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Perkins RK, van Vliet S, Miranda ER, Fuller KNZ, Beisswenger PJ, Wilund KR, Paluska SA, Burd NA, Haus JM. Advanced Glycation End Products and Inflammatory Cytokine Profiles in Maintenance Hemodialysis Patients After the Ingestion of a Protein-Dense Meal. J Ren Nutr 2023; 33:181-192. [PMID: 34923111 PMCID: PMC10580815 DOI: 10.1053/j.jrn.2021.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/11/2021] [Accepted: 11/28/2021] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE The goal of this investigation was to evaluate circulating and skeletal muscle inflammatory biomarkers between maintenance hemodialysis (MHD) and demographic-matched control subjects (CON) before and after ingestion of a protein-rich meal. DESIGN AND METHODS CON (n = 8; 50 ± 2 years; 31 ± 1 kg/m2) and MHD patients (n = 8; 56 ± 5 years; 32 ± 2 kg/m2) underwent a basal blood draw and muscle biopsy and serial blood draws after the ingestion of a mixed meal on a nondialysis day. Plasma advanced glycation end products (AGEs) and markers of oxidation were assessed via liquid chromatography-tandem mass spectrometry before and after the meal (+240 min). Circulating inflammatory cytokines and soluble receptors for AGE (sRAGE) isoforms (endogenous secretory RAGEs and cleaved RAGEs) were determined before and after the meal (+240 min). Basal muscle was probed for inflammatory cytokines and protein expression of related signaling components (RAGE, Toll-like receptor 4, oligosaccharyltransferase subunit 48, TIR-domain-containing adapter-inducing interferon-β, total IκBα, and pIκBα). RESULTS Basal circulating AGEs were 7- to 343-fold higher (P < .001) in MHD than those in CON, but only MG-H1 increased in CON after the meal (P < .001). There was a group effect (MHD > CON) for total sRAGEs (P = .02) and endogenous secretory RAGEs (P < .001) and a trend for cleaved RAGEs (P=.09), with no meal effect. In addition, there was a group effect (MHD < CON; P < .05) for circulating fractalkine, interleukin (IL)10, IL17A, and IL1β and a trend (P < .10) for IL6 and macrophage inflammatory protein 1 alpha, whereas tumor necrosis factor alpha was higher in MHD (P < .001). In muscle, Toll-like receptor 4 (P = .03), TIR-domain-containing adapter-inducing interferon-β (P = .002), and oligosaccharyltransferase subunit 48 (P = .02) expression was lower in MHD than that in CON, whereas IL6 was higher (P = .01) and IL8 (P = .08) tended to be higher in MHD. CONCLUSION Overall, MHD exhibited an exaggerated, circulating, and skeletal muscle inflammatory biomarker environment, and the meal did not appreciably affect the inflammatory status.
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Affiliation(s)
- Ryan K Perkins
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | - Stephan van Vliet
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Edwin R Miranda
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Kenneth R Wilund
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois; Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Scott A Paluska
- Department of Family Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Nicholas A Burd
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois; Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Jacob M Haus
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan.
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Lim SC, Dorajoo R, Zhang X, Wang L, Ang SF, Tan CSH, Yeoh LY, Ng XW, Li N, Su C, Liu S, Wong MDS, Low KMS, Yao AO, Babitha J, Fun S, Zhou S, Lee SBM, Tang WE, Tavintharan S, Sum CF, Liu JJ. Genetic variants in the receptor for advanced glycation end products (RAGE) gene were associated with circulating soluble RAGE level but not with renal function among Asians with type 2 diabetes: a genome-wide association study. Nephrol Dial Transplant 2018; 32:1697-1704. [PMID: 27448675 DOI: 10.1093/ndt/gfw263] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/30/2016] [Indexed: 01/26/2023] Open
Abstract
Background The soluble receptor for advanced glycation end products (sRAGE) has been shown to play an important role in diabetic complications. We conducted genome-wide association study (GWAS) of sRAGE in Asian type 2 diabetes mellitus (T2DM) patient and validated the association in an independent cohort of T2DM. Methods GWAS for sRAGE was performed in 2058 T2DM patients. Associations between single-nucleotide polymorphisms (SNPs) and plasma sRAGE level were analyzed in an additive model using a linear mixed model. To validate the associations, we performed de novo genotyping in an independent cohort (n = 1984). We selected the top SNP for assessment with diabetic kidney disease (DKD). Results The strongest SNP, rs2070600C>T (P = 1.21 × 10-52), was a genotyped, missense SNP located on chromosome 6, corresponding to the RAGE (AGER) gene locus, the gene encoding RAGE. Conditioning analysis on rs2070600 revealed that rs2071288C>T was the top genotyped independent SNP (P = 8.36 × 10-10). Both SNPs were strongly and dose-dependently correlated with sRAGE level (TT = 399.6 pg/mL, CT = 737.0 pg/mL and CC = 967.0 pg/mL, P < 0.001 for rs2070600; TT = 687.9 pg/mL, CT = 737.6 pg/mL and CC = 904.7 pg/mL, P < 0.001 for rs2072188). Both SNPs were robustly replicated in the independent cohort, especially among Chinese patients (P = 9.02 × 10-72 for rs2070600; P = 1.13 × 10-9 for rs2071288). Log-transformed sRAGE was associated with DKD after adjustment for age, gender and ethnicity in pooled cohorts [odds ratio 2.536 (95% confidence interval 1.864-3.450), P < 0.001]. However, we did not observe any significant association between rs2070600 and DKD. Conclusions Common variants in RAGE are strongly associated with plasma sRAGE level, which is associated with DKD. However, we did not find a causal link between sRAGE and renal function by Mendelian randomization.
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Affiliation(s)
- Su Chi Lim
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore.,Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Rajkumar Dorajoo
- Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Xiao Zhang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Ling Wang
- Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Su Fen Ang
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Lee Ying Yeoh
- Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Xiao Wei Ng
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Na Li
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Chang Su
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | - Sylvia Liu
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | | | - Amy Ou Yao
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Sharon Fun
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore
| | - Shiyi Zhou
- Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
| | | | - Wern Ee Tang
- National Healthcare Group Polyclinics, Singapore
| | - Subramaniam Tavintharan
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore.,Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Chee Fang Sum
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore.,Department of Medicine, Khoo Teck Puat Hospital, Singapore
| | - Jian-Jun Liu
- Human Genetics, Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
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l -Carnosine supplementation attenuated fasting glucose, triglycerides, advanced glycation end products, and tumor necrosis factor– α levels in patients with type 2 diabetes: a double-blind placebo-controlled randomized clinical trial. Nutr Res 2018; 49:96-106. [DOI: 10.1016/j.nutres.2017.11.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 10/24/2017] [Accepted: 11/14/2017] [Indexed: 12/31/2022]
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Association between plasma soluble RAGE and renal function is unaffected by medication usage and enzymatic antioxidants in chronic kidney disease with type 2 diabetes. Clin Chim Acta 2016; 453:56-61. [DOI: 10.1016/j.cca.2015.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/02/2015] [Accepted: 12/02/2015] [Indexed: 11/23/2022]
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Tang SC, Yeh SJ, Tsai LK, Hu CJ, Lien LM, Peng GS, Yang WS, Chiou HY, Jeng JS. Cleaved but not endogenous secretory RAGE is associated with outcome in acute ischemic stroke. Neurology 2015; 86:270-6. [PMID: 26683643 DOI: 10.1212/wnl.0000000000002287] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/18/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the expression patterns of 2 soluble isoforms of receptor for advanced glycation end-product (RAGE), including endogenous secretory RAGE (esRAGE) and cleaved RAGE (cRAGE), and their associations with outcome in acute ischemic stroke (IS). METHODS Acute IS patients (n = 106) and age- and sex-matched controls (n = 150) were recruited. Plasma levels of total soluble RAGE (sRAGE) and esRAGE in patients at <48 hours and 48-72 hours after IS and in controls were measured by ELISA. The level of cRAGE was calculated by subtracting the level of sRAGE from that of esRAGE. Poor outcome was defined as modified Rankin Scale score >2 at 3 months after stroke. RESULTS The plasma levels of cRAGE were significantly higher and correlated to those of esRAGE (p < 0.001). The plasma levels of esRAGE and cRAGE were both significantly higher in IS patients <48 hours and 48-72 hours after onset than in controls, but only level of cRAGE at <48 hours was independently associated with poor outcome after adjusting for clinical variables (odds ratio 2.44; 95% confidence interval 1.16-5.16; p = 0.019). CONCLUSION The plasma level of cRAGE at <48 hours after IS, rather than esRAGE, is a significant predictor of acute IS outcome.
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Affiliation(s)
- Sung-Chun Tang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Shin-Joe Yeh
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Kai Tsai
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Ming Lien
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Giia-Sheun Peng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Wei-Shiung Yang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Jiann-Shing Jeng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan.
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Buraczynska M, Zaluska W, Buraczynska K, Markowska-Gosik D, Ksiazek A. Receptor for advanced glycation end products (RAGE) gene polymorphism and cardiovascular disease in end-stage renal disease patients. Hum Immunol 2015; 76:843-8. [PMID: 26429324 DOI: 10.1016/j.humimm.2015.09.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 11/18/2014] [Accepted: 09/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVES Receptor for advanced glycation end products (RAGE) contributes to the pathogenesis of vascular and inflammatory diseases. We investigated whether the functional polymorphism in the promoter region of the RAGE gene (-374 T/A) influences development of cardiovascular disease in the end-stage renal disease (ESRD) patients. METHODS The cohorts of 1866 ESRD patients and 1143 healthy subjects were genotyped by polymerase chain reaction (PCR) for the RAGE variant rs1800624. RESULTS The genotype and allele frequencies did not differ significantly between ESRD patients and controls. There was no significant difference in the genotype distribution when patients with CVD were compared to those without it (p for A allele = 0.62). After stratifying CVD patients according to CVD clinical phenotype, the ESRD patients with stroke had a lower frequency of A allele than patients without CVD (0.12 vs. 0.21, p = 0.027). To confirm this finding, we genotyped 163 patients with ischemic stroke but without renal disease. In this group, the AA/TA genotypes were also significantly associated with lower risk of stroke (OR 0.46, p = 0.0002). CONCLUSION Our data suggest that the presence of the A allele of -374 T/A polymorphism in the RAGE gene has a protective effect against stroke.
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Affiliation(s)
- Monika Buraczynska
- Laboratory for DNA Analysis and Molecular Diagnostics, Department of Nephrology, Medical University of Lublin, Lublin, Poland.
| | - Wojciech Zaluska
- Laboratory for DNA Analysis and Molecular Diagnostics, Department of Nephrology, Medical University of Lublin, Lublin, Poland
| | - Kinga Buraczynska
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Dorota Markowska-Gosik
- Laboratory for DNA Analysis and Molecular Diagnostics, Department of Nephrology, Medical University of Lublin, Lublin, Poland
| | - Andrzej Ksiazek
- Laboratory for DNA Analysis and Molecular Diagnostics, Department of Nephrology, Medical University of Lublin, Lublin, Poland
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Yang ZK, Shen Y, Shen WF, Pu LJ, Meng H, Zhang RY, Zhang Q, Chen QJ, De Caterina R, Lu L. Elevated glycated albumin and reduced endogenous secretory receptor for advanced glycation endproducts levels in serum predict major adverse cardio-cerebral events in patients with type 2 diabetes and stable coronary artery disease. Int J Cardiol 2015; 197:241-7. [PMID: 26142969 DOI: 10.1016/j.ijcard.2015.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/10/2015] [Accepted: 06/12/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM Glycated albumin (GA) and the endogenous secretory receptor for advanced glycation endproducts (esRAGE) may modulate risk related to atherosclerosis. We tested the hypothesis that elevated GA and reduced esRAGE in serum are associated with adverse clinical outcomes in patients with type 2 diabetes and stable coronary artery disease (CAD). METHODS We determined GA and esRAGE serum levels in 576 consecutive patients with type 2 diabetes and stable CAD undergoing sirolimus-eluting stent (SES)-PCI. The primary endpoint was the incidence of major adverse cardio-cerebral events (MACCE) including cardiac death, non-fatal myocardial infarction, and non-fatal stroke during a 2-year follow-up. The secondary endpoint was the occurrence of clinically driven repeat revascularization during a 2-year follow-up. The prognostic value of GA and esRAGE was determined with the Cox-proportional hazard model after adjustment for covariates. RESULTS A total 40 patients (6.9%) experienced MACCE, and 108 (18.8%) patients underwent repeat coronary revascularization during the follow-up. Serum GA (HR=1.22, 95% CI 1.16-1.28; HR=1.15, 95% CI 1.11-1.19, respectively; for both p<0.001) and esRAGE (HR=0.60, 95% CI 0.40-0.87; HR=0.75, 95% CI 0.61-0.92, respectively; for both p<0.01) levels remained independent predictors of the primary and secondary endpoints after adjustment for possible confounders. CONCLUSIONS Serum GA and esRAGE are novel predictors of long-term clinical outcomes in patients with type 2 diabetes and stable CAD. Increased serum GA and decreased esRAGE are associated with a poor prognosis in such patients.
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Affiliation(s)
- Zhen Kun Yang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China
| | - Ying Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China
| | - Wei Feng Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Li Jin Pu
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Hua Meng
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Rui Yan Zhang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China
| | - Qi Zhang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China
| | - Qiu Jing Chen
- Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China
| | - Raffaele De Caterina
- "G. d'Annunzio University", Chieti, Italy; Fondazione "G. Monasterio", Pisa, Italy.
| | - Lin Lu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiaotong University School of Medicine, People's Republic of China; Institute of Cardiovascular Diseases, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People's Republic of China.
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Gugliucci A, Menini T. The axis AGE-RAGE-soluble RAGE and oxidative stress in chronic kidney disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 824:191-208. [PMID: 25039001 DOI: 10.1007/978-3-319-07320-0_14] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chronic kidney disease (CKD) has been shown to be associated with high oxidative stress and cardiovascular disease. In this chapter our focus will be on the role of advanced glycation end products (AGE) and their receptor, RAGE in CKD progression and their role on cardiovascular complications. We provide a succinct, yet comprehensive summary of the current knowledge, the challenges and the future therapeutic avenues that are stemming out from novel recent findings. We first briefly review glycation and AGE formation and the role of the kidney in their metabolism. Next, we focus on the RAGE, its signaling and role in oxidative stress. We address the possible role of soluble RAGEs as decoys and the controversy regarding this issue. We then provide the latest information on the specific role of both AGE and RAGE in inflammation and perpetuation of kidney damage in diabetes and in CKD without diabetes, which is the main purpose of the review. Finally, we offer an update on new avenues to target the AGE-RAGE axis in CKD.
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Affiliation(s)
- Alejandro Gugliucci
- Glycation, Oxidation and Disease Laboratory, Department of Research, College of Osteopathic Medicine, Touro University-California, 1310 Club Drive, 94592, Vallejo, CA, USA,
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Effect of different stages of chronic kidney disease and renal replacement therapies on oxidant-antioxidant balance in uremic patients. Biochem Res Int 2013; 2013:358985. [PMID: 24416590 PMCID: PMC3876691 DOI: 10.1155/2013/358985] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 01/12/2023] Open
Abstract
Oxidative stress seems to be involved in the path physiology of cardiovascular complications of chronic kidney disease (CKD). In this study, we determined the effect of different stages of CKD and substitutive therapies on oxidative stress. One hundred sixty-seven patients (age: 44 ± 06 years; male/female: 76/91) with CKD were divided into 6 groups according to the National Kidney Foundation classification. Prooxidant status was assessed by assaying thiobarbituric acid reactive substances, hydroperoxides, and protein carbonyls. Antioxidant defence was performed by analysis of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, vitamin E, Iron, and bilirubin. TBARS and LPO were higher in HD patients compared to other groups (P < 0.001), while protein carbonyls were more increased in PD patients. The antioxidant enzymes were declined already at severe stage of CKD and they were declined notably in HD patients (P < 0.001). Similar observation was found for vitamin E, Fe, and bilirubin where we observed a significant decrease in the majority of study groups, especially in HD patients (P < 0.001). The evolution of CKD was associated with elevated OS. HD accentuates lipid, while PD aggravates protein oxidation. However, the activity of antioxidant enzymes was altered by impaired renal function and by both dialysis treatments.
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Abstract
RAGE is a key molecule in the onset and sustainment of the inflammatory response. New studies indicate that RAGE might represent a new link between the innate and adaptive immune system. RAGE belongs to the superfamily of Ig cell-surface receptors and is expressed on all types of leukocytes promoting activation, migration, or maturation of the different cells. RAGE expression is prominent on the activated endothelium, where it mediates leukocyte adhesion and transmigration. Moreover, proinflammatory molecules released from the inflamed or injured vascular system induce migration and proliferation of SMCs. RAGE binds a large number of different ligands and is therefore considered as a PRR, recognizing a structural motif rather than a specific ligand. In this review, we summarize the current knowledge about the signaling pathways activated in the different cell types and discuss a potential activation mechanism of RAGE, as well as putative options for therapeutic intervention.
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Affiliation(s)
- Katrin Kierdorf
- Department of Neuropathology, University of Freiburg, Freiburg, Germany
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Lu L, Peng WH, Wang W, Wang LJ, Chen QJ, Shen WF. Effects of atorvastatin on progression of diabetic nephropathy and local RAGE and soluble RAGE expressions in rats. J Zhejiang Univ Sci B 2011; 12:652-9. [PMID: 21796806 DOI: 10.1631/jzus.b1101004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Advanced glycation end-products (AGEs) exert inflammatory and oxidative stress insults to produce diabetic nephropathy mainly through the receptor for AGEs (RAGE). This study aimed to assess the effect of atorvastatin on diabetic nephropathy via soluble RAGE (sRAGE) and RAGE expressions in the rat kidney. METHODS Thirty-two male Sprague-Dawley rats were divided into four groups based on the presence or absence of streptozotocin-induced diabetes with or without atorvastatin treatment (10 mg/kg for 24 weeks). Serum sRAGE and glycated albumin (GA) levels were measured with enzyme-linked immunosorbent assay (ELISA) and improved bromocresol purple methods. Renal AGEs, RAGE, endogenous secretory RAGE (esRAGE), and sRAGE were determined with reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. RESULTS Mesangial expansion and microalbuminuria were aggravated in diabetic rats, and improved with atorvastatin treatment. Serum sRAGE levels were lower in diabetic than in normal rats. After atorvastatin treatment, serum and renal sRAGE levels were up-regulated, while renal RAGE expression was decreased in diabetic rats, associated with a reduction in accumulation of AGEs, though renal esRAGE mRNA expression was not significantly increased. CONCLUSIONS Atorvastatin exerted a beneficial effect on diabetic nephropathy with reduced AGE accumulation, down-regulating RAGE expression and up-regulating sRAGE in the kidney.
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Affiliation(s)
- Lin Lu
- Department of Cardiology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
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Nasrallah MM, El-Shehaby AR, Osman NA, Salem MM, Nassef A, El Din UAAS. Endogenous soluble receptor of advanced glycation end-products (esRAGE) is negatively associated with vascular calcification in non-diabetic hemodialysis patients. Int Urol Nephrol 2011; 44:1193-9. [PMID: 21643645 DOI: 10.1007/s11255-011-0007-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 05/20/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND Advanced glycation end-products (AGE) accumulate in CKD and may predispose to cardiovascular disease by inducing inflammatory and oxidant stress in the vascular endothelium. Soluble forms of the receptor for AGE (RAGE) may be protective against these effects by binding AGE in the soluble phase. Accumulating evidence suggests a protective role of soluble RAGE against vascular calcification. This study investigates the association between endogenous soluble RAGE (esRAGE) and vascular calcification in hemodialysis patients. METHODS We studied 65 non-diabetic hemodialysis patients, on 3 × 4 h dialysis schedule, and 19 controls. Serum levels of esRAGE, hsCRP, parathormone, lipids, calcium, and phosphorus were measured. Aortic calcification index (ACI) was measured using non-contrast CT of the abdominal aorta. RESULTS Aortic calcification was detected in 64 out of 65 hemodialysis patients. Levels of esRAGE were lower in hemodialysis patients (278 pg/ml, SD 101.1) than in controls (443 ± 109 pg/ml; P = 0.001). ACI correlated negatively in stepwise multivariate analysis with esRAGE (P = 0.002) and positively with hsCRP (<0.0001), systolic blood pressure (P < 0.0001) and dialysis vintage (P = 0.05); R (2) = 0.65. CONCLUSION Levels of esRAGE were low among hemodialysis patients and correlated negatively with ACI.
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Affiliation(s)
- Mohamed M Nasrallah
- Department of Nephrology, Kasr El-Aini School of Medicine, Cairo University, Cairo, Egypt.
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Dalal M, Semba RD, Sun K, Crasto C, Varadhan R, Bandinelli S, Fink JC, Guralnik JM, Ferrucci L. Endogenous secretory receptor for advanced glycation end products and chronic kidney disease in the elderly population. Am J Nephrol 2011; 33:313-8. [PMID: 21389696 DOI: 10.1159/000324846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 02/01/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIMS The relationship of circulating endogenous secretory receptor for advanced glycation end products (esRAGE) and chronic kidney disease (CKD) has not been well characterized. The aim of the study was to determine whether plasma esRAGE is associated with CKD and is predictive of developing CKD in older adults. METHODS The relationship between plasma esRAGE and CKD (more than stage 3 of the National Kidney Foundation classification; estimated glomerular filtration rate <60 ml/min/1.73 m(2)) and CKD over 6 years of follow-up was examined in a cross-sectional and prospective study design in 1,016 men and women, ≥65 years, in the InCHIANTI study, a population-based cohort study of aging in Tuscany, Italy. RESULTS At enrollment, 158 (15.5%) had CKD. Mean (SD) plasma esRAGE was 0.45 (0.24) ng/ml. Plasma esRAGE (ng/ml) was associated with CKD (odds ratio per 1 SD = 1.30; 95% CI 1.1-1.6; p < 0.005) in a multivariable logistic regression model, adjusting for potential confounders. Plasma esRAGE was an independent predictor of incident CKD over 6 years of follow-up (hazard ratio per 1 SD = 1.37; 95% CI 1.1-1.7; p < 0.008) in a multivariable Cox proportional hazards model, adjusting for potential confounders. CONCLUSIONS Elevated plasma esRAGE is independently associated with CKD and is an independent predictor of incident CKD in older community-dwelling adults.
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Affiliation(s)
- Mansi Dalal
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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14
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Abstract
BACKGROUND Cardiovascular disease is the major cause of death in patients with renal insufficiency, accounting for 50% of all deaths in renal replacement therapy patients. Mortality from cardiovascular diseases in these patients is approximately 9% per year, which is about 30 times the risk in the general population. So far, intensive interventions to the general risk factors, such as high LDL-cholesterol or C-reactive protein, have not been successful in improving their cardiovascular outcomes, suggesting that the beneficial effect of risk reduction may be overwhelmed by accumulated risk memorized by long-term exposure to oxidative stress during the progression of renal failure. DESIGN In this review, we propose that this irreversible memory effect in renal failure may be mediated by advanced glycation end-products (AGEs). RESULTS The generation of AGEs has been implicated to be deeply associated with increased oxidative stress. Moreover, interaction of the receptor for AGEs (RAGE) with AGEs leads to crucial biomedical pathway generating intracellular oxidative stress and inflammatory mediators, which could result in further amplification of the pathway involved in AGE generation. Several lines of evidence suggest that AGEs/RAGE axis can profoundly be involved in cardiovascular diseases. Recent advances in AGEs and RAGE measurements led us to be capable of understanding more about the role of AGEs/RAGE axis as a risk for cardiovascular diseases in patients with renal failure. CONCLUSION AGEs/RAGE axis could be a crucial mediator of oxidative stress in renal failure. RAGE could be not only a useful biomarker, but also a potentially therapeutic target to overcome the accumulated adverse metabolic memory in renal failure.
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Affiliation(s)
- Hidenori Koyama
- Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka, Japan.
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15
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Sliman SM, Eubank TD, Kotha SR, Kuppusamy ML, Sherwani SI, O’Connor Butler ES, Kuppusamy P, Roy S, Marsh CB, Stern DM, Parinandi NL. Hyperglycemic oxoaldehyde, glyoxal, causes barrier dysfunction, cytoskeletal alterations, and inhibition of angiogenesis in vascular endothelial cells: aminoguanidine protection. Mol Cell Biochem 2010; 333:9-26. [PMID: 19585224 PMCID: PMC3671881 DOI: 10.1007/s11010-009-0199-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 06/25/2009] [Indexed: 10/20/2022]
Abstract
Vascular endothelium is vulnerable to the attack of glucose-derived oxoaldehydes (glyoxal and methylglyoxal) during diabetes, through the formation of advanced glycation end products (AGEs). Although aminoguanidine (AG) has been shown to protect against the AGE-induced adverse effects, its protection against the glyoxal-induced alterations in vascular endothelial cells (ECs) such as cytotoxicity, barrier dysfunction, and inhibition of angiogenesis has not been reported and we investigated this in the bovine pulmonary artery ECs (BPAECs). The results showed that glyoxal (1-10 mM) significantly induced cytotoxicity and mitochondrial dysfunction in a dose- and time-dependent (4-12 h) fashion in ECs. Glyoxal was also observed to significantly inhibit EC proliferation. The study also revealed that glyoxal induced EC barrier dysfunction (loss of trans-endothelial electrical resistance), actin cytoskeletal rearrangement, and tight junction alterations in BPAECs. Furthermore, the results revealed that glyoxal significantly inhibited in vitro angiogenesis on the Matrigel. For the first time, this study demonstrated that AG significantly protected against the glyoxal-induced cytotoxicity, barrier dysfunction, cytoskeletal rearrangement, and inhibition of angiogenesis in BPAECs. Therefore, AG appears as a promising protective agent in the treatment of AGE-induced vascular endothelial alterations and dysfunction during diabetes, presumably by blocking the reactivity of the sugar-derived dicarbonyls such as glyoxal and preventing the formation of AGEs.
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Affiliation(s)
- Sean M. Sliman
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Timothy D. Eubank
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sainath R. Kotha
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - M. Lakshmi Kuppusamy
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Shariq I. Sherwani
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Elizabeth Susan O’Connor Butler
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Periannan Kuppusamy
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Sashwati Roy
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Clay B. Marsh
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - David M. Stern
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Narasimham L. Parinandi
- Lipid Signaling and Lipidomics and Vasculotoxicity Laboratory, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
- Room 611-A, Division of Pulmonary, Critical Care, and Sleep Medicine, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, 473 W. 12th Avenue, Columbus, OH 43210, USA
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16
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Negre-Salvayre A, Salvayre R, Augé N, Pamplona R, Portero-Otín M. Hyperglycemia and glycation in diabetic complications. Antioxid Redox Signal 2009; 11:3071-109. [PMID: 19489690 DOI: 10.1089/ars.2009.2484] [Citation(s) in RCA: 260] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diabetes mellitus is a multifactorial disease, classically influenced by genetic determinants of individual susceptibility and by environmental accelerating factors, such as lifestyle. It is considered a major health concern,as its incidence is increasing at an alarming rate, and the high invalidating effects of its long-term complications affect macro- and microvasculature, heart, kidney, eye, and nerves. Increasing evidence indicates that hyperglycemia is the initiating cause of the tissue damage occurring in diabetes, either through repeated acute changes in cellular glucose metabolism, or through the long-term accumulation of glycated biomolecules and advanced glycation end products (AGEs). AGEs represent a heterogeneous group of chemical products resulting from a nonenzymatic reaction between reducing sugars and proteins, lipids, nucleic acids, or a combination of these.The glycation process (glucose fixation) affects circulating proteins (serum albumin, lipoprotein, insulin, hemoglobin),whereas the formation of AGEs implicates reactive intermediates such as methylglyoxal. AGEs form cross-links on long-lived extracellular matrix proteins or react with their specific receptor RAGE, resulting inoxidative stress and proinflammatory signaling implicated in endothelium dysfunction, arterial stiffening, and microvascular complications. This review summarizes the mechanism of glycation and of AGEs formation and the role of hyperglycemia, AGEs, and oxidative stress in the pathophysiology of diabetic complications.
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Lu L, Jin Pu L, Chen QJ, Wang L, Peng W, Yan X, Zhang Q, Yan Zhang R, Gong PH, Qiu JP, Shen WF. Increased glycated albumin and decreased esRAGE concentrations are associated with in-stent restenosis in Chinese diabetic patients. Clin Chim Acta 2008; 396:33-7. [PMID: 18638464 DOI: 10.1016/j.cca.2008.06.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2007] [Revised: 04/13/2008] [Accepted: 06/19/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND We investigated the impact of glycated albumin (GA) and endogenous secretory receptor for advanced glycation end products (esRAGE) and RAGE polymorphisms on occurrence of in-stent restenosis (ISR) in Chinese patients with type 2 diabetes. METHODS Four hundred nineteen patients with diabetes were divided, based upon the presence or absence of coronary artery disease (CAD) and ISR, into Group I (205 patients without CAD), Group II (128 patients with CAD but without ISR) and Group III (86 patients with ISR). One hundred fifty-two normal subjects were served as controls. Serum concentrations of GA and esRAGE were measured, and RAGE polymorphisms (-374T>A, -429T>C and G82S) were analyzed. RESULTS Serum GA concentration was higher and, in contrast, esRAGE concentration was lower in Group III than in the other groups (P<0.05). These two protein concentrations correlated closely with loss index (all P<0.01), and were independent risk factors for ISR in diabetic patients (P=0.01 and P=0.025, respectively). However, there were no differences in the allele and genotype frequencies in the 3 polymorphisms of RAGE gene between groups. CONCLUSIONS Increased GA and decreased esRAGE concentrations, but not -374T>A, -429T>C and Gly82Ser polymorphisms of RAGE gene, are associated with ISR in Chinese patients with type 2 diabetes.
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Affiliation(s)
- Lin Lu
- Department of Cardiology, Rui Jin Hospital, Institute of Cardiovascular Diseases, Jiaotong University School of Medicine, Shanghai, People's Republic of China
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