Glucosylation of human lens protein and cataractogenesis

Role of Glycation in Human Lens Protein Structure Change

PURPOSE

Protein glycation may be involved in cataract development, by altering protein structure, particularly amino acid composition, and formation of fluorophores through a Maillard reaction. This study was designed to evaluate major changes in early and advanced (fluorescent) glycation products, with special emphasis on glycation-induced changes in amino acid composition of lens proteins.

METHODS

We analyzed 50 human cataractous lenses (25 diabetic and 25 non-diabetic). Glycated proteins were isolated by affinity chromatography. Glycated and non-glycated proteins were separated by molecular sieve chromatography and further analyzed by RP-HPLC to establish the amino acid content. Early glycation levels were determined as furosine content and advanced glycation products were quantified by the characteristic fluorescence.

RESULTS

Specific lens fractions (HMW and LMW) present significant differences in fluorescence levels between glycated and non-glycated proteins, specially in cataractous lenses from diabetic patients in which all proteins analyzed presented higher glycation levels than in non-diabetic patients. The amino and analysis of glycated proteins also revealed some important differences in specific basic residues (namely Lys, Arg and His) compared to the non-glycated fraction.

CONCLUSIONS

The results suggest that protein glycation may be involved in changes in amino acid composition and fluorophore formation. This process may well account for the increased risk factor that diabetes represents for cataract development.

Diabetic and galactosaemic cataracts

An increased prevalence of cataract is associated with diabetes. Biochemical studies of diabetic lenses have revealed a variety of metabolic abnormalities including changes in the levels of electrolytes, glutathione, nucleotides and sugars. Similar biochemical changes have also been observed in cataracts associated with galactosaemia, suggesting that these sugar cataracts have a common biochemical aetiology. The common biochemical factor found to initiate both types of sugar cataract is the formation of sugar alcohols (polyols) from either glucose or galactose by the enzyme aldose reductase (alditol: NADP+ 1-oxidoreductase, EC 1.1.1.21). Increased intracellular levels of these polar alcohols have a hyperosmotic effect which leads to lens fibre swelling, vacuole formation and subsequent opacification. The process of sugar cataract formation in animals can be prevented by inhibiting aldose reductase.

Helical peptide models for protein glycation: proximity effects in catalysis of the Amadori rearrangement

INTRODUCTION

Non-enzymatic glycation of proteins has been implicated in various diabetic complications and age-related disorders. Proteins undergo glycation at the N-terminus or at the epsilon-amino group of lysine residues. The observation that only a fraction of all lysine residues undergo glycation indicates the role of the immediate chemical environment in the glycation reaction. Here we have constructed helical peptide models, which juxtapose lysine with potentially catalytic residues in order to probe their roles in the individual steps of the glycation reaction.

RESULTS

The peptides investigated in this study are constrained to adopt helical conformations allowing residues in the i and i+4 positions to come into spatial proximity, while residues i and i+2 are far apart. The placing of aspartic acid and histidine residues at interacting positions with lysine modulates the steps involved in early peptide glycation (reversible Schiff base formation and its subsequent irreversible conversion to a ketoamine product, the Amadori rearrangement). Proximal positioning of aspartic acid or histidine with respect to the reactive lysine residue retards initial Schiff base formation. On the contrary, aspartic acid promotes catalysis of the Amadori rearrangement. Presence of the strongly basic residue arginine proximate to lysine favorably affects the pK(a) of both the lysine epsilon-amino group and the singly glycated lysine, aiding in the formation of doubly glycated species. The Amadori product also formed carboxymethyl lysine, an advanced glycation endproduct (AGE), in a time-dependent manner.

CONCLUSIONS

Stereochemically defined peptide scaffolds are convenient tools for studying near neighbor effects on the reactivity of functional amino acid sidechains. The present study utilizes stereochemically defined peptide helices to effectively demonstrate that aspartic acid is an efficient catalytic residue in the Amadori arrangement. The results emphasize the structural determinants of Schiff base and Amadori product formation in the final accumulation of glycated peptides.

Crystallin composition of human cataractous lens may be modulated by protein glycation

BACKGROUND

This study was designed to establish whether increased glycation of human crystallins could be related to an increased susceptibility to aggregation and insolubilization. The study was focused particularly on the glycation levels and composition of low-molecular-weight (LMW) peptides present in human cataractous lenses.

METHODS

Lens crystallins from the water-soluble fraction were separated on a preparative scale by gel filtration. Each crystallin was purified and its glycation level evaluated as furosine content. The peptides were further purified by reverse-phase chromatography. The amino acid composition of each of these peptides was also determined by RP-HPLC using PITC pre-column derivatization.

RESULTS

The high-molecular-weight (HMW), alpha L-crystallin and LMW crystallins from diabetic patients present high furosine content. LMW peptides were shown to constitute a heterogeneous population of three major peptides with a lysine content similar to that observed for native crystallins. These peptides were shown to present glycation levels ten times higher than those observed for the crystallins. Glycated proteins from insoluble fraction were found to be mostly urea soluble and were present at higher concentration in diabetic cataracts.

CONCLUSIONS

LMW peptides are suggested to play a major role in protein aggregation and insolubilization, probably via a mechanism involving protein glycation. This process seems to be particularly relevant to diabetic cataract development.

Protein glycation and in vivo distribution of human lens fluorescence

Glycated proteins formed by the Maillard reaction were measured by furosine determination in human normal lenses and in senile and diabetic cataracts. Furosine, an hydrolysis product of fructose-lysine adduct formed in the early stages of the Maillard reaction, was measured by high performance liquid chromatography (HPLC). Furosine levels in diabetic cataracts were found to be 3 to 4 times higher than those observed for senile cataracts. The increased glycation levels both in cortex and nucleus were related to the increase of fluorescence determined in vitro by fluorometry and in vivo by Scheimpflug photography. Lens proteins were incubated with glucose and it has been demonstrated that protein glycation occurred parallel with the increase in concentration of fluorescent chromophores that present similar characteristics as those observed in vivo. The results indicate that protein insolubilization seemed to involve preferentially glycated proteins and at least in diabetic cataracts, the process seems to be initiated in the cortical region.

The lens in diabetes

This paper reviews the changes which occur in the human lens in diabetes. They include refractive changes and cataract and age-related increases in thickness, curvatures, light scattering, autofluorescence and yellowing. The incidence of cataract is greatly increased over the age of 50 years, slightly more so in women, compared with non-diabetics. Experimental models of sugar cataract provide some evidence for the mechanism of the uncommon, but morphologically distinct, juvenile form of human diabetic cataract, where an osmotic mechanism due to sugar alcohol accumulation has been thoroughly studied in diabetic or galactose-fed rats. The discrepancy between the ready accumulation of sugar alcohol in the lens in model systems and the very slow kinetics of aldose reductase (AR) has not been satisfactorily explained and suggests that the mechanism of polyol formation is not yet fully understood in mammalian systems. The activity of AR in the human lens lies mainly in the epithelium and there appears to be a marginal expectation that sufficient sorbitol accumulates in cortical lens fibres to explain the lens swelling and cataract on an osmotic basis. This is even more so in the cataracts of adult diabetics, which resemble those of age-related non-diabetic cataracts in appearance. The very low levels of sorbitol in adult diabetic lenses make an osmotic mechanism for the increased risk of cataract even less likely. Other mechanisms, including glycation and oxidative stress, are discussed. The occurrence of cataract is a predictor for increased mortality in the diabetic.

Diabetes, glaucoma, sex, and cataract: analysis of combined data from two case control studies

Data from two case control studies in Oxfordshire were combined and analysed. The combined study covered 1940 subjects, 723 cases, and 1217 controls, between the ages of 50 and 79 with a response rate of 97% for cases and 94% for controls. Diabetes was shown to be a powerful and highly significant risk factor for cataract with a relative risk of 5.04. More than 11% of cataracts in Oxfordshire are attributable to diabetes. The relative risk did not increase significantly with age within the range 50 to 79 years but was higher in females than in males. For females with diabetes the relative risk was 7.85 with 95% confidence interval from 4.30 to 14.3 compared with 3.42 with confidence interval from 2.05 to 5.71 for males with diabetes. Diabetes remained a powerful risk factor when other identified risk factors had been controlled for. No known mechanism for the development of diabetic complications provides an explanation for the excess risk in females. Combination of the two studies led to better estimates of the relative risk of glaucoma as a risk factor for cataract (3.96 with 95% confidence interval from 2.35 to 6.68). The relative risk appeared to be greater in women than in men but this difference was not statistically significant. There was no significant change in risk with age. Glaucoma is a powerful and independent risk factor for cataract in both sexes and may be responsible for 5% of all cataracts in our area.

Studies on the solubilization of the water-insoluble fraction from human lens and cataract

Studies were carried out comparing the ability of urea extraction and sonication to solubilize the water-insoluble (WI) protein fraction from human lens tissue. Sonication and urea extraction were able to solubilize greater than 80% of the insoluble protein whether whole lenses or lens nuclei were used. This was true for normal lens and +1 cataracts; however, only 60% solubilization was obtained with the WI fraction from more advanced cataracts. Equal aliquots of a WI fraction from both pooled normal and pooled cataract lens nuclei were solubilized with and without reducing agents. The addition of dithiothreitol (DTT) had no significant effect on solubilization of the normal lens WI fraction. DTT did increase the protein solubilized from the cataract WI fraction by 30% with urea extraction; however, no increase was seen with sonication. When sodium borohydride was used as the reducing agent, essentially the same results were obtained. The solubilized protein populations were identical by SDS-PAGE and amino acid analysis. The addition of reducing agents had no effect on the amino acid content of the solubilized proteins with the single exception of lysine. This amino acid was markedly decreased in the proteins extracted in the presence of 40 mM sodium borohydride, but not with DTT. These data suggest that the borohydride not only increased the amount of protein solubilized, but likely also stabilized glycated lysine residues during the acid hydrolysis. Therefore, sonication readily provides a soluble preparation of the WI proteins from normal and cataract lens nuclei without the need for denaturing agents, however, disulfide-linked and lysine modified crystallins were best solubilized with urea.

Glycation of human lens proteins: preferential glycation of alpha A subunits

Glycation of crystallins and high molecular weight (HMW) aggregates was followed during aging (16-85 years) and in diabetes (44 and 70 years old). Lens soluble and insoluble fractions were reduced with [3H]NaBH4 and separated by molecular sieve HPLC. The protein content in each HPLC peak was measured by the Lowry method. The tritium incorporation, expressed as cpm mg-1 protein, was taken as a measure of early glycation and specific non-tryptophan fluorescence (Ex: 370 nm; Em: 440 nm), expressed as relative fluorescence U mg-1 protein, was taken as a measure of advanced glycation. The youngest lenses analysed were 16 and 17 years old and these provided the baseline values. The results showed that during aging there was about a three-fold increase in tritium incorporation and fluorescence of alpha-crystallin, while the increases in beta and gamma were only two-fold from the levels seen in 16- and 17-year-old lenses. On the other hand, both the soluble and insoluble HMW aggregate fractions showed up to five-fold increase in tritium incorporation during aging. The fluorescence was about two-fold higher in the insoluble HMW aggregates as compared to the soluble HMW aggregates in 16- and 17-year-old lenses and both showed an increase of about three-fold during aging. Diabetes resulted in an approximately 10-50% increase in tritium incorporation and non-tryptophan fluorescence of various crystallins and HMW aggregates.(ABSTRACT TRUNCATED AT 250 WORDS)

Glycation-induced crosslinking of calf lens crystallins

To investigate the possible role of glycation in the onset of diabetic cataract we used calf lens crystallins as a model. After incubation with reducing sugars, the proteins were investigated by high-pressure gel permeation chromatography, SDS-PAGE and analytical ultracentrifugation. Glucose-6-phosphate incubation resulted in an increase in mean molecular weight of all crystallin fractions and the occurrence of high-molecular weight material, partly formed by disulphide bonds. The glycated crystallins showed a decrease of tryptophan fluorescence and an increase of a specific non-tryptophan fluorescence. This fluorescence was, however, not exclusively associated with the high molecular weight protein, but was present in all protein fractions.

Possible process of insolubilization of lens proteins--direct effect of glucose

The effect of glucose on the insolubilization of lens proteins was investigated in the presence of visible light. The amount of glucose-induced insolubilization of lens proteins showed a dose-dependent increase. The velocity of insolubilization accelerated under acidic conditions. These results suggest that this phenomenon may be due to the direct action of glucose rather than glycosylation. 1H-NMR spectroscopy results suggest that the action of glucose might be to induce conformational changes, and aggregation of the proteins. The in vitro observation of glucose-derived insolubilization of the lens proteins may be similar to that observed in diabetic mellitus. Elevated free glucose per se may have a role in diabetic cataractogenesis in addition to the metabolism of glucose to sorbitol and osmotic changes to the lens. Protein structural perturbation by glucose was demonstrated with isolated proteins from the aged normal human lenses over 40 years and may contribute to senile cataractogenesis. The results suggest that elevated lens glucose may act directly as one of the triggers of cataractogenesis.

Glycation of lens proteins by the oxidation products of ascorbic acid

Bovine lens water-soluble proteins were incubated with [I-14C]ascorbic acid (ASA) for 6 days, and the incorporation into protein was measured at daily intervals. Aliquots were also withdrawn to determine the distribution of label among the various ASA oxidation products. A linear incorporation into protein was observed in the presence of NaCNBH3, however, little or no incorporation was seen in its absence. TLC analysis showed a complete loss of ASA by day 3, whereas both dehydroascorbate (DHA) and diketogulonic acid (DKG) remained constant for 6 days, consistent with the linear incorporation into protein. The amino acid composition of the proteins glycated in the presence of NaCNBH3 was identical to controls except for a 70% reduction in lysine residues and a corresponding increase in an unknown product which eluted slightly earlier than methionine. In the absence of NaCNBH3 lysine decreased linearly to 20% with an additional decrease in arginine and histidine at later times concurrent with protein crosslinking. DHA and DKG were prepared and incubated directly with lens proteins for an 8 day period. Both compounds glycated lens protein as evidenced by an increased binding to a boronate affinity column. SDS-PAGE showed that both compounds were also capable of causing protein crosslinking. DHA is apparently capable of reacting directly with protein since glycation was observed with the ASA analog, reductic acid, which can be oxidized to dehydroreductic acid, but which cannot be hydrolyzed to an open chain structure. DHA also produced a lysine adduct which was not obtained with DKG, supporting the idea that both species have glycating ability.

The non-enzymic glycosylation of bovine lens proteins by glucosamine and its inhibition by aspirin, ibuprofen and glutathione

Cataract is a long-term complication of diabetes mellitus. Diabetics have increased glucosamine levels and it is possible that the non-enzymic glycosylation of the lens structural proteins by glucosamine induces conformational changes in the lens that contribute to cataract formation. Aspirin and aspirin-like analgesics may protect against glycosylation. In this paper the binding of glucosamine to bovine lens proteins and the effects of aspirin, paracetamol and ibuprofen on this reaction were investigated. Significant binding of glucosamine to the lens proteins was found. Gel-chromatography indicated that beta H-crystallin was most reactive to the amino-sugar. Of the analgesics studied, aspirin was the most effective inhibitor of glycosylation, followed by the other anti-inflammatory drug, ibuprofen. Preincubation of the lens homogenate with aspirin was no more effective at decreasing binding of glucosamine than was simultaneous incubation with aspirin. Glutathione significantly inhibited glucosamine binding. Glucosamine is active in non-enzymic glycosylation but the reaction can be inhibited by agents thought to protect against cataract.

Glutathione inhibits the glycation and crosslinking of lens proteins by ascorbic acid

The incubation of crude extracts of bovine lens with 20 mM ascorbic acid leads to the formation of covalent adducts even in the presence of saturating levels of a metal chelator. When dialysed lens extracts were used both ASA-protein adducts and highly crosslinked lens proteins were observed which are similar to those found in the water insoluble fraction from cataractous lenses. Both adduct formation and protein crosslinking, however, were markedly inhibited if undialysed lens extracts were used or if increasing concentrations of glutathione were added to the incubation mixture. Similar inhibition was seen with cysteine, dithiothreitol and sodium bisulfite, but little effect was observed with the glutathione analog ophthalmic acid or with free radical quenchers. Glutathione was readily oxidized during the incubation and no oxidation of ascorbic acid was observed until all the reduced glutathione was exhausted. No loss of ascorbic acid and no protein crosslinking were observed when oxygen was completely removed from the reaction mixture. These data strongly suggest that the glycating species was an oxidized form of ascorbic acid. Ascorbic acid solutions displayed a rapid oxidation in vitro, which was decreased 80-fold upon the addition of 1 mM chelator and was completely inhibited by both glutathione and chelator. A rapid decrease in the level of dissolved oxygen was seen in the presence of ascorbic acid or ascorbic acid and glutathione, but not with glutathione alone. These data argue that glutathione inhibits glycation by rapidly reducing dehydroascorbic acid back to ascorbic acid, which is not active in protein glycation

Ascorbic acid-induced crosslinking of lens proteins: evidence supporting a Maillard reaction

The incubation of calf lens extracts with 20 mM ascorbic acid under sterile conditions for 8 weeks caused extensive protein crosslinking, which was not observed with either 20 mM sorbitol or 20 mM glucose. While no precipitation was observed, ascorbic acid did induce the formation of high-molecular-weight protein aggregates as determined by Agarose A-5m chromatography. Proteins modified by ascorbic acid bound strongly to a boronate affinity column, however, crosslinked proteins were present mainly in the unbound fraction. These observations suggest that the cis-diol groups of ascorbic acid were present in the primary adduct, but were either lost during the crosslinking reaction or sterically hindered from binding to the column matrix. The amino acid composition of the ascorbic acid-modified proteins was identical to controls except for a 15% decrease in lysine. Amino acid analysis after borohydride reduction, however, showed a 25% decrease in lysine, a 7% decrease in arginine and an additional peak which eluted between phenylalanine and histidine. Extensive browning occurred during the ascorbic acid-modification reaction. This resulted in protein-bound chromophores with a broad absorption spectrum from 300 to 400 nm, and protein-bound fluorophores with excitation/emission maxima of 350/450 nm. A 4 week incubation of dialyzed crude lens extract with [1-14C]ascorbic acid showed increased incorporation for 2 weeks, followed by a decrease over the next 2 weeks as crosslinking was initiated. The addition of cyanoborohydride to the reaction mixture completely inhibited crosslinking and increased [1-14C]ascorbic acid incorporation to a plateau value of 180 nmol per mg protein. Amino acid analysis showed a 50% loss of lysine, and 8% decrease in arginine and the presence of a new peak which eluted slightly earlier than methionine. These data are consistent with the non-enzymatic glycation of lens proteins by either ascorbic acid or an oxidation product of ascorbic acid via a Maillard-type reaction.

The precipitation and cross-linking of lens crystallins by ascorbic acid

Bovine lens beta-crystallin was incubated with increasing concentrations of sugars and sugar derivatives for a period of 2 weeks in the dark at 37 degrees C. Marked protein precipitation and a browning reaction was observed with both ascorbic acid (ASA) and dehydroascorbic acid (DHA), but little or no reaction was seen with several other sugars and sugar analogs. Similar incubations were carried out with 20 mM ASA, 20 mM DHA and 20 mM glucose, but with increasing amounts of the individual crystallins. Glucose was capable of precipitating gamma-crystallin in the presence of air, but this reaction was decreased if dithiothreitol and a chelating agent were added prior to incubation. ASA and DHA produced precipitation and browning with gamma- and beta-crystallin, but not with alpha-crystallin or lens soluble proteins. Similar reactivities were observed both in air and under reducing conditions. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of these reaction mixtures showed little or no cross-linking with any of the lens proteins by glucose. ASA and DHA caused detectable dimer formation with gamma-crystallin, but produced the formation of dimers as well as highly polymerized proteins at the top of the gel with all the other crystallins and with lens soluble proteins. A time-course experiment with alpha-crystallin in the presence of air showed no cross-linking with 100 mM glucose over a 6-week period; however, 10 mM ASA caused definite cross-linking at 2 weeks, and at 6 weeks a dark smear of protein was visible throughout the gel. ASA was still capable of inducing cross-linking under low oxygen conditions but the protein smearing was markedly diminished. Further, the cross-linking pattern was similar to that seen in the water-insoluble fraction from older human lenses and cataracts. This reaction may be significant in vivo because cross-linking was observed under low-oxygen conditions with as little as 2 mM ASA, which is the level of ASA normally present in human lenses.

Low glycation level and browning in human cataracts

The extent of human cataract glycation has been determined by the 5-HMF/TBA method in 236 samples (53 from diabetic patients and 183 from non-diabetic controls). The brownish-yellow coloration typical of the advanced products of the Maillard reaction was measured spectrophotometrically. Glycation of crystallins was three times higher in diabetics than in controls, and was positively correlated with age in the latter group. The two groups did not differ significantly as regards the degree of browning, which was also uncorrelated with the primary products measured by the 5-HMF/TBA method. It is concluded that lens glycation is relatively mild and does not determine the intensity of the characteristic brownish-yellow colour of diabetic and senile cataracts. It is suggested that other coloured compounds produced with age interfere at the relevant wavelengths.

Specific radioimmunoassay of glucitol-lysine--application to lens proteins in streptozotocin-diabetic rats

A radioimmunoassay using antibody against glucitol-lysine was developed to quantitate glycated proteins in the lens of diabetic rats. The amount of glycated protein was expressed as molar equivalents of reduced glycated hippuryl lysine (GlcRED-Hip-Lysine). Significant differences (p less than 0.01) were found in the amounts of glycated protein in the lenses of rats with streptozotocin-induced diabetes (3.92 +/- 0.59 nmol/mg protein, n = 5), those with streptozotocin-induced diabetes treated with insulin (2.94 +/- 0.36 nmol/mg protein, n = 4) and normal rats (1.23 +/- 0.22 nmol/mg protein, n = 5). There was a significant correlation between the concentration of glycated protein in the lens and the HbA1c level at the end of the 12 week experiment (r = 0.957, p less than 0.001). These results indicate that glycation of lens protein is parallel with the severity of diabetes in rats.

Glycation of cataractous lens in non-diabetic senile subjects and in diabetic patients

Early- and advanced-stage products in the Maillard reaction, glycation, were measured in patients with diabetic or senile cataracts. Early-stage products were measured by means of furosine, which is an acid-hydrolysis product derived from fructose-lysine. Advanced-stage products were measured by fluorometry using high-performance liquid chromatography. Furosine levels were high (listed in descending order) in capsule, cortex and nucleus in both diabetic and senile cataracts. The advanced-stage products were also high (listed in descending order) in nucleus, cortex and capsule in both diabetic and senile cataracts. These results suggest that advanced-stage products might accumulate in larger amounts in the nucleus and cortex than in the capsule, resulting in the formation of cataracts. The study also revealed that the Maillard reaction plays an important role in causing not only diabetic cataracts but also senile cataracts.

Galactose and cataract

Galactosemia is a disorder caused by a deficiency of any one of three possible enzymes involved in the metabolism of galactose: galactokinase, transferase or epimerase. Any single deficient enzyme can result in cataract through the accumulation of galactitol in the lens. The ophthalmologist may play an important role in this disease, since early recognition of cataract development followed by the initiation of a galactose-free diet may lead to clearing of lenticular opacities. The clinical and laboratory findings that distinguish the three enzyme deficiency disorders of galactosemia are discussed. The biochemical genetics of each enzyme also are reviewed, along with the recent evidence linking heterozygous galactokinase deficiency and presenile cataract.

Evidence for an increased glycation of IgG in diabetic patients

The levels of non-enzymatically glycated total plasma proteins, albumin and IgG were determined in diabetic and non-diabetic patients using affinity chromatography on boronate-agarose gels. A significant increase in both glycated albumin and IgG, and in total glycated plasma proteins was demonstrated. A good correlation between glycated albumin and glycated hemoglobin was observed, while the correlation between glycated IgG and glycated albumin (or hemoglobin) was lower. This was found probably related to wide variations of glycated IgG for diabetics patients who have high glycated hemoglobin levels. These variations were inversely correlated with total serum IgG. Determination of fructosamine or 5-hydroxymethylfurfural content of IgG showed a significant increase in diabetics. Glycated IgG was found to contain approximately one mole of glucose. The main site of glycation was determined to be present in the Fab (more precisely the Fd) part of the IgG molecule.

The relative extent of glycation of haemoglobin and albumin

The level of non-enzymatic glycation of a protein is thought to depend on the number of sites available for reaction, the half-life of the protein and the ambient concentration of glucose. Accordingly, the modification of two blood proteins with a similar number of potential sites but different survival times was examined in non-diabetic patients by periodate oxidation and by reduction with [3H]borohydride. The amount of glycation of haemoglobin and its sub-fractions HbA1 and HbA1c were determined to be 0.44, 2.42 and 2.24 mol/mol respectively and the corresponding value for albumin was 0.37 mol/mol protein. Amino acid analysis showed that the epsilon amino groups of albumin were more extensively modified than they were in haemoglobin and thus it is concluded that the average rate of reaction of the lysine residues in albumin is markedly faster than in haemoglobin.

Nonenzymatically glycosylated proteins

Nonenzymatic glycosylation takes place in all proteins with a free-reacting lysine or valine in the presence of glucose. The formation of glycosylated plasma albumin, hemoglobin (Hb A1c), and skin collagen provides a diagnostic index of short- to long-term time-concentration of glucose in vivo. A wide range of assay methods are available, with affinity chromatographic, isoelectric focusing, and spectrophotometric methods providing the best accuracy and versatility. Glycosylated hemoglobin assays indicate glucose pressure over the previous 2 to 3 months and are of diagnostic value in general diabetic control, while glycosylated plasma albumin determinations are preferable in acute episodes in the life of a diabetic (e.g., pregnancy, infection, stress, trauma, surgery), since they provide an overview of changing blood glucose values of the previous 2 to 4 weeks. Glycosylated collagen estimations reflect tissue aging and are relevant in healing processes. Glycosylation alters the biologic activity of proteins, and these may relate to the manifold complications concomitant on the lifelong elevation of blood and tissue glucose in the diabetic (C6a). Assays for glycosylated hemoglobin have been routinely performed in clinical chemistry laboratories for a decade, and convenient determination for other nonenzymatically glycosylated proteins is proceeding apace.

Non-enzymic glycation of proteins: analysis of N-(1-deoxyhexitol-1-yl)amino acids by high-performance liquid chromatography

A method for determining the extent of non-enzymic glycation (originally called "glycosylation") of both lysyl and N-terminal residues of a protein is described. The glycated protein is treated with sodium borohydride, and is then subjected to acid-catalysed hydrolysis. The resulting N-(1-deoxy-D-hexitol-1-yl)amino acids are separated by cation-exchange high-performance liquid chromatography (l.c.), and detected by a post-column reaction with periodate. The method has been applied successfully to samples of human hemoglobin and human serum albumin, for measurement of numbers of valine-attached and of lysine-attached N-(1-deoxy-D-fructos-1-yl) groups per protein molecule.

Non-enzymatic glycosylation in human diabetic lens crystallins

Lens crystallins undergo non-enzymatic glycosylation with aging and diabetes mellitus. It is not known, however, whether all crystallins are subject to the same extent of glycosylation. Human diabetic lenses (approximately 80 years of age) were dissected into cortex and nucleus, then fractionated into various crystallins with gel chromatography (Sephacryl S-200, Sephadex G-75 or Bio Gel A-15m). The glycosylated crystallins were then separated from the nonglycosylated crystallins by affinity chromatography on Glyco Gel B boronic acid. The percentage of glycosylated crystallin was about 20-30%, and did not differ much among most crystallins, although gamma-crystallin has significantly less (p less than 0.01) glycosylated protein. The extent of glycosylation in the glycosylated crystallins, however, was found to be greater in the high molecular weight crystallins. The extent of glycosylation in alpha-crystallins is approximately two to four times that observed in beta- or gamma-crystallin. The extent of glycosylation appears to depend not only on the lysine content, which does not vary much among the crystallins, but also on the accessibility of the surface areas where lysine residues are located. This accessibility depends on the protein conformation and appears to correlate with protein unfolding.

A study of lectin-binding to the water-insoluble proteins of the lens

Binding of lectins to the water-insoluble fractions from human, monkey and mouse lenses was investigated. Lectins bound to glycoproteins blotted from SDS-polyacrylamide gels onto nitrocellulose paper. Use of multiple lectins showed that glycoproteins with apparent molecular weights of about 120 000 and 90 000 were present in all species. These proteins were found in the urea-insoluble fraction. Multiple lectins also bound to two bands around 67 000 and 63 000 molecular weight in both human and monkey lens fractions as well as a urea-soluble band at about 140 000. A 35 000 MW glycoprotein containing N-acetyl-galactosamine and fucose sugars was present in the capsule-epithelium of monkey lenses but was not detected in cortical or nuclear fractions. Glycoproteins from normal and cataractous mice were identified using this new methodology and compared with previously published work using sodium borohydride labelling of glycoproteins. Because of the numerous glycoproteins that can be detected and the ability to assign sugar residues to individual proteins, the lectin-binding method is a powerful tool to investigate lens glycoproteins.

Loss of diabetic control and increased protein glycosylation following minor intercurrent infections

To investigate the effect of intercurrent infections, 30 insulin-dependent diabetics and 12 normal subjects were followed prospectively during one winter, with short-term periods of control being assessed by the degree of glycosylation of plasma proteins. Eight diabetics and 7 normal subjects developed an intercurrent infection. During stable control, the diabetics had a mean +/- 1 S.D. glycosylation of 0.90 +/- 0.06 nmol HMF/mg protein/2 hour incubation, compared with the normal subjects of 0.63 +/- 0.04 nmol HMF/mg protein/2 hour. Following infection, there was no increase in glycosylated plasma protein in the normal subjects, but the diabetics increased at 3 and 6 days to 1.07 +/- 0.17 and 1.12 +/- 0.17 nmol HMF/mg protein/2 hour respectively (p less than 0.05 and p less than 0.01). This was similar to levels (1.09 +/- 0.20 nmol HMF/mg protein/2 hour) found in 12 diabetic subjects admitted to hospital because of marked loss of control with ketonuria. The marked protein glycosylation effect of temporary loss of glucose control following 'minor' intercurrent infections suggests that more attention should be paid to diabetic control during brief illnesses.

Nonenzymatic glycation of human lens crystallin. Effect of aging and diabetes mellitus

We have examined the nonenzymatic glycation of human lens crystallin, an extremely long-lived protein, from 16 normal human ocular lenses 0.2-99 yr of age, and from 11 diabetic lenses 52-82-yr-old. The glucitol-lysine (Glc-Lys) content of soluble and insoluble crystallin was determined after reduction with H-borohydride followed by acid hydrolysis, boronic acid affinity chromatography, and high pressure cation exchange chromatography. Normal lens crystallin, soluble and insoluble, had 0.028 +/- 0.011 nanomoles Glc-Lys per nanomole crystallin monomer. Soluble and insoluble crystallins had equivalent levels of glycation. The content of Glc-Lys in normal lens crystallin increased with age in a linear fashion. Thus, the nonenzymatic glycation of nondiabetic lens crystallin may be regarded as a biological clock. The diabetic lens crystallin samples (n = 11) had a higher content of Glc-Lys (0.070 +/- 0.034 nmol/nmol monomer). Over an age range comparable to that of the control samples, the diabetic crystallin samples contained about twice as much Glc-Lys. The Glc-Lys content of the diabetic lens crystallin samples did not increase with lens age.

Effects of parathyroid hormone on cAMP production and alkaline phosphatase activity in osteoblastic clone MC3T3-E1 cells

The effect of parathyroid hormone (PTH) was tested on osteoblastic cells (clone MC3T3-E1) cultured in serum-free medium containing 0.3% bovine serum albumin. PTH stimulated an increase in cAMP production in a dose-related fashion up to a concentration of 0.5 unit/ml, the maximum increase being 23-fold above that of controls. Although PTH did not affect DNA content, this peptide also increased dose-dependently alkaline phosphatase activity up to a concentration of 0.5 unit/ml. PTH plus isobutylmethyl xanthine elevated enzyme activity 1.5-fold over that in PTH-treated cells. These results strongly indicate that PTH has a direct stimulatory effect on the differentiation of osteoblasts via intracellular cAMP production in vitro.

Glycosylation of lens proteins in senile cataract and diabetes mellitus

We have investigated glycosylation of lens proteins in diabetic and non-diabetic senile cataract patients. Our study reveals that glycosylation of lens cortical proteins, but not of nuclear proteins, is significantly higher in diabetic patients with senile cataract. This finding serves to clarify the confusion over glycosylation of lens proteins as it relates to diabetes mellitus and further contributes to an understanding of glycosylation of lens tissues as a distinct posttranslational modification.

Glycosylation of proteins: its implications in diabetic control and complications

The author shows that nonenzymic glucosylation of proteins can modify the structure and function of proteins isolated from non-insulin-dependent tissues and that these glucosylated proteins, whose normal functions have been altered or removed, may be related to diabetes and some of its sequelae.

Recent advances in glycosylated hemoglobin measurements

Glycosylated hemoglobins have gained wide acceptance as an accurate index of long-term blood glucose control in diabetes mellitus. A variety of glycosylated hemoglobin assays is available. There is a high degree of correlation between results determined by these assays. The ideal laboratory method for measuring glycosylated hemoglobin in the diabetic should be accurate, precise, easily standardized, inexpensive, and rapidly performed. Unfortunately, none of the currently used methods meet all of the criteria necessary to be considered the ideal laboratory method. The most widely used methods for quantitating glycosylated hemoglobins--including ion exchange chromatography, electrophoresis, isoelectric focusing, thiobarbituric acid colorimetry, and affinity chromatography--are reviewed with respect to the important advantages and disadvantages of each method for the clinical laboratory. Techniques for quantitating glycosylated proteins other than hemoglobins, such as albumin, are also discussed.

Glycosylation in vivo of human lens capsule (basement membrane) and diabetes mellitus

Glycosylation represents a nonenzymatic posttranslational modification of some proteins in vivo. We have investigated possible glycosylation, in vivo, of human lens capsule (basement membrane of lens epithelium) using a colorimetric method. Our study reveals, for the first time, in vivo glycosylation of human lens capsule. Furthermore, the glycosylation of the lens capsule in the diabetics (57.30 +/- 11.26 n moles/mg. protein) is found to be significantly greater than that in their nondiabetic counterparts (29.11 +/- 4.90 n moles/mg. protein) (p less than 0.0005). The present observation represents the first example of increased glycosylation of a basement membrane in the diabetic patients as compared to the nondiabetic controls.

Metabolic abnormalities in diabetic peripheral nerve: relation to impaired function

An hypothesis is presented relating several well-defined metabolic abnormalities in diabetic peripheral nerve to impaired peripheral nerve function by a sodium-potassium ATPase mechanism. It is proposed that this hypothesis be tested in the most well-defined animal model for human insulin deficiency diabetes currently available--the BB diabetic rat.

Non-enzymatic glycosylation of tissue protein in diabetes in the rat

Non-enzymatic glycosylation of tissue and haemolysate proteins has been studied in normal and diabetic rats by reduction with tritiated sodium borohydride (NaB3H4) alone or in combination with chromatography on m-aminophenylboronic acid coupled to Biogel P-6. With NaB3H4 reduction alone, there was a linear relationship between plasma glucose and tritium incorporation into haemolysate protein. However, increased non-enzymatic glycosylation of tissue protein could not be demonstrated with NaB3H4 reduction alone. Tritiated glycosylated amino acids could be selectively removed by m-aminophenylboronic acid immobilized on Biogel P-6, then eluted by acidification and the radioactivity in the acidic peak used to estimate non-enzymatic glycosylation. Using the combined techniques, an increase in non-enzymatic glycosylation was observed in heart, kidney and liver obtained from rats with diabetes of 18 weeks duration.

Sodium- and energy-dependent uptake of myo-inositol by rabbit peripheral nerve. Competitive inhibition by glucose and lack of an insulin effect

Experimental diabetes consistently reduces the concentration of free myo-inositol in peripheral nerve, which usually exceeds that of plasma by 90-100-fold. This phenomenon has been explicitly linked to the impairment of nerve conduction in the acutely diabetic streptozocin-treated rat. However, the mechanism by which acute experimental diabetes lowers nerve myo-inositol content and presumably alters nerve myo-inositol content and presumably alters nerve myo-inositol metabolism is unknown. Therefore, the effects of insulin and elevated medium glucose concentration of 2-[3H]myo-inositol uptake were studied in a metabolically-defined in vitro peripheral nerve tissue preparation derived from rabbit sciatic nerve, whose free myo-inositol content is reduced by experimental diabetes. The results demonstrate that myo-inositol uptake occurs by at least two distinct transport systems in the normal endoneurial preparation. A sodium- and energy-dependent saturable transport system is responsible for at least 94% of the measured uptake at medium myo-inositol concentrations approximating that present in plasma. This carrier-mediated transport system has a high affinity for myo-inositol (Kt = 63 microM), and is not influenced acutely by physiological concentrations of insulin; it is, however, inhibited by hyperglycemic concentrations of glucose added to the incubation medium in a primarily competitive fashion. Thus, competitive inhibition of peripheral nerve myo-inositol uptake by glucose may constitute a mechanism by which diabetes produces physiologically significant alterations in peripheral nerve myo-inositol metabolism.

Characterization of N-glycosylated type I collagen in streptozotocin-induced diabetes

The N epsilon-glycosylation of lysine and hydroxylysine residues in collagen from streptozotocin-induced-diabetic rats was confirmed and the stability of the complex shown to be due to an Amadori rearrangement. The studies also demonstrate the relative specificities of glucose, galactose and mannose in their reaction with collagen. The glycosylation of lysine in vitro occurs with glucose and galactose, but not with mannose, whereas only gucose reacts with hydroxylysine to any significant extent. Glycosylation of collagen occurs slowly during normal aging, but in contrast with reports suggesting accelerated aging of collagen in diabetic animals, we clearly demonstrated that the apparent increased stability is not due to an acceleration of the normal maturation process involving the reducible cross-links.

Reaction of monosaccharides with proteins: possible evolutionary significance

Measurements were made of the rate of condensation of various monosaccharides with amino groups of hemoglobin to form Schiff base linkages. The reactivity of each sugar was dependent on the extent to which it exists in the open (carbonyl) structure rather than in the ring (hemiacetal or hemiketal) structure. Among the 15 monosaccharides tested, aldoses showed higher reactivities than ketoses. Glucose was the least reactive of the aldohexoses. The emergence of glucose as the primary metabolic fuel may be due in part to the high stability of its ring structure which limits potentially deleterious nonenzymatic glycosylation of proteins.