Low-molecular weight advanced glycation end products: markers of tissue AGE accumulation and more?
Incomplete digestion of advanced glycation end product (AGE)-modified protein results in the formation of low-molecular weight degradation products incorporating AGE modifications (LMW-AGEs). In addition to being biomarkers of AGE modification, LMW-AGEs may have a high toxic potential, being free to interact with AGE receptors at distant sites via the circulation. Several free AGEs have been identified, including pentosidine, N(epsilon)-(carboxymethyl)lysine (CML), and free-imidazole AGEs. In addition, fluorescence (370 nm [excitation]/440 nm [emission]) in the LMW phase of serum correlates with tissue fluorescence, an established marker for AGE modification. In experimental diabetes, LMW fluorescence increases with duration of disease and is normalized with the AGE inhibitor aminoguanidine. LMW fluorescence is also higher in patients with diabetes, in whom it is associated with glomerular filtration rate and hemoglobin. Patients with hyperfiltration have lower LMW fluorescence than those with normal renal function, which may protect them from AGE accumulation in the short term. These findings provide clinical support for the association between AGEs and progressive renal injury in diabetes.
Thomas
Merlin C
MC
The Baker Heart Research Institute, P.O. Box 6492, St. Kilda Rd. Central, Melbourne, Victoria, Australia. mthomas@baker.edu.au
Forbes
Josephine M
JM
MacIsaac
Richard
R
Jerums
George
G
Cooper
Mark E
ME
D015415:Biomarkers / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism; D017127:Glycation End Products, Advanced / Q000737:chemistry* / Q000378:metabolism*; D006801:Humans; D008856:Microscopy, Fluorescence; D008970:Molecular Weight
D015415:Biomarkers; D017127:Glycation End Products, Advanced