Nonenzymatic glycation of basement membranes from human glomeruli and bovine sources. Effect of diabetes and age

The lens capsule

The lens capsule is a modified basement membrane that completely surrounds the ocular lens. It is known that this extracellular matrix is important for both the structure and biomechanics of the lens in addition to providing informational cues to maintain lens cell phenotype. This review covers the development and structure of the lens capsule, lens diseases associated with mutations in extracellular matrix genes and the role of the capsule in lens function including those proposed for visual accommodation, selective permeability to infectious agents, and cell signaling.

Glucosepane Is a Major Protein Cross-link of the Senescent Human Extracellular Matrix

The extracellular matrix in most tissues is characterized by progressive age-related stiffening and loss of proteolytic digestibility that are accelerated in diabetes and can be duplicated by the nonenzymatic reaction of reducing sugars and extracellular matrix proteins. However, most cross-links of the Maillard reaction described so far are present in quantities too low to account for these changes. Here we have determined in human skin and glomerular basement membrane (GBM) collagen the levels of the recently discovered lysine-arginine cross-links derived from glucose, methylglyoxal, glyoxal, and 3-deoxyglucosone, i.e. glucosepane, MODIC, GODIC, and DOGDIC, respectively. Insoluble preparations of skin collagen (n = 110) and glomerular basement membrane (GBM, n = 28) were enzymatically digested, and levels were measured by isotope dilution technique using liquid chromatography/mass spectrometry. In skin, all cross-links increased with age (p < 0.0001) except DOGDIC (p = 0.34). In nondiabetic controls, levels at 90 years were 2000, 30, and 15 pmol/mg for glucosepane, MODIC, and GODIC, respectively. Diabetes, but not renal failure, increased glucosepane to 5000 pmol/mg (p < 0.0001), and for all others, increased it to <60 pmol/mg (p < 0.01). In GBMs, glucosepane reached up to 500 pmol/mg of collagen and was increased in diabetes (p < 0.0001) but not old age. In conclusion, glucosepane is the single major cross-link of the senescent extracellular matrix discovered so far, accounting for up to >120 mole% of triple helical collagen modification in diabetes. Its presence in high quantities may contribute to a number of structural and cell matrix dysfunctions observed in aging and diabetes.

Effect of dietary fibres on constituents of complex carbohydrates in streptozotocin induced diabetic rat tissues

The effect of dietary fibres on constituents of complex carbohydrates in various tissues of streptozotocin induced diabetic rats is presented by analysing different constituents of complex carbohydrates in presence and absence of dietary fibre. Wheat bran was effective in preventing the decrease (14%) in total sugars in spleen and an increase in total sugars in stomach (33%) during diabetes. Decrease in uronic acid content during diabetes in spleen was prevented to the extent of 25% by the presence of wheat bran in the diet. The other parameters which were affected by the presence of wheat bran in the diet during diabetes are amino sugar (brain and stomach), sulphates (liver) and protein (lungs and stomach). Guar gum was effective in preventing the decrease in total sugar content in spleen by 28% and sulphate content in liver by 14% during diabetes. Variation in protein content in lungs was observed in diabetes. The results indicated beneficial role of dietary fibres like wheat bran and guar gum on complex carbohydrates to varying extents in different tissues.

Nonenzymatic glycation of type IV collagen and matrix metalloproteinase susceptibility

The glomerular basement membrane (GBM) is damaged in diabetes through complex mechanisms that are not fully understood. Prominent among them is nonenzymatic protein glycation leading to the formation of so-called advanced glycation end products (AGEs). We examined the effects of in vitro glycation of intact collagen type IV in bovine lens capsule (LBM) and kidney glomerular (GBM) basement membranes on their susceptibility to matrix metalloproteinases, using stromelysin 1 (MMP-3) and gelatinase B (MMP-9). Sites of cleavage of unmodified LBM collagen were located in the triple helical region. In vitro glycation by glucose severely inhibited the release of soluble collagen cleavage peptides by MMP-3 and MMP-9. The distribution of AGEs within the three domains of collagen IV (7S, triple helical, and noncollagenous NC1) were compared for LBM glycation using AGE fluorescence, pentosidine quantitation, and immunoreactivity towards anti-AGE antibodies that recognize the AGE carboxymethyllysine (CML). Marked asymmetry was observed, with the flexible triple helical domain having the most pentosidine and fluorescent AGEs but the least CML. The in vivo relevance of these findings is supported by preliminary studies of AGE distribution in renal basement membrane (RBM) collagen IV domains from human kidneys of two insulin-dependent diabetics and one normal subject. Pentosidine and fluorescent AGE distributions of diabetic RBM were similar to LBM, but the CML AGE in diabetic kidney was less in the triple helical domain than in NC1. Our results support the hypothesis that nonenzymatic glycation of collagen IV contributes to the thickening of basement membranes, a hallmark of diabetic nephropathy.

Accumulation of advanced glycation endproducts in the rat nephron: link with circulating AGEs during aging

The accumulation of advanced glycosylation end products (AGEs) is believed to be a factor in the development of aging nephropathy. We have attempted to establish a link between the formation of AGEs and the onset of renal impairment with aging, indicated by albuminuria, using a fluorescence assay and immunohistochemical detection of AGEs in the renal extracellular matrix in rats. The fluorescence of collagenase-digested Type IV collagen from GBM increased with age, from 1.65 +/- 0.05 AU/mM OHPro (3 months) and 1.58 +/- 0.04 (10 months) to 2.16 +/- 0.06 (26 months) (p < 0.001) and 2.53 +/- 0.18 (30 months) (p < 0.001). In contrast, the extent of early glycation products significantly decreased from 5.35 +/- 0.25 nmol HCHO/nmol OHPro at 3 months to 3.14 +/- 0.19 at 10 months (p < 0.001), 3.42 +/- 0.38 at 26 months, and 0.74 +/- 0.08 at 30 months (p < 0.001). The urinary fluorescence of circulating AGE rose from 2.42 +/- 0.15 AU/mg protein (3 months), 1.69 +/- 0.07 (10 months), to 4.63 +/- 0.35 (26 months) (p < 0.01) and 4.73 +/- 0.72 (30 months), while the serum fluorescence increased from 0.39 +/- 0.02 AU/mg protein at 3 months and 0.43 +/- 0.02 at 10 months to 0.59 +/- 0.04 at 26 months (p < 0.001) and 0.54 +/- 0.03 at 30 months (p < 0.04). Polyclonal antibodies raised against AGE RNase showed faint areas of AGE immunoreactivity in mesangial areas in the nephrons of young rats. The immunolabeling of Bowman's capsule, the mesangial matrices, and the peripheral loops of glomerular and tubule basement membranes increased with rat age. The increase in circulating AGE peptides parallels the accumulation of AGEs in the nephron, and this parallels the pattern of extracellular matrix deposition, suggesting a close link between AGE accumulation and renal impairment in aging rats.

Ageing promotes the increase of early glycation Amadori product as assessed by epsilon-N-(2-furoylmethyl)-L-lysine (furosine) levels in rodent skin collagen. The relationship to dietary restriction and glycoxidation

Glucose has been implicated in the aging process by its ability to react nonenzymatically with long-lived proteins like collagen to produce advanced glycosylated end-products (AGEs). In the initial phase of this reaction, referred to as glycation, glucose reacts with the free amino group of proteins resulting in Schiff base formation followed by rearrangement to an Amadori product. Since the Amadori product is transient due to its conversion to other products as well as its reversibility to the initial products, glycation as an age-related marker in collagen has questionable significance. In human studies, glycation of collagen has been found to increase modestly with age. In rodent studies, results are conflicting due to differences in methodology. Thus, it has been concluded that collagen glycation either does not vary or increases modestly with age. In the present study, a C8 HPLC column was used to measure Amadori product formation as the acid-hydrolyzed breakdown product furosine in the skin of rats and mice. Surprisingly, levels were found to increase at a rapid rate during aging of rodents. Impurity of the furosine peak from the use of crude acid-hydrolyzed skin samples was ruled-out because reductive properties and spectroscopic profiles matched those previously described for furosine. In the present study, glycemia was found important in furosine formation as shown by the glycation lowering effects of dietary restriction on collagen. Decreased collagen turnover probably plays a substantial role in explaining the age-related increase in furosine levels in rodent skin collagen.

[The effect of Maillard reaction products on enzyme reactions]

In this article current knowledge about the Maillard reaction in vivo is described first, especially the glycosylation reactions of various tissues and the identification of different final products and intermediates of Maillard reaction. The influence of MRP on digestion is of significant importance. These products are absorbed in different ways and are excreted in various amounts. Hence, the organism is variably influenced by MRP. The influence of defined MRP, of glycosylated proteins and of melanoidins on glycosidases and proteases is described. The effects produced depend on the enzyme and on the used MRP. Reactive alpha-dicarbonyl compounds play an important role in the organism. Further possible reactions of these compounds caused by reductases are discussed. The protein structure of enzymes is changed by Maillard reaction. Thereby the enzyme activity is influenced by covalent modifications of different amino acids and by inter- and intramolecular crosslinking. Finally, the use of enzymes and monoclonal antibodies for detection of MRP is discussed.

High-resolution ultrastructural study of the rat glomerular basement membrane in long-term experimental diabetes

The ultrastructure of the glomerular basement membrane of the long-term diabetic and age-matched control rats was studied with the application of advanced high-resolution microscopy. By using the freeze substitution method for the preparation of the renal tissue, it was possible to observe that the glomerular basement membrane in control and diabetic animals is composed on only a single lamina densa without the presence of a lamina lucida interna or externa. High-resolution electron microscopy of the diabetic glomerular basement membrane showed significant alterations in its morphology and ultrastructure. First, the basement membrane in diabetic condition appeared to be split into two halves, endothelial and epithelial. In the epithelial half of the membrane, the network of distinct strands referred to as cords, which were clearly present in the glomerular basement membrane of age-matched control animals, became less distinct and showed a diffused appearance being evenly replaced by thin filaments. The openings of the network were filled with a granular material. In the endothelial half of the membrane, on the other hand, the cord network was variably lost in diabetic condition and, within the resulting vacant spaces, bundles of fibrils 12 nm in width, identified as basotubules, were deposited. Immunolabeling for type IV collagen was found to be enriched in the endothelial half of the basement membrane being associated with the bundles of basotubules. The ultrastructural changes reported by high-resolution microscopy could be related to the molecular alterations of the basement membrane components and to the loss in permselectivity occurring during diabetes.

Selective proteinuria in diabetic nephropathy in the rat is associated with a relative decrease in glomerular basement membrane heparan sulphate

In the present study we investigated whether glomerular hyperfiltration and albuminuria in streptozotocin-induced diabetic nephropathy in male Wistar-Münich rats are associated with changes in the heparan sulphate content of the glomerular basement membrane. Rats with a diabetes mellitus duration of 8 months, treated with low doses of insulin, showed a significant increase in glomerular filtration rate (p < 0.01) and effective renal plasma flow (p < 0.05), without alterations in filtration fraction or mean arterial blood pressure. Diabetic rats developed progressive albuminuria (at 7 months, diabetic rats (D): 42 +/- 13 vs control rats (C): 0.5 +/- 0.2 mg/24 h, p < 0.002) and a decrease of the selectivity index (clearance IgG/clearance albumin) of the proteinuria (at 7 months, D: 0.20 +/- 0.04 vs C: 0.39 +/- 0.17, p < 0.05), suggesting loss of glomerular basement membrane charge. Light- and electron microscopy demonstrated a moderate increase of mesangial matrix and thickening of the glomerular basement membrane in the diabetic rats. Immunohistochemically an increase of laminin, collagen III and IV staining was observed in the mesangium and in the glomerular basement membrane, without alterations in glomerular basement membrane staining of heparan sulphate proteoglycan core protein or heparan sulphate. Glomerular basement membrane heparan sulphate content, quantitated in individual glomerular extracts by a new inhibition ELISA using a specific anti-glomerular basement membrane heparan sulphate monoclonal antibody (JM403), was not altered (median (range) D: 314 (152-941) vs C: 262 (244-467) ng heparan sulphate/mg glomerulus). However, the amount of glomerular 4-hydroxyproline, as a measure for collagen content, was significantly increased (D: 1665 (712-2014) vs C: 672 (515-1208) ng/mg glomerulus, p < 0.01). Consequently, a significant decrease of the heparan sulphate/4-hydroxyproline ratio (D: 0.21 (0.14-1.16) vs C: 0.39 (0.30-0.47), p < 0.05) was found. In summary, we demonstrate that in streptozotocin-diabetic rats glomerular hyperfiltration and a progressive, selective proteinuria are associated with a relative decrease of glomerular basement membrane heparan sulphate. Functionally, a diminished heparan sulphate-associated charge density within the glomerular basement membrane might explain the selective proteinuria in the diabetic rats.

Immunoelectron microscopic analyses of Maillard reaction products in bovine anterior lens capsule and Descemet's membrane

It has been hypothesized that Maillard reaction products form in basement membranes during aging and may affect protein turnover. The purpose of this study was to localize Maillard reaction products in intact lens capsules and Descemet's membranes by immunoelectron microscopy to determine whether Maillard products accumulated with age and whether basement membrane thickness increased to a similar degree. The monoclonal antibodies antiglucitollysine and antipyrraline were employed to detect the products in native and glucose-treated bovine basement membranes. The content of basic amino acids, furosine, and fluorophores (370/440), as well as resistance to trypsin digestion showed that the basement membranes formed significant quantities of Maillard products when incubated with 200 mM glucose in vitro (P < 0.05). Likewise, incubation in 200 mM glucose resulted in at least a 4-fold increase in immunoreactivity (P < 0.001). Native basement membranes increased in thickness more than 2-fold with age (P < 0.001). Immunoreactivity varied similarly in that bound antiglucitollysine increased approx. 2-fold and antipyrraline approx. 3-fold in old vs. young basement membranes, but these differences were significant only in pyrraline immunoreactivity in the lens capsule (P < 0.01). Advanced products other than pyrraline may accumulate in Descemet's membrane since significant increases in fluorescence and resistance to trypsin were noted. These data suggest that the Maillard reaction may, to a small degree, contribute to basement membrane thickening.

Chemistry of collagen cross-links: glucose-mediated covalent cross-linking of type-IV collagen in lens capsules

The incubation of lens capsules with glucose in vitro resulted in changes in the mechanical and thermal properties of type-IV collagen consistent with increased cross-linking. Differential scanning calorimetry (d.s.c.) of fresh lens capsules showed two major peaks at melting temperatures Tm 1 and Tm 2 at approx. 54 degrees C and 90 degrees C, which can be attributed to the denaturation of the triple helix and 7S domains respectively. Glycosylation of lens capsules in vitro for 24 weeks caused an increase in Tm 1 from 54 degrees C to 61 degrees C, while non-glycosylated, control incubated capsules increased to a Tm 1 of 57 degrees C. The higher temperature required to denature the type-IV collagen after incubation in vitro suggested increased intermolecular cross-linking. Glycosylated lens capsules were more brittle than fresh samples, breaking at a maximum strain of 36.8 +/- 1.8% compared with 75.6 +/- 6.3% for the fresh samples. The stress at maximum strain (or 'strength') was dramatically reduced from 12.0 to 4.7 N.mm.mg-1 after glycosylation in vitro. The increased constraints within the system leading to loss of strength and increased brittleness suggested not only the presence of more cross-links but a difference in the location of these cross-links compared with the natural lysyl-aldehyde-derived cross-links. The chemical nature of the fluorescent glucose-derived cross-link following glycosylation was determined as pentosidine, at a concentration of 1 pentosidine molecule per 600 collagen molecules after 24 weeks incubation. Pentosidine was also determined in the lens capsules obtained from uncontrolled diabetics at a level of about 1 per 100 collagen molecules. The concentration of these pentosidine cross-links is far too small to account for the observed changes in the thermal and mechanical properties following incubation in vitro, clearly indicating that another as yet undefined, but apparently more important cross-linking mechanism mediated by glucose is taking place.

Glycation and oxidation: a role in the pathogenesis of atherosclerosis

Reactions involving glycation and oxidation of proteins and lipids are believed to contribute to atherogenesis. Glycation, the nonenzymatic binding of glucose to protein molecules, can increase the atherogenic potential of certain plasma constituents, including low-density lipoprotein (LDL). Glycation of LDL is significantly increased in diabetic patients compared with normal subjects, even in the presence of good glycemic control. Metabolic abnormalities associated with glycation of LDL include diminished recognition of LDL by the classic LDL receptor; increased covalent binding of LDL in vessel walls; enhanced uptake of LDL by macrophages, thus stimulating foam cell formation; increased platelet aggregation; formation of LDL-immune complexes; and generation of oxygen free radicals, resulting in oxidative damage to both the lipid and protein components of LDL and to any nearby macromolecules. Oxidized lipoproteins are characterized by cytotoxicity, potent stimulation of foam cell formation by macrophages, and procoagulant effects. Combined glycation and oxidation, "glycoxidation," occurs when oxidative reactions affect the initial products of glycation, and results in irreversible structural alterations of proteins. Glycoxidation is of greatest significance in long-lived proteins such as collagen. In these proteins, glycoxidation products, believed to be atherogenic, accumulate with advancing age: in diabetes, their rate of accumulation is accelerated. Inhibition of glycation, oxidation, and glycoxidation may form the basis of future antiatherogenic strategies in both diabetic and nondiabetic individuals.

Protein synthesis, posttranslational modifications, and aging

Posttranslational modifications of proteins are involved in determining their activities, stability, and specificity of interaction. More than 140 major and minor modifications of proteins have been reported. Of these, only a few have been studied in relation to the aging of cells, tissues, and organisms. These include phosphorylation, methylation, ADP-ribosylation, oxidation, glycation, and deamidation. Several of these modifications occur on proteins involved in crucial cellular processes, such as DNA synthesis, protein synthesis, protein degradation, signal transduction, cytoskeletal organization, and the components of extracellular matrix. Some of the modifications are the markers of abnormal and altered proteins for rapid degradation. Others make them less susceptible to degradation by normal proteolytic enzymes, and hence these accumulate during aging.

Hexose-specific inhibition in vitro of human red cell Ca(2+)-ATPase activity

In a concentration-dependent manner (5.5-27.5 mmol/l), D-glucose incubated in vitro with human erythrocyte membranes at 37 degrees C for 1 h inhibited membrane Ca(2+)-ATPase activity by up to 75%. The IC50 was 11 mmol/l. L-Glucose was ineffective, as were 3-O-methylglucose, 2-deoxyglucose, sorbitol and myo-inositol. In contrast, D-fructose decreased Ca(2+)-ATPase activity nearly as effectively as D-glucose and mannose and galactose at 11 mmol/l were less than 50% as effective as D-glucose. Tunicamycin (12 pmol/l), but not 10 mmol/l aminoguanidine, progressively antagonized in vitro the D-glucose effect on the enzyme. Erythrocyte membrane Ca(2+)-ATPase activity may be regulated by glycosylation, rather than nonenzymatic glycation.

Heparan sulfate proteoglycan in the glomerular basement membrane in type 1 diabetes mellitus

Heparan sulfate proteoglycans (HSPG) are negatively charged constituents of the renal extracellular matrix including the glomerular basement membrane (GBM) and mesangial matrix. Biochemical and functional studies of patients with type-1 insulin dependent diabetes mellitus (IDDM) suggest that alterations of HSPG may occur in diabetic nephropathy. We have utilized a specific cytochemical method and electron microscopy to quantitate the distribution of HSPG in the GBM of 10 normal people and in 16 IDDM patients with a spectrum of clinical and structural changes. Enzyme incubation studies of normal infant kidney demonstrated that heparitinase removed 94% of the stainable anionic sites in the lamina rara externa (LRE) and 77% of the sites in the lamina rara interna (LRI) of the GBM. In contrast, incubation in the enzyme chondroitinase ABC did not reduce the number of sites in the LRE but reduced the number of sites in the LRI by 26%. The HSPG anionic sites in normal subjects were distributed in the LRE as 20.9 +/- 1.3, and in the LRI as 13.1 +/- 2.2 per micron GBM length. Anionic sites were slightly reduced (19.6 +/- 1.3, P less than 0.04) in the LRE of IDDM patients with normal urinary albumin excretion rates (UAE), or microalbuminuria, and were reduced in both the LRE and LRI of IDDM patients with clinical proteinuria (13.1 +/- 2.3, P less than 0.001 and 8.9 +/- 2.1, P less than 0.001, respectively). The number of anionic sites in the LRE and LRI, respectively, correlated with UAE (r = +0.78, P less than 0.001, r = +0.58, P less than 0.02), with GBM thickness (LRE, r = +0.81, P less than 0.001; LRI, r = +0.67, P less than 0.01) and with the volume fraction of mesangium (LRE, r = +0.59, P less than 0.02; LRI, r = +0.58, P less than 0.03). These data confirm earlier biochemical findings of a reduction of HSPG in the GBM in advanced diabetic nephropathy but do not provide evidence for the loss of HSPG in the GBM as a mechanism for early microalbuminuria.

Decrease in skin collagen glycation with improved glycemic control in patients with insulin-dependent diabetes mellitus

Glycation, oxidation, and nonenzymatic browning of protein have all been implicated in the development of diabetic complications. The initial product of glycation of protein, fructoselysine (FL), undergoes further reactions, yielding a complex mixture of browning products, including the fluorescent lysine-arginine cross-link, pentosidine. Alternatively, FL may be cleaved oxidatively to form N(epsilon)-(carboxymethyl)lysine (CML), while glycated hydroxylysine, an amino-acid unique to collagen, may yield N(epsilon)-(carboxymethyl)hydroxylysine (CMhL). We have measured FL, pentosidine, fluorescence (excitation = 328 nm, emission = 378 nm), CML, and CMhL in insoluble skin collagen from 14 insulin-dependent diabetic patients before and after a 4-mo period of intensive therapy to improve glycemic control. Mean home blood glucose fell from 8.7 +/- 2.5 (mean +/- 1 SD) to 6.8 +/- 1.4 mM (P less than 0.005), and mean glycated hemoglobin (HbA1) from 11.6 +/- 2.3% to 8.3 +/- 1.1% (P less than 0.001). These changes were accompanied by a significant decrease in glycation of skin collagen, from 13.2 +/- 4.3 to 10.6 +/- 2.3 mmol FL/mol lysine (P less than 0.002). However, levels of browning and oxidation products (pentosidine, CML, and CMhL) and fluorescence were unchanged. These results show that the glycation of long-lived proteins can be decreased by improved glycemic control, but suggest that once cumulative damage to collagen by browning and oxidation reactions has occurred, it may not be readily reversed. Thus, in diabetic patients, institution and maintenance of good glycemic control at any time could potentially limit the extent of subsequent long-term damage to proteins by glycation and oxidation reactions.

The role of glycation in aging and diabetes mellitus

One of the hypotheses trying to explain the process of aging is the idea of glycation of proteins. This reaction, also called the Maillard or browning reaction, may explain age-related symptoms such as cataract, atherosclerosis and modification of collagen-containing tissues. Diabetics, which possess elevated blood sugar levels, show signs of accelerated aging exposing similar complications. The Maillard reaction, which occurs on a large scale in vivo, may play a key role in the initiation of these symptoms.

Age-dependent accumulation of N epsilon-(carboxymethyl)lysine and N epsilon-(carboxymethyl)hydroxylysine in human skin collagen

N epsilon-(Carboxymethyl)lysine (CML) is formed on oxidative cleavage of carbohydrate adducts to lysine residues in glycated proteins in vitro [Ahmed et al. (1988) J. Biol. Chem. 263, 8816-8821; Dunn et al. (1990) Biochemistry 29, 10964-10970]. We have shown that, in human lens proteins in vivo, the concentration of fructose-lysine (FL), the Amadori adduct of glucose to lysine, is constant with age, while the concentration of the oxidation product, CML, increases significantly with age [Dunn et al. (1989) Biochemistry 28, 9464-9468]. In this work we extend our studies to the analysis of human skin collagen. The extent of glycation of insoluble skin collagen was greater than that of lens proteins (4-6 mmol of FL/mol of lysine in collagen versus 1-2 mmol of FL/mol of lysine in lens proteins), consistent with the lower concentration of glucose in lens, compared to plasma. In contrast to lens, there was a slight but significant age-dependent increase in glycation of skin collagen, 33% between ages 20 and 80. As in lens protein, CML, present at only trace levels in neonatal collagen, increased significantly with age, although the amount of CML in collagen at 80 years of age, approximately 1.5 mmol of CML/mol of lysine, was less than that found in lens protein, approximately 7 mmol of CML/mol of lysine. The concentration of N epsilon-(carboxymethyl)hydroxylysine (CMhL), the product of oxidation of glycated hydroxylysine, also increased with age in collagen, in parallel with the increase in CML, from trace levels at infancy to approximately 5 mmol of CMhL/mol of hydroxylysine at age 80.(ABSTRACT TRUNCATED AT 250 WORDS)

[The significance of the Maillard reaction in human physiology]

More than 50 years after Maillard's original paper describing the reaction of amino acids with glucose it was found that this reaction also occurs under physiological conditions in the human body. Initially, it was discovered that human hemoglobin contains protein-bound Amadori-products that are increased in diabetic patients with elevated blood glucose levels. Measurements of fructosylated hemoglobin are now widely used as an index of glycemia in diabetes. It was soon recognized that this postribosomal modification is common to other proteins in vivo like albumin, lens crystallins, proteins of the clotting cascade, collagens, lipoproteins, proteins of the cell membrane, and others. This may lead to alterations in structure and function of the respective protein. Later, the realization that long-lived proteins become browned, fluorescent, and insoluble with age, and at an accelerated rate in diabetes, suggested that later stages of the Maillard reaction might proceed in vivo and contribute to some of the pathophysiology associated with both aging and diabetes. Although the contribution of the Maillard products to the development of diabetic late complications is not fully understood, attempts are being made to prevent formation of late Maillard product with aminoguanidine, a drug currently under clinical testing.

Immunogold studies of monomeric elements from the globular domain (NC1) of type IV collagen in renal basement membranes during experimental diabetes in the rat

The protein A-gold immunocytochemical technique was applied to reveal the monomeric elements M1, M2* and M3 from the non-collagenous globular domain (NC1) of type IV collagen over various renal basement membranes from control and long-term streptozotocin-induced diabetic rats. This study includes the basement membranes of the proximal tubule, the Bowman's capsule and the glomerulus as well as the extracellular matrix of the mesangium. The labellings obtained were confined to basement membrane material. The quantitative analysis demonstrated changes in labelling intensities and distribution between tissues from normal and diabetic animals. Increased labelling intensities were observed for M1 and M2* monomers in all the basement membranes studied except for the mesangial matrix which remained unchanged. In addition, the labelling for M1 monomers, present on the endothelial side of the glomerular basement membrane of control animals, was found to be distributed throughout the entire thickness of the basement membrane of diabetic animals. In contrast, neither the intensity of the labelling, nor the distribution of M3 monomers were altered in diabetic animals. Since M1 monomers are markers of the alpha 1(IV) and alpha 2(IV) chains of type IV collagen while M2* and M3 mark alpha 3(IV) and alpha 4(IV) chains respectively, the present results demonstrate changes in the nature of the collagenous elements of basement membranes during diabetes. Furthermore, the results indicate that the alpha 3(IV) and the alpha 4(IV) chains are not necessarily present in the same molecule. The modifications of the collagenous elements of the basement membranes during diabetes must alter the structural characteristics of these matrices which in turn might influence their functional properties.

Immunoglobulin deposits in diabetic microangiopathy. Observations in autopsy materials

Non-enzymatic glycosylation of vascular wall collagen is considered to be most important in the pathogenesis of diabetic microangiopathy, and glycosylated collagens are reported to bind immunoglobulins in vivo. We investigated the occurrence of IgG or IgM deposits in the microvasculature of certain organs of diabetics using routine autopsy materials. Glomerular capillary basement membrane/endothelium was often positive for IgM in diabetics. Endothelial cells of glomerular capillaries were positive for HLA-DR in 6 of 16 diabetics and in 2 of 11 controls. This was associated with IgM or IgG deposits in 5 cases. In the esophagus and/or tongue of diabetics, IgG was frequently deposited in the microvasculature. In total, IgG deposits were found in 13 of 16 diabetics, either in the esophagus or the tongue, but in only 3 of 16 controls. The difference was significant at p less than 0.005. These observations suggest that deposition of immunoglobulins is a component of diabetic microangiopathy. Differences in expression of HLA-DR in glomeruli between diabetics and non-diabetics remain to be explored.

2',3'-cyclic nucleotide phosphohydrolase activity determined using an image analyzer detection system

The activity of 2',3'-cyclic nucleotide phosphohydrolase (CNPase) was assayed using high-performance thin-layer chromatography (HPTLC) and an image analyzer detection system. The assay system was used to study a possible inhibitory effect by aminoguanidine on CNPase specific activity. One advantage of using a fixed-time HPTLC system over a real-time spectrophotometric system for an enzyme activity study was that apparent inhibition of the enzyme due to interference of the assay system (chromophore inhibition, etc.) was avoided. In addition, due to the increased accuracy of the image analyzer over conventional methods of TLC plate analysis, a rapid and more accurate measurement of HPTLC plates was possible which required only nanomole amounts of substrate. Also, a digital image of each plate analyzed was stored indefinitely in the computer's memory for future reference. The measurements of CNPase specific activity made using this system compared favorably to those found in recent literature.

Ultrastructural distribution of endogenous IgGs in the glomerular wall of control and diabetic rats

Endogenous IgG molecules were revealed with high resolution EM over the glomerular wall in renal tissues sampled from short and longterm control and streptozotocin induced diabetic rats by applying the protein A-gold immunocytochemical approach. In tissues from control animals, IgG antigenic sites were revealed on the subendothelial side of the basement membrane, the epithelial side being only weakly labelled. In contrast, in longterm diabetic animals IgG antigenic sites were present throughout the entire thickness of the basement membrane, and in patches closely associated with the plasma membrane of the epithelial cells. Deposits of basement membrane-like material present in the mesangial area were also highly labelled for IgG. Numerous intensely labelled lysosome-like structures were present in the epithelial cells. Morphometrical evaluation of the distribution of the labelling over the basement membrane confirmed these observations. In control animals a peak of labelling was found at 30 nm from the endothelial cell region corresponding to the subendothelial side of the lamina densa. In longterm diabetic animals the labelling was more uniformly distributed throughout the entire thickness of the basement membrane. These data were correlated to biochemical determinations of proteinuria and IgG excretion in urine samples from the control and the diabetic animals. These results suggest that in normal conditions the lamina densa may represent the main barrier for the restriction of the passage of IgGs through the glomerular wall. Modifications at that level occur during diabetes leading to or participating in the loss of the selective permeability of the basement membrane.