Role of the aluminium in situ bioaccumulation in the evolutive state of carotid atheromatous plaques

Aluminium (Al), a widespread environmental contaminant, has been implicated in various human pathologies, yet its role in atherogenesis remains unexplored. In this study, we investigate Al bioaccumulation in human carotid atheromatous plaques and its possible association with plaque instability. Using ICP-MS, scanning and transmission electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM/TEM-EDX), we assessed the presence and localization of Al in 50 carotid endarterectomy specimens. Aluminium was detected in all of cases, with no preferential localization or significant association with plaque instability. Multivariate analyses demonstrated that Al presence did not influence the effect of major cardiovascular risk factors on plaque vulnerability. These findings suggest that Al bioaccumulation in the vascular wall is a diffuse and passive process, independent of acute thrombotic transformation. While not predictive of instability, Al may contribute to plaque growth or reflect cumulative environmental exposure.