies is that aluminum hydroxide enhances immune responses while also raising concerns about potential side effects.

Differences

The severity and types of side effects observed in research involving aluminum hydroxide vary. This disparity could be attributed to factors such as the dosage and manufacturing process of the aluminum hydroxide used, and the age and overall health of the study participants.

Points to Note Regarding Applications in Everyday Life

Aluminum hydroxide plays a significant role in various medical applications, including vaccines and allergy treatments. The decision to use aluminum hydroxide should be made with careful consideration of its benefits and risks. If you are using a product containing aluminum hydroxide, it is essential to consult your doctor or pharmacist to receive accurate and relevant information.

Limitations of Current Research

The current understanding of the safety of aluminum hydroxide remains incomplete. There are still significant gaps in our knowledge, particularly regarding its long-term effects. More research is needed to address these uncertainties.

Future Research Directions

Further research on the safety of aluminum hydroxide is essential. Important areas of focus include investigating long-term effects, assessing the impact on individuals of various ages and health conditions, and exploring the development of alternative adjuvants. These research directions are crucial for advancing safer medical practices.

Conclusion

Aluminum hydroxide is an effective adjuvant for enhancing immune responses but carries potential side effects. It is crucial to weigh its benefits and risks carefully when considering its use. More research is necessary to fully understand the safety of aluminum hydroxide and to develop safer alternatives.

Literature analysis of 28 papers
Positive Content
26
Neutral Content
0
Negative Content
2
Article Type
7
0
0
5
28
1.

The hypocholesterolemic effect of an antacid containing aluminum hydroxide.

Author: SperberA D, HenkinY, ZuiliI, BearmanJ E, ShanyS

Improved atherogenic index
LDL-C reduction
HDL-C reduction

An aluminum hydroxide-containing antacid reduced low-density lipoprotein cholesterol (LDL-C) by 9.8% after 2 months and 18.5% after 4 months, leading to an improvement in the atherogenic index. The treatment was well tolerated, but long-term safety and efficacy need further investigation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Oral phosphate binders for the management of serum phosphate levels in dialysis patients.

Author: MohammedIsmail, HutchisonAlastair J

Cardiovascular mortality
Hypercalcemia
Vascular calcification

Hyperphosphatemia is a common consequence of end-stage chronic kidney disease and affects the majority of dialysis patients. It is statistically linked to increased cardiovascular mortality in this population. Dietary restriction and current dialysis modalities are not sufficiently effective to maintain serum phosphate levels within the recommended range, leading most dialysis patients to require oral phosphate binders. However, the benefits of achieving the recommended range have not been demonstrated prospectively. Traditional phosphate binders have limitations and side effects. Aluminium-containing agents, while highly efficient, are no longer widely used due to established toxicity. Calcium-based salts are inexpensive, effective, and most widely used but are now associated with hypercalcemia and vascular calcification. Sevelamer hydrochloride and lanthanum carbonate, non-aluminum, calcium-free phosphate binders, are effective and generally well-tolerated but do not control phosphate levels in all patients. Patient education programs have been shown to be effective in improving serum phosphate target achievement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Hepatitis B vaccine induces apoptotic death in Hepa1-6 cells.

Author: HamzaHeyam, CaoJianhua, LiXinyun, LiChangchun, ZhuMengjin, ZhaoShuhong

Apoptosis
Cytotoxicity

Hepatitis B vaccine exposure induced apoptosis in mouse liver hepatoma cells (Hepa1-6) and mouse myoblast cells (C2C12) through the intrinsic apoptotic pathway, involving cytochrome c release and caspase activation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Suramin has adjuvant properties and promotes expansion of antigen-specific Th1 and Th2 cells in vivo.

Author: DenkingerMichael, ShiveCarey L, PantenburgBirte, ForsthuberThomas G

Vaccine adjuvant

Suramin is a small molecular weight compound that has been shown to act as an adjuvant, promoting the expansion of T helper 1 (Th1) and T helper 2 (Th2) cells in mice. This suggests that it could be a potential alternative to bacterial toxins as a vaccine adjuvant.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

7.

Specific immunotherapy in honeybee venom allergy: a comparative study using aqueous and aluminium hydroxide adsorbed preparations.

Author: RuëffF, WolfH, SchnitkerJ, RingJ, PrzybillaB

Reduced local reactions
Venom immunotherapy

An aluminium hydroxide adsorbed honeybee venom (HBV) preparation caused fewer large local reactions than an aqueous preparation. The therapeutic efficacy of three different venom immunotherapy (VIT) protocols did not differ significantly.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

[Evaluation of the safety of aluminium adjuvant in the preparation of allergic rhinitis animal model].

Author: FanEr-zhong, XiLin, HanDe-min, ZhangSheng-zhong, LiYing, ZhangLuo

Allergic rhinitis animal model preparation
Foreign body granuloma

Al(OH)(3) powder (5mg) is effective and safe in the preparation of allergic rhinitis animal models. Al(OH)(3) colloid gel of different concentrations (0.5-5mg) may cause side effects such as foreign body granuloma.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Chinese

9.

An open-label tolerability and efficacy study of an aluminum sesquichlorohydrate topical foam in axillary and palmar primary hyperhidrosis.

Author: InnocenziDaniele, RuggeroArianna, FrancesconiLidia, LacarrubbaFrancesco, NardoneBeatrice, MicaliGiuseppe

Reduces sweating
Well-tolerated
Mild itching

A new foam formulation containing 20% aluminum sesquichlorohydrate was found to be effective and well-tolerated for treating axillary and palmar hyperhidrosis.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

12.

[A comparative evaluation of the antacid properties of the preparations Maalox and Almagel].

Author: GrebenevA L, SheptulinA A, OkhlobystinA V

Duodenal ulcer treatment
Erosive gastroduodenitis treatment
Erosive reflux-esophagitis treatment
Gastric ulcer treatment

This study compared the antacid properties of Maalox and Almagel in patients with duodenal ulcers. Maalox was found to be more effective and well-tolerated, with fewer side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Russian

13.

Magnesium-aluminum hydroxide suspension for the treatment of dermal capsaicin exposures.

Author: LeeDavid C, RyanJames R

Cheap and readily available
Reduced pain
Minimal side effects

Magnesium-aluminum-hydroxide-simethicone suspension (MgAl) was found to significantly reduce pain scores during the first 30 minutes of treatment for dermal capsaicin exposure. Although the clinical significance of this difference is questionable, MgAl is a cheap and readily available treatment option with minimal side effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

An Update on Phosphate Binders: A Dietitian's Perspective.

Author: GutekunstLisa

Improved PO4 control
Safer phosphate binders

Phosphate binders are used to treat hyperphosphatemia in patients with chronic kidney disease. This article reviews the most common binder categories, discussing their pharmacokinetics, side effects, doses, phosphate affinity, and controversies of use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

Safety and immunogenicity of HBAI20 Hepatitis B vaccine in healthy naïve and nonresponding adults.

Author: KocÖ M, SavelkoulP H M, van LooI H M, PeetersA, Oude LashofA M L

Faster protection
Safe and well-tolerated

A new vaccine, HBAI20, containing recombinant human IL-2, shows promise as a safer and more effective treatment for hepatitis B.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

Challenges for the development of a universal vaccine against leptospirosis revealed by the evaluation of 22 vaccine candidates.

Author: MaiaMara A C, BettinEverton B, BarbosaLiana N, de OliveiraNatasha R, BundeTiffany T, PedraAna Carolina K, RosaGuilherme A, da RosaElias E B, Seixas NetoAmilton C P, GrassmannAndré A, McFaddenJohnjoe, DellagostinOdir A, McBrideAlan J A

Leptospirosis vaccine

This study evaluates the immunogenicity and protective efficacy of 22 vaccine formulations containing protein fragments from leptospiral β-barrel outer membrane proteins (βb-OMPs) in a hamster model of leptospirosis. While several formulations induced significant humoral immune responses, only four constructs induced significant protection in two independent experiments, suggesting that the hamster model may not be ideal for evaluating leptospirosis vaccines.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

The Rising Risk of Chronic Kidney Disease (CKD) and How it is Dealt with: A Review of Current and Potential Phosphate Binders (PB).

Author: GosikRobert, DanelKrzysztof

CKD
Hyperphosphatemia
Phosphate Binders
Aluminum Toxicity
Calcium Overload
Gastrointestinal Bleeding

This review discusses different phosphate binders (PBs) used for treating hyperphosphatemia, a risk factor for chronic kidney disease (CKD). The review explores the pros and cons of current PBs, highlighting the need for new PBs that can also function as protection modifiers.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Anti-asthmatic effects of volatile organic compounds from Chamaecyparis obtusa, Pinus densiflora, Pinus koraiensis, or Larix kaempferi wood panels.

Author: AhnC, JangY-J, KimJ-W, ParkM-J, YooY-M, JeungE-B

Asthma treatment

VOCs emitted from certain wood panels have shown antiasthmatic effects in mice, suggesting a potential for natural remedies for asthma.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Safety and immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine in HIV-positive women in South Africa: a partially-blind randomised placebo-controlled study.

Author: DennyLynette, HendricksBronwyn, GordonChivaugn, ThomasFlorence, HezarehMarjan, DobbelaereKurt, DurandChristelle, HervéCaroline, DescampsDominique

HPV vaccine efficacy
HPV vaccine safety

The HPV-16/18 AS04-adjuvanted vaccine was immunogenic and well-tolerated in women with HIV infection in a study conducted in South Africa. All vaccinated women were seropositive for both HPV-16 and HPV-18 after the second vaccine dose and remained seropositive at month 12. The vaccine induced sustained anti-HPV-16/18 CD4⁺ T-cell responses in both HIV-positive and HIV-negative women. CD4⁺ T-cell count, HIV viral load, and HIV clinical stage were unaffected by HPV-16/18 vaccine administration.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Optimal use of phosphate binders in chronic kidney disease.

Author: SonikianMakrouhi, PapachristouEvangelos, GoumenosDimitrios S

Hyperphosphatemia treatment
Side effects

Hyperphosphatemia is a major factor in vascular calcification in patients with chronic kidney disease (CKD). Due to phosphate retention in these patients, pharmacological treatment and other measures are needed to control hyperphosphatemia. Although several phosphate binders are available, none have shown overall superiority, and their potency and side effects vary significantly, making it challenging to choose the optimal drug for each patient.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

23.

First-in-human safety and immunogenicity investigations of three adjuvanted reduced dose inactivated poliovirus vaccines (IPV-Al SSI) compared to full dose IPV Vaccine SSI when given as a booster vaccination to adolescents with a history of IPV vaccination at 3, 5, 12months and 5years of age.

Author: LindgrenLine M, TingskovPernille N, JustesenAnnette H, NedergaardBettina S, OlsenKlaus J, AndreasenLars V, KromannIngrid, SørensenCharlotte, DietrichJes, Thierry-CarstensenBirgit

Immunogenic
Safe

This study investigated the immunogenicity and safety of three reduced dose IPV formulations adsorbed to aluminium hydroxide in Danish adolescents who were previously vaccinated with IPV. The study found that the three IPV-Al formulations were highly immunogenic, but inferior to IPV Vaccine SSI. The three IPV-Al SSI were also safe in adolescents and the booster effects were satisfactory.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

24.

Safety and immunogenicity of a parenterally administered rotavirus VP8 subunit vaccine in healthy adults.

Author: FixAlan D, HarroClayton, McNealMonica, DallyLen, FloresJorge, RobertsonGeorge, BoslegoJohn W, CryzStanley

Immune response
Rotavirus prevention
Well tolerated

The P2-VP8 subunit vaccine was well tolerated and evoked promising immune responses in adults. All vaccine recipients demonstrated significant IgA responses and all but one demonstrated IgG responses. Homologous neutralizing antibody responses were observed in about half of participants in all three dose cohorts.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Safety and immunogenicity of the Na-GST-1 hookworm vaccine in Brazilian and American adults.

Author: DiemertDavid J, FreireJanaína, ValenteVanderson, FragaCarlo Geraldo, TallesFrederico, GrahekShannon, CampbellDoreen, JariwalaAmar, PeriagoMaria Victoria, EnkMartin, GazzinelliMaria Flávia, BottazziMaria Elena, HamiltonRobert, BrelsfordJill, YakovlevaAnna, LiGuangzhao, PengJin, Correa-OliveiraRodrigo, HotezPeter, BethonyJeffrey

Hookworm protection

This study investigated the safety and immunogenicity of a recombinant Necator americanus Glutathione-S-Transferase-1 (Na-GST-1) vaccine in hookworm-naïve and hookworm-exposed adults. The vaccine was well-tolerated and induced significant antigen-specific IgG responses in a dose-dependent fashion.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

The safety of cluster immunotherapy with aluminium hydroxide-adsorbed honey bee venom extract.

Author: QuerciaO, RafanelliS, PuccinelliP, StefaniniG F

Insect allergy treatment
Systemic side effects

This study compared the tolerance of aqueous cluster or rush venom immunotherapy (VIT) versus cluster depot VIT in patients sensitized to Apis mellifera venom. Aqueous cluster VIT resulted in large local reactions in 4 patients, while 4 patients in the aqueous rush VIT group experienced systemic side effects. Depot VIT was well-tolerated and showed better tolerance compared to aqueous-rush VIT.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

28.

The Neurobiology of Methamphetamine Addiction and the Potential to Reduce Misuse Through Conjugate Vaccines Targeting Toll-Like Receptor 4.

Author: PrasadSavita, MathewPhoebe S, PiperBrian J, KaurKarndeep, TianMaria

Decrease drug-seeking behavior
Improve withdrawal symptoms
Minimal health side effects

Methamphetamine addiction is a significant public health concern. This paper reviews the neurobiology of methamphetamine addiction and drug-seeking behaviors, examining the potential of vaccinations in addressing this epidemic.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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