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August 7, 2006Circulation2,260 citations

Advanced Glycation End Products

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AGAlison GoldinJBJoshua A. BeckmanASAnn Marie Schmidt

Key Points

  • To review the mechanisms by which advanced glycation end products contribute to microvascular and macrovascular pathology in diabetes.
  • Narrative synthesis of cellular and molecular pathways linking sugar-mediated protein and lipid glycation to diabetic vascular disease.
  • Evaluation of receptor-dependent and receptor-independent signaling cascades, endothelial dysfunction markers, and emerging therapeutic inhibitors.
  • Advanced glycation end products (AGEs) cross-link basement membrane proteins and bind the RAGE receptor, triggering NF-κB activation and downstream inflammatory gene expression.
  • AGE-RAGE interactions increase endothelial permeability to macromolecules, inhibit nitric oxide activity, and stimulate reactive oxygen species production.
  • Soluble AGEs activate circulating monocytes, whereas matrix-bound AGEs impair monocyte migration, collectively accelerating diabetic atherosclerosis.

Abstract

Advanced glycation end products (AGEs) are proteins or lipids that become glycated after exposure to sugars. AGEs are prevalent in the diabetic vasculature and contribute to the development of atherosclerosis. The presence and accumulation of AGEs in many different cell types affect extracellular and intracellular structure and function. AGEs contribute to a variety of microvascular and macrovascular complications through the formation of cross-links between molecules in the basement membrane of the extracellular matrix and by engaging the receptor for advanced glycation end products (RAGE). Activation of RAGE by AGEs causes upregulation of the transcription factor nuclear factor-kappaB and its target genes. Soluble AGEs activate monocytes, and AGEs in the basement membrane inhibit monocyte migration. AGE-bound RAGE increases endothelial permeability to macromolecules. AGEs block nitric oxide activity in the endothelium and cause the production of reactive oxygen species. Because of the emerging evidence about the adverse effects of AGEs on the vasculature of patients with diabetes, a number of different therapies to inhibit AGEs are under investigation.

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Cite This Study

Goldin et al. (2006) studied this question.

synapsesocial.com/papers/69d89bba18b0ca7f91d1873chttps://doi.org/10.1161/circulationaha.106.621854
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