title: Paradox of advanced glycation end-products in late cardiac biopsies of heart transplant recipients.
abstract: BACKGROUND
  A pilot study of orthotopic heart transplant (OHT) recipients showed that advanced glycation end-product (AGE) deposits were related to acute rejection episodes among subjects with diabetes mellitus (DM); in contrast, among non-DM patients it was associated with prolonged freedom from coronary artery vasculopathy (CAV). However the number of observations in non-diabetic subjects was low. The aim of the current study was to establish the role of AGEs in late endomyocardial biopsies (EMBs) among a larger group of non-diabetic patients.
  
  
  METHODS
  Elective EMBs were performed at 3 years post OHT in 62 subjects with DM, namely, 57 males and 5 females of overall mean age of 50±8 years versus 92 free of DM, including 79 males and 13 females of mean age 51±13 years. We localized AGEs in myocardial paraffin sections using monoclonal mouse anti-AGE antibodies. The presence of AGEs in cardiomyocytes, stromal cells, capillaries, and arterioles was described with a semiquantitative scale.
  
  
  RESULTS
  All-cause deaths, CAV, and CAV-related events were observed in 28% versus 23%, 27% versus 29%, and 15% versus 19% of non-DM versus DM patients (P=NS). The occurrence of AGEs was significantly more frequent among non-DM than DM subjects: cardiocytes, 100% versus 69% (P<.0001); stroma, 54% versus 31% (P=.0037); capillaries, 67% versus 31% (P<.0001); and arterioles, 26% versus 3% (P=.0002; chi-square). Among the DM group, mean EMB score correlated with AGE presence in cardiomyocytes (n=0.29; P<.05, Spearman test) AGE presence had no impact on survival or CAV development.
  
  
  CONCLUSIONS
  AGE presence was more common in late EMB from non-diabetic than diabetic OHT recipients; they had no impact on survival or CAV in non-diabetic patients.
authors: Silesian Center for Heart Diseases, Zabrze, Poland. zaklimed@onet.pl
authors: M
authors: M
authors: Zakliczynski
authors: J
authors: J
authors: Nozynski
authors: D
authors: D
authors: Konecka-Mrowka
authors: D
authors: D
authors: Lange
authors: H
authors: H
authors: Zakliczynska
authors: B
authors: B
authors: Szygula-Jurkiewicz
authors: M
authors: M
authors: Zembala
mesh_terms: D000328:Adult; D001706:Biopsy; D003324:Coronary Artery Disease / Q000378:metabolism / Q000473:pathology; D048909:Diabetes Complications / Q000378:metabolism / Q000473:pathology; D005260:Female; D017127:Glycation End Products, Advanced / Q000378:metabolism*; D006084:Graft Rejection / Q000378:metabolism / Q000473:pathology; D016027:Heart Transplantation / Q000473:pathology* / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology*; D013997:Time Factors
chemical_list: D017127:Glycation End Products, Advanced