title: Expression of advanced glycation end products and their cellular receptor RAGE in diabetic nephropathy and nondiabetic renal disease.
abstract: Advanced glycation end products (AGE) contribute to diabetic tissue injury by two major mechanisms, i.e., the alteration of extracellular matrix architecture through nonenzymatic glycation, with formation of protein crosslinks, and the modulation of cellular functions through interactions with specific cell surface receptors, the best characterized of which is the receptor for AGE (RAGE). Recent evidence suggests that the AGE-RAGE interaction may also be promoted by inflammatory processes and oxidative cellular injury. To characterize the distributions of AGE and RAGE in diabetic kidneys and to determine their specificity for diabetic nephropathy, an immunohistochemical analysis of renal biopsies from patients with diabetic nephropathy (n = 26), hypertensive nephrosclerosis (n = 7), idiopathic focal segmental glomerulosclerosis (n = 11), focal sclerosis secondary to obesity (n = 7), and lupus nephritis (n = 11) and from normal control subjects (n = 2) was performed, using affinity-purified antibodies raised to RAGE and two subclasses of AGE, i.e., N(epsilon)-(carboxymethyl)-lysine (CML) and pentosidine (PENT). AGE were detected equally in diffuse and nodular diabetic nephropathy. CML was the major AGE detected in diabetic mesangium (96%), glomerular basement membranes (GBM) (42%), tubular basement membranes (85%), and vessel walls (96%). In diabetic nephropathy, PENT was preferentially located in interstitial collagen (90%) and was less consistently observed in vessel walls (54%), mesangium (77%), GBM (4%), and tubular basement membranes (31%). RAGE was expressed on normal podocytes and was upregulated in diabetic nephropathy. The restriction of RAGE mRNA expression to glomeruli was confirmed by reverse transcription-PCR analysis of microdissected renal tissue compartments. The extent of mesangial and GBM immunoreactivity for CML, but not PENT, was correlated with the severity of diabetic glomerulosclerosis, as assessed pathologically. CML and PENT were also identified in areas of glomerulosclerosis and arteriosclerosis in idiopathic and secondary focal segmental glomerulosclerosis, hypertensive nephrosclerosis, and lupus nephritis. In active lupus nephritis, CML and PENT were detected in the proliferative glomerular tufts and crescents. In conclusion, CML is a major AGE in renal basement membranes in diabetic nephropathy, and its accumulation involves upregulation of RAGE on podocytes. AGE are also accumulated in acute inflammatory glomerulonephritis secondary to systemic lupus erythematosus, possibly via enzymatic oxidation of glomerular matrix proteins.
authors.affiliation: Department of Pathology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Nozomu
authors.initials: N
authors.lastname: Tanji
authors.affiliation: Department of Pathology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Glen S
authors.initials: GS
authors.lastname: Markowitz
authors.affiliation: Department of Physiology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Caifeng
authors.initials: C
authors.lastname: Fu
authors.affiliation: Department of Physiology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kislinger
authors.affiliation: Department of Physiology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Taguchi
authors.affiliation: Institut fur Pharmazie und Lebensmittelchemie, Universitat Erlangen-Nurnberg, Erlangen, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Pischetsrieder
authors.affiliation: Department of Physiology, Columbia University College of Physicians and Surgeons, New York, New York.|Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: David
authors.initials: D
authors.lastname: Stern
authors.affiliation: Department of Surgery, Columbia University College of Physicians and Surgeons, New York, New York.|Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Schmidt
authors.affiliation: Department of Pathology, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Vivette D
authors.initials: VD
authors.lastname: D'Agati
mesh_terms: D000328:Adult; D000906:Antibodies; D001120:Arginine / Q000031:analogs & derivatives* / Q000276:immunology; D003928:Diabetic Nephropathies / Q000378:metabolism*; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D007674:Kidney Diseases / Q000378:metabolism*; D008239:Lysine / Q000031:analogs & derivatives* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012333:RNA, Messenger / Q000378:metabolism; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000235:genetics / Q000378:metabolism*; D012016:Reference Values
chemical_list: D000906:Antibodies; D017127:Glycation End Products, Advanced; D012333:RNA, Messenger; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; C048496:N(6)-carboxymethyllysine; D001120:Arginine; C062187:pentosidine; D008239:Lysine