Dissertations / Theses on the topic 'Advanced glycation endproducts (AGE)'

Background:- Diabetes mellitus (OM) is a metabolic disorder commonly associated with advanced glycation endproducts (AGEs) and the specific receptor for AGE (RAGE). Cardiovascular disease is the main cause of mortality in patients with OM. Accordingly, accelerated atherosclerosis and AGEs are. common pathological features of OM. Chronic AGE exposure and AGE-activated intracellular signalling mechanisms were examined in coronary arteries as a causative link for the phenotypic modulation of VSMC associated with the severe atherosclerotic complications seen in diabetic patients. Methods and Results:- Cultured porcjfle coronary artery vascular smooth .muscle (CVSM) cells exposed to AGE for 96 hours were used as a relevant diabetic model. Calcium imaging studies and electrophysiology studies revealed chronic AGE treatment lead to significantly enhanced intracellular Ca2+ release and sustained activation of Ca2+-sensitive membrane ion channels, respectively, using agonists to evoke intracellular Ca2+ mobilization. Intracellular Ca2+ release from caffeinesensitive intracellular stores was enhanced in CVSM cells with AGE treatment, suggesting an upregulation of RyRs, or distinct RyR subtype expression. Brd U proliferation assay results confirmed proliferation was significantly increased in AGEtreated CVSM cells, which was abolished with cyclosporin A (CsA). Calcineurin activity, nuclear factor of activated T-cells (NFAT)-binding and RAGE expression were all significantly increased in CVSM cells after AGE exposure for 96 hC?urs. Conclusions:- This study concludes that the activation of the Ca2+-dependent calcineurin/NFAT pathway is responsible for the increased proliferative response in CVSM cells chronically exposed to AGE. An upregulation of the RAGE receptor after 96 hours AGE treatment mediates the phenotypic modulation of porcine coronary VSMC from a fully differentiated contractile phenotype to a dedifferentiated synthetic proliferative phenotype. The results of this study suggest that the uncontrollable proliferation of VSMCs associated with the accelerated atherosclerosis seen in diabetic coronary vasculature is partly due to the irreversible formation and deposition of AGEs.

Study of lysozyme in the context of diabetic nephropathy Introduction Lysozyme (LZ), enzyme known for its antimicrobial and immunomodulant activity, has recently shown to be effective in the context of diabetic nephropathy, one of the major complications associated to diabetes and one of the major cause of end stage kidney disease in Western countries. Experimental evidences strictly link the development and progression of the diabetic nephropathy to the enormous production and accumulation of Advanced Glycation Endproducts (AGEs). AGEs are a chemically heterogeneous group of macromolecules which formation is dramatically increased in diabetic patient mainly due to chronic hyperglicaemia. Nevertheless, several factor, such oxidative and carbonyl stress and reduced renal clereance seem to be related to the increase of the production and accumulation of AGEs. The first step of AGEs formation starts in presence of reducing sugars, as glucose, which are able to interact with free amino group (Maillard reaction), forming Schiff base. The rearrangements from the Schiff base leads to the formation of Amadori products, that are eventually oxidazed, leading to the formation of AGEs. AGEs binding to structural proteins and deposition in tissues alter functions, leading to stiffening, enhanced local cytokine production and is a marker of cumulative metabolic stress. At cellular level, AGEs-induced events, depend mainly by their interaction with specific receptor, among which RAGE, is the most well characterized. AGE-RAGE interactions determine a number of events, such as an increased production of reactive oxygen species (ROS), induction of pro-inflammatory mediators, upregulation of RAGE receptor. In the last decades, it has been shown that hen egg white LZ is able to act effectively as AGEs scavenger (Kd= 50 nM). In in vivo models it was demonstrated that orally administered microencapsulated LZ, can act prevent the insurgence of a number of relevant early manifestations of diabetic nephropathy, such as microalbuminuria and glomerular hypertrophy. Aim The aim of the present work is to develop an in vitro model for studying the molecular mechanisms responsible for the nephroprotective activity of LZ, through the identification and validation of an adequate cell line and a marker. In order contribute to understand the higher in vivo effectiveness of microencapsulated LZ compared to an equidose of “free” LZ, a sophisticated model of incannulated rat will be developed. Results and discussion An adequate cell model was selected among three different cell lines: a primary culture of endothelial cells (ADMEC), due to the implication of vascular tissue in diabetes and two proximal tubular cell lines, LLC-PK1 (porcine cells) and HK-2 (human cells) due to the tubular involvement in the context of diabetic nephropathy. HK-2 cell line was selected on the basis of its dose-dependent sensibility to the AGE treatments, quantified, in terms of viability, by means of MTT test. One of the most relevant AGE-induced effect is the induction of inflammatory response. A pivotal event in the context of inflammation is represented by macrophage recruitment. For this reason, it was performed a migration assay, using monocyte U937 differentiated in macrophage, toward a stimulus represented by supernatants obtained treating HK-2 cells with AGE e LZ. AGE treatment induced a significant increased (+50%) of the migrated macrophage. The co-treatment significantly prevented the migration induction. LZ treatment, as expected, did not modify migratory ratio. It is known that cytokine play a crucial role in macrophage recruitment. Interleukin-6 (IL-6), for what diabetic nephropathy is concerned, has a pivotal role. On the basis of this evidence, the IL-6 mRNA levels after AGE and LZ treatments were measured. According with expectations, AGE induced a significant IL-6 mRNA increase after 24 h of treatment. LZ exposition did not induced any modifications, whereas the co-treatment with AGE and LZ showed that LZ prevented IL-6 mRNA increase. In order to confirm the effectiveness of LZ toward AGE-induced IL-6 increase, an ELISA assay was performed. LZ was able to significantly and dose-dependently reduce the AGE-induced release of IL-6 in the supernatants. Several mechanisms have been reported to be capable to induce IL-6 release. The mechanisms that determine IL-6 release are several. On the basis of the recognized crucial role attributed to RAGE receptor, it was tested the capacity of LZ to influence RAGE mRNA levels, by means of RT-PCR technique. The results showed no variations of RAGE levels after exposition to AGE and LZ for 24 up to 96 h. The induction of ROS represents one of the events attributable to AGEs. Nevertheless, on the cellular model employed, this parameter did not show any significant increase. Considering that LZ activity is associated also to its AGE scavenging action, it was evaluated by means of confocal microscopy, if the presence of LZ could influence the AGE capacity to enter inside the cell. The images obtained by means of this technique showed that AGEs and LZ are both able to enter in the cells. In order to investigate the co-treatment effect a cytometry analysis was performed. The results suggest that LZ is not able, in this cellular model, to prevent the entrance on AGEs inside the cells, excluding that LZ scavenging action could be the cause of preventive action of in vitro IL-6 production. Subsequent studies were performed on pathways potentially involved in the action of LZ toward AGEs, such as MAPK cascade (p38) and lysosomial degradation. Preliminary data showed a possible involvement of p38. In fact, AGEs showed the capacity to increase phosphorylation level of this protein, effect reduced by the co-treatment with an equimolar dose of LZ. Promising are also the first results obtained from the lysosomial localization study of AGE, in presence of LZ. In fact, the qualitative analysis of the obtained figures confirms the hypothesis that LZ is able to bring AGEs in lysosomes, supporting their degradation. Taken together these data do not exclude stochastically that LZ action is mainly antidotic. However, the LZ capacity to act toward pivotal mediators of AGE-induced effects, such as IL-6 and p38, open new work perspectives for what LZ action is concerned, allowing to speculate its use as cooperating drug in the control of inflammation in the context of diabetic nephropathy. In order to investigate if the higher effectiveness of orally administered microencapsulated LZ was due to the capacity of microparticles to deliver more efficiently the LZ in the blood stream an in vivo test was performed. The results showed that microparticles can contribute significantly to deliver LZ more efficiently to serum
Studio del lisozima nel contesto della nefropatia diabetica Introduzione Il lisozima (LZ), enzima noto per la sua attività antibatterica ed immunomodulante, è stato recentemente identificato come principio attivo con potenzialità terapeutica nel contesto della nefropatia diabetica, una delle principali complicanze associate al diabete e principale causa di patologie renali terminali nell’Occidente sviluppato. Evidenze sperimentali correlano strettamente l’insorgenza e la progressione della nefropatia diabetica all’abnorme formazione ed accumulo di molecole note come prodotti finali della glicosilazione avanzata (Advanced Glycation Endproducts, AGE). Gli AGE sono un gruppo chimicamente eterogeneo di macromolecole la cui formazione risulta drammaticamente incrementata nel paziente diabetico a causa dell’iperglicemia cronicizzata. La formazione degli AGE ha inizio in presenza di zuccheri riducenti, come il glucosio, i quali nella loro forma aperta sono in grado di interagire con gruppo amminici liberi (reazione di Maillard) formando le basi di Schiff. Tali composti si riarrangiano in prodotti di Amadori, dai quali derivano direttamente gli AGE. Gli effetti patologici AGE-indotti derivano dal loro deposito tissutale e dal legame con proteine a lento turnover, con conseguente riduzione della funzionalità e/o dell’elasticità degli stessi. Gli eventi AGE-indotti, a livello cellulare, dipendono principalmente dalla loro interazione con i propri recettori specifici, tra i quali il meglio caratterizzato è RAGE. L’interazione AGE-RAGE è alla base di numerosi eventi tra i quali un ruolo centrale spetta all’aumento di specie reattive dell’ossigeno (ROS), all’induzione del rilascio di stimoli pro-infiammatori e all’upregolazione del recettore RAGE stesso. Recentemente, è stato dimostrato che il LZ da bianco d’uovo è in grado di fungere efficacemente da scavenger degli AGE (Kd= 50 nM). In modelli in vivo con diabete indotto, è stato dimostrato che il LZ microincapsulato, somministrato oralmente, è in grado di prevenire l’insorgenza di alcuni dei principali sintomi precoci della nefropatia diabetica, quali microalbuminuria ed ipertrofia glomerulare. Scopo L’obiettivo di questo lavoro di dottorato è quello di sviluppare un modello in vitro per lo studio dei meccanismi molecolari alla base dell’attività nefroprotettiva del LZ attraverso l’individuazione e la validazione di una linea cellulare e di un marker adeguati. Per chiarire alcuni aspetti di ordine farmacocinetico è stata anche quantificata la concentrazione plasmatica di LZ, in seguito a somministrazione orale in forma microincapsulata, rispetto alla somministrazione in forma libera. Risultati e discussione La selezione di un modello cellulare adeguato ai successivi studi in vitro è avvenuta nell’ambito di tre linee cellulari potenzialmente adatte, ovvero: una coltura primaria di cellule endoteliali del microcircolo dermico (ADMEC), per via dell’implicazione del sistema vascolare nel diabete e due linee cellulare di tubulo prossimale renale, LLC-PK1 (di origine suina) e HK-2 (di origine umana), per via del coinvolgimento tubulare nel contesto della nefropatia diabetica. Una serie di esperimenti ha permesso di far ricadere la scelta sulle cellule HK-2, le quali hanno mostrato la maggior sensibilità ai trattamenti con AGE (decremento dose-dipendente e tempo-indipendente) in termini di vitalità misurata mediante MTT test e per questioni di ordine pratico e logistico. Uno dei principali effetti degli AGE nell’organismo è l’induzione della risposta infiammatoria. Un evento cruciale dell’infiammazione è rappresentato dal reclutamento macrofagico. Sulla base di questi presupposti è stato effettuato un saggio di migrazione dei monociti U937, differenziati a macrofagi, verso uno stimolo rappresentato da sovranatanti ottenuti trattando le cellule HK-2 con AGE e LZ. Il trattamento con AGE ha indotto un incremento significativo (+ 50%) dei macrofagi migrati. Il trattamento con il LZ, come atteso, non ha modificato il tasso migratorio mentre, in presenza di AGE, è stato in grado di prevenire significativamente l’induzione della migrazione. È noto che le citochine svolgono un ruolo fondamentale nel reclutamento macrofagico. Nell’ambito della nefropatia diabetica, l’interleuchina-6 (IL-6) risulta rivestire un ruolo rilevante. Si è quindi deciso di misurare i livelli di mRNA di IL-6 in seguito a trattamenti con AGE e LZ. In conformità alle nostre aspettative, gli AGE hanno indotto un incremento statisticamente significativo dei livelli di mRNA di IL-6 dopo 24 h di trattamento. L’esposizione al LZ non ha indotto modificazione, mentre il co-trattamento con AGE e LZ ha evidenziato la capacità del LZ di prevenire l’incremento dei livelli di IL-6, mantenendoli a valori comparabili a quelli dei controlli. Per confermare l’attività del LZ nei confronti di IL-6 AGE-indotto, è stato condotto un saggio ELISA che ha rafforzato i dati ottenuti mediante RT-PCR: il LZ è in grado di ridurre, in maniera dose-dipendente e statisticamente significativa, la quantità di IL-6 rilasciata AGE-indotta. I meccanismi che portano al rilascio di IL-6 sono molteplici. Nell’arco di questa ricerca, ci si è focalizzati su alcuni eventi direttamente correlati all’incremento del rilascio di IL-6. Visto il ruolo chiave attribuito al recettore RAGE negli effetti AGE-indotti, si è deciso di testare la capacità del LZ di influenzare i livelli di mRNA di RAGE, mediante RT-PCR. I risultati non hanno evidenziato variazioni dei livelli di RAGE dopo esposizione al LZ a 24 e 96 h. L’induzione delle ROS rappresenta uno degli eventi notoriamente attribuibili ad un’azione AGE-indotta. Tuttavia, nel modello cellulare da noi utilizzato, questo parametro non ha mostrato innalzamenti rispetto al controllo negativo, pur mostrandosi sensibile al trattamento con ABAP (induttore di ROS di riferimento). Dal momento che l’attività del LZ è associata anche alla sua azione di scavenger degli AGE si è deciso di investigare, mediante microscopia confocale, se la presenza del LZ potesse influenzare la capacità degli AGE di penetrare all’interno della cellula. Le immagini acquisite con questa tecnica hanno permesso di stabilire che gli AGE e il LZ sono in grado di penetrare attraverso la membrana cellulare. Per quel che concerne il co-trattamento sono stati effettuati alcuni studi di citometria a flusso. I risultati suggeriscono che il LZ non è in grado, in questo modello cellulare, di ridurre l’ingresso degli AGE nella cellula, escludendo che l’azione di scavenger sia alla base della prevenzione della produzione di IL-6 in vitro. Successivi studi, sono stati effettuati su due possibile vie coinvolte negli effetti AGE-indotti, quali la cascata delle MAPk, mediante p38, e la via di degradazione lisosomiale. I dati preliminari ottenuti hanno evidenziato un possibile ruolo i p38. Gli AGE si sono dimostrati capaci di incrementare i livelli di fosforilazione di questa proteina, effetto ridotto dalla contemporanea presenza di una dose equimolare di LZ. Promettenti sono anche i primi risultati ottenuti dallo studio di co-localizzazione degli AGE, in presenza di LZ, nei lisosomi. Le immagini acquisite confermano, infatti, l’ipotesi che il LZ sia in grado di veicolare gli AGE nei lisosomi, favorendone la degradazione. Nel loro insieme i risultati ottenuti non escludono che l’azione del LZ nei confronti degli AGE e dei suoi effetti sia prettamente di tipo antidotico e di scavenging. Tuttavia, la capacità del LZ di agire su un mediatore chiave degli effetti AGE-indotti come IL-6 e p38, aprono una nuova finestra di studio per quel che concerne il LZ, permettendo di ipotizzare un suo possibile impiego come co-adiuvante per il controllo dell’infiammazione nella nefropatia diabetica. Al fine di investigare se la maggior efficacia del lisozima microincapsulato sia dovuta alla capacità dei microsistemi di veicolare il LZ, nel torrente circolatorio di quanto non avvenga con la forma libera è stato messo a punto un modello in vivo nell’ambito del quale il LZ è stato somministrato oralmente microincapsulato oppure libero. Nel corso di tale prova è stato dimostrato che i microsistemi sono capaci di veicolare il lisozima a livelli serici superiori di quanto non avvenga dopo somministrazione di un’equidose di LZ in forma libera. Questi risultati dimostrano l’efficacia dei microsistemi orali per la veicolazione in circolo di principi biologicamente attivi

Kohlenhydrate und Proteine gehören neben Wasser und Fetten zu den quantitativ bedeutendsten Grundbestandteilen biologischer Systeme und der Lebensmittel. Unter milden Bedingungen in lebenden Organismen oder unter thermischer Belastung bei der Lebensmittelverarbeitung können reduzierende Kohlenhydrate amin-katalysiert durch die Abspaltung von Wasser und Fragmentierungen des Kohlenstoffgerüsts abgebaut werden, wobei die noch reaktiveren 1,2-Dicarbonylverbindungen entstehen. Aus der Reaktion der N-α-Aminogruppe und funktioneller Gruppen der Seitenketten von Aminosäuren mit Kohlenhydraten bzw. 1,2-Dicarbonylverbindungen können stabile Endprodukte entstehen. In vivo können proteingebundene Maillard-Produkte (MRPs) aus der Reaktion mit Glucose (Amadori-Produkte) oder 1,2-Dicarbonylverbindungen (Advanced Glycation Endproducts: AGEs) entstehen. Beispielsweise ist das „N-terminale“ N-α-Fructosylderivat der β-Kette des Hämoglobins ein etablierter Parameter zur Diagnose von Diabetes mellitus (HbA1c-Wert). Diese nicht-enzymatische, posttranslationale Modifizierung von Proteinen wird allgemein als Glykierung bezeichnet und kann die Funktionalität von Proteinen beeinträchtigen. Deshalb wird untersucht, ob die Trübung der Augenlinsen, die Versteifung von Blutgefäßen oder Schädigungen von Nervenzellen durch eine erhöhte Glykierung verursacht werden. Diese Veränderungen treten im Alter und bei Stoffwechselkrankheiten wie Diabetes mellitus und Urämie auf, die durch eine erhöhte Glucosekonzentration bzw. die Anreicherung von 1,2-Dicarbonylverbindungen im Blut gekennzeichnet sind. Zwar gibt es Publikationen zum Vorkommen N-terminaler Amadori-Produkte an Hämoglobin und in Lebensmitteln, aber die Bildung N-terminaler AGEs wurde bisher nur in wenigen Studien untersucht. Deshalb waren die Bildung und das Vorkommen N-terminaler AGEs im physiologischen Modell, in Hämoglobin und in Backwaren Gegenstand der vorliegenden Arbeit. In der vorliegenden Arbeit wurde erstmals systematisch die Sequenzabhängigkeit der Bildung der Fructosylderivate bzw. der CM-Derivate in Konkurrenz zu den Glyoxal-2(1H)-Pyrazinonen am N-Terminus von Peptiden unter physiologischen und backtechnologischen Bedingungen untersucht. Dabei wurde nachgewiesen, dass die Variation der C-terminalen Aminosäure in Dipeptiden den Glykierungsgrad und das Produktspektrum erheblich beeinflusst. Mit dem konsequenten Nachweis der N-terminalen von Glyoxal und Methylglyoxal ableitbaren Carboxyalkylderivate und 2(1H)-Pyrazinone in humanen Hämoglobin wurde die Relevanz der N-terminalen Glykierung in vivo untermauert. Damit wird eine umfassendere Beurteilung des Dicarbonylstresses und der Glykierung insbesondere bei Urämikern und Diabetikern ermöglicht. Am Beispiel von Backwaren wurde für Lebensmittel gezeigt, dass unter trockenen Reaktionsbedingungen die 2(1H)-Pyrazinone und in wasserhaltigen Systemen die Carboxyalkylderivate bevorzugt zu erwarten sind.

Advanced Glycation Endproducts (AGEs), resulting from the non-enzymatic reaction of reducing sugars with proteins, accumulate in patients with diabetes mellitus and with advancing age and are implicated in the pathogenesis of vascular disease. Oxidative stress also participates in vascular pathology and has also been reported in the context of diabetes and ageing. This study set out to explore the contribution of AGEs to oxidant stress generation, particularly by examining their effects on the respiratory burst of neutrophils and lymphoblasts. Using chemiluminescence to detect reactive oxygen species (ROS), AGEs did not stimulate the neutrophil respiratory burst directly, but caused a dose-dependent enhancement of the neutrophil respiratory burst in response to a mechanical stimulus (up to 265% +/- 42%, p=0.022) or chemical stimulation with fMLP (formylleucylphenylalanine) 100nM (up to 218% +/- 19%, p<0.001). This phenomenon was immediate and reversible, and depended on the simultaneous presence of AGEs with the additional stimulus; hence AGEs appear to act as neutrophil 'co-agonists'. The in vivo correlates of mechanical and chemical stimulation may be vascular stress and microbial exposure respectively, especially since some acute vascular events have been correlated with infective episodes. The 'co-agonist' effect of AGEs on the neutrophil respiratory burst appears to involve upregulation of the NADPH oxidase enzyme, as evidenced by a DPI-dependent suppression of basal and augmented ROS output. This in turn is dependent upon the generation of arachidonic acid (which may potentiate NADPH oxidase subunit function), via cytosolic phospholipase A2 (cPLA2) activation. The whole process is sensitive to adjustments of the intracellular redox status, implying a role for upstream redox signalling.

Doctor of Philosophy
Food Science Institute
J. Scott Smith
Advanced glycation endproducts (AGEs) are formed in many cooked meat products via Maillard browning reactions. Current research suggests consumption of these compounds may be a contributor to chronic diseases such as diabetes and heart diseases. Thus, information on the prevalence and inhibition of these compounds in food is desirable. The first objective was to determine the AGE content, as determined as N[superscript]ε-carboxymethyllysine (CML) level, in cooked meat and fish prepared by general cooking methods recommended by U.S. Department of Agriculture, Food Safety and Inspection Service (USDA-FSIS). We found AGE was detected in all the cooked samples, but the levels depended on the different cooking conditions. Broiling and frying at higher cooking temperatures produced higher levels of CML and broiled beef contained the highest CML content (21.84 μg/g). However, the baked salmon (8.59 μg/g) and baked tilapia (9.72 μg/g) contained less CML as compared to the other samples. In order to investigate the inhibitory effect of selected natural antioxidant on AGEs formation in cooked meat, four cereal brans, wheat (Jagger, JA), triticale (Spring Triticale, ST; Thundercale, TH), and Rye (RY) bran were added to beef patties before cooking. RY (42.0% inhibition), ST (27.5% inhibition), and TH (21.4% inhibition) brans significantly decreased CML formation compared with the control. The inhibition of CML was correlated to the water-holding activity (WHC) of the samples, and the radical scavenging activity of the brans. The effect of cereal bran extracts (JA, ST, TH, and RY), was studied in a bovine serum albumin and glucose (BSA-GLU) model system. The ST extract significantly (P <0.05) inhibited CML formation compared to the control group. ST particularly contained vanillic acid (VA), chlorogenic acid (CHA), gentisic acid (GEA), and ferulic acid (FA), where GEA and CHA mitigated CML with an average percentage decrease of 29.6% for CHA and 51.1% for GEA. It therefore may be useful in preventing AGEs formation by using ST bran as a food addictive, which contains abundant phenolic acids. In summary, current dietary AGEs database will provide important information for use in estimating AGEs exposure, and also these data demonstrate that a significantly reduced intake of dietary AGEs can be achieved by low heat AGE cooking methods such as baking, which can be used at home or in the meat industry. Cereal bran addition to meat products may reduce formation of AGEs that is a desired attribute for the processed meat products industry.

INTRODUCTION AGEs and ALEs (Advanced Glycoxidation/Lipoxidation End products) are covalently modified proteins that can act as pathogenic factors in several chronic diseases, like diabetes and cardiovascular diseases. These covalent adducts are formed by different mechanisms. AGEs are proteins covalently modified by reducing sugars or their oxidative degradation products, involving the Maillard reaction. ALEs are proteins modified by reactive carbonyl species (RCS) generated by lipid peroxidation. AGEs/ALEs can be the basis of many different pathologies, underlining the importance for good analytical methods for identification and characterization for the use of biomarkers, but also as a drug target. However, the identification, characterization and quantification of AGEs/ALEs remains to be very challenging due to heterogeneous precursors (sugars, lipids) leading to heterogeneous AGEs/ALEs, present in low concentrations and being very complex analytes. Various techniques to identify and characterize AGEs/ALEs have been described, making use of an isolation/enrichment step based on reactive groups, like carbonyls. However, not all AGEs/ALEs retain reactive groups and therefore can not be isolated and identified using these techniques, indicating the need for a new strategy. The strategy that has been employed in our laboratory is to use the soluble domain of the RAGE receptor, VC1, to affinity enrich AGEs. Using this approach, AGEs/ALEs will be enriched independently of the protein and type of modification. Moreover, a ligand of RAGE can be identified, which could be a potential biomarker of a disease caused by oxidative stress. RAGE is a type I cell surface receptor that is expressed in several cells, such as endothelial cells, smooth muscle cells, but also dendritic cells and T-lymphocytes and is predominantly located in the lungs. The receptor has been implicated in many different pathologies with a marked oxidative base, such as diabetes, atherosclerosis and neurodegenerative diseases. One of the pathways that can be activated is the Nf-κB pathway. The Nf-κB pathway is the ideal signaling pathway to investigate the binding and activation of RAGE by AGEs or ALEs. For this purpose, a cell line was obtained with and without overexpression of RAGE. Furthermore, the cell lines were transfected with a Nf-κB reporter gene, providing us with a fast and high-throughput assay for the evaluation of a pro-inflammatory response upon stimulation with AGEs/ALEs. AIM OF THE PROJECT The identification and characterization of AGEs/ALEs has proven to be crucial in the onset and development of many pathologies. Therefore, good analytical strategies need to be developed/optimized for better understanding of the exact nature of modification, to understand the role they play in disease progression. Identified AGEs/ALEs can serve as biomarker, as well as drug targets. The VC1 technique was proven to be a promising technique to accommodate the need for enrichment of AGEs for better characterization. The first aim of the project was therefore to investigate whether also ALEs are binder of RAGE, since they share the same structural properties than AGEs, and also have been shown to activate the Nf-κB pathway, implicating a role for receptors, like RAGE. Furthermore, to gain a deeper insight into the molecular mechanisms involved in the protein-protein engagement. Since a successful enrichment strategy was developed, the second aim of this project was focused on identifying AGEs/ALEs in biological samples. The first part was focused on oxidizing healthy human plasma in-vitro using AAPH as a radical initiator, and the incubation of plasma directly with RCS, anticipating the production of AGEs/ALEs. The VC1 technique was then used to identify which AGEs/ALEs are produced. Simultaneously, other variables during the sample preparation and analysis were optimized. As explained before, AGEs/ALEs are present in very low concentrations in biological samples, hence the need for very sensitive methods and instrumentation allowing identification. Since human serum albumin (HSA) is the main protein present in plasma, around 50-60%, and has multiple nucleophilic targets, it represents the best model for characterizing AGEs/ALEs. For this reason, the focus was on extracting HSA from plasma, using the newest generation of tribrid MS for the analysis of AGEs/ALEs in plasma samples. AGEs are ligands for RAGE, meaning, they can bind and activate the receptor, inducing a signaling pathway and pro-inflammatory response. ALEs have also been shown to induce a pro-inflammatory response; however, no specific receptor has been linked to this cellular event. Using a cell line with and without RAGE, we aimed to determine whether ALEs can bind and activate the Nf-κB pathway through RAGE. RESULTS AND DISCUSSION ALEs as binder of RAGE In order to investigate the interaction between RAGE and ALEs, different ALEs were produced in-vitro by incubating HSA with different concentrations of well-known lipid derived RCS and in particular: ACR, MDA and HNE. After 24, 48 and 72 h, aliquots of the incubation mixtures were withdrawn, and the reaction was stopped by removing the excess of RCS by ultrafiltration. Intact protein analysis by direct infusion MS was used to evaluate the extent of HSA modifications and demonstrated that by using a wide range of molar ratios and different time-points a quite wide array of ALEs for each tested RCS was generated. In order to characterize ALEs selectively enriched by RAGE, a VC1 pull-down assay was performed as previously described. HSA and HSA treated with MDA, ACR or HNE were assayed for binding to VC1-resins and to control resin. As expected, unmodified HSA was not retained by the VC1-resin. At increasing molar ratios and incubation time, higher amounts of albumin modified with MDA or ACR were eluted from the VC1 resin, with a predominance of the high molecular weight (HMW) species. The modified albumins were retained by the VC1-resin, but not by the control resin. ALEs in the reaction mixtures and those enriched by VC1 were analyzed by bottom-up MS in order to identify the PTMs and to localize the amino acid residues involved in the protein adduct formation. With regard to MDA, only di-hydropyridine adducts on lysines (DHPK), and N-2-pyrimidyl-ornithine adducts on arginines (NPO) were retained by VC1-domain. The n-propenal modifications of lysine (NPK), largely identified before enrichment, were not identified after the enrichment. ACR induced a set of modifications which were identified only after VC1 enrichment and in particular the N-(3-formyl-3,4-dehydro-piperidinyl) lysine (FDPK) modifications, the Michael adduct on cysteines, the double Michael adduct of lysines, the Michael adduct of histidine, the N-2-(4 hydroxy-tetrahydro-pyrimidyl) ornitine (propane-arginine, HTPO) and the Nε-(3-methylpyridinium)-lysine (MP-lysine). Most of the ALEs generated by HNE were found both before or after enrichment, with the exception of a few Michael adducts which were selectively retained by VC1 (not detected before enrichment). With a view to rationalizing the key factors influencing the RAGE binding of the monitored adducts, in silico studies were performed. They were focused on the adducts on arginine and lysine residues as formed by ACR and MDA since they are numerous, with a very broad range of affinity, thus allowing the development of clear structure-affinity relationships. RAGE-ligand interacting regions are characterized by a rich set of positively charged residues which can bind acidic regions of a protein. The mechanism identified using in silico studies, involves a basic amino acid at the center of carboxylic acids like glutamate and aspartate, which forms a set of ionic bridges. Once the basic amino acid is modified by ACR or MDA to an adduct with a neutral charge, the carboxylic acids become available to freely contact the RAGE positive residues. Identification of AGEs/ALEs in biological samples The VC1 technique has proven to be successful in enriching AGEs and ALEs, so the next step was to exploit this technique in biological samples. In order to identify proteins prone to be modified due to oxidative pathways, and possibly serve as biomarker, healthy human plasma was oxidized using the radical initiator AAPH. Different concentrations of AAPH and different timepoints were tested for the presence of protein carbonyl groups, an indicator for protein oxidation and possibly the formation of AGEs/ALEs. A time and concentration dependent formation of carbonyl groups is observed in plasma. Next, samples were analyzed using a bottom-up approach. Results obtained were showing many oxidation products, such as amino side chain oxidation, however no AGEs/ALEs were identified. Thus, a new approach was adopted, including the incubation of plasma directly with RCS, such as HNE, MDA and ACR. This resulted in the formation of AGEs/ALEs in plasma samples, however, they could not be retained by the VC1 domain. Instead of using the VC1 technique to enrich AGEs/ALEs from biological samples, other variables throughout the experimental set-up were optimized. Previously, peptides were analyzed using the Orbitrap LTQ XL, a very powerful instrument. Nonetheless, the newest generation of tribrid MS offers even higher resolution, and it increases protein coverage due to parallel isolation and detection, and faster analyzers. Moreover, we focused on AGEs/ALEs from HSA and using NaBH4 to reduce and stabilize adducts throughout the analysis. This new approach permitted us to identify many AGEs/ALEs in both healthy human plasma samples, but also AGEs/ALEs only present in heart failure samples. Glycation on lysine residues was the main modification identified, present in both healthy and heart failure plasma samples. Important is the HNE Michael adduct, specifically identified in only heart failure samples. Moreover, the importance of stabilizing adducts is underlined by the fact that the acrolein Michael adduct could only be identified after reduction with NaBH4. Development of a cellular assay to determine pro-inflammatory activity of RAGE binders Another part of this project was focused on elucidating whether AGEs/ALEs induce an inflammatory response in cells. For this purpose, a collaboration was started with the Laboratory of Vascular Biology and Regenerative Medicine, Centro Cardiologico Monzino. Using a rat epithelial lung cell line overexpressing RAGE, and a control cell line not expressing RAGE, it could be detected if AGEs/ALEs exhibit an effect by binding to RAGE. Moreover, both cell lines were transfected with a Nf-κB reporter gene allowing us a fast and sensitive method for determining if binding of RAGE induces a down-stream signaling pathway. This system implies a firefly luciferase gene downstream from the Nf-κB gene. When the Nf-κB pathway is activated, independently from RAGE, it produces the firefly luciferase enzyme. After adding a luciferin substrate, firefly luciferase is able to convert this substrate into another substrate with light as by-product, which can be measured by a luminometer. IL-1α was used as a positive control, since it induces a strong inflammatory response through Nf-κB. Moreover, known ligands of RAGE able to activate the Nf-κB pathway, were used to validate the cellular experiment, including HSA modified with fructose (AGE), and HMGB1. Results show that Nf-κB is already increased in untreated cells with RAGE and that AGEs induce the Nf-κB pathway independently from RAGE. Moreover, the difference between control and RAGE cells is not significantly increased in the presence of HMGB1 compared to untreated. However, the positive control seemed to induce a much stronger activity in cells with RAGE. Overall, this cellular assay is good for assessing pro-inflammatory activity, however, it is not optimized yet for distinguishing a RAGE-dependent mechanism. CONCLUSION In summary, by using an integrated MS (intact protein and bottom-up approach) and computational approach we have found that some ALEs generated from lipid peroxidation RCS are RAGE binders. We have also found the basic features that ALEs from HNE, MDA and ACR must have to be a RAGE binder: 1) the covalent adducts should greatly reduce or abolish the basicity of the target amino acid, 2) the basic amino acid should be at the center of a set of carboxylic acids which, once the residue is modified, become available to freely contact the RAGE positive residues. Next step was to use the VC1 technique to enrich AGEs/ALEs in biological samples. First, oxidized human plasma was used, however, using the Orbitrap LTQ XL, it was not sufficient to identify AGEs/ALEs. Therefore, analysis was moved to a higher resolution mass spectrometer, which allowed us to identify AGEs/ALEs in plasma samples of heart failure patients, showing the powerfulness of this new generation MS. Important was to understand whether ALEs could induce pro-inflammatory activity through RAGE, since we showed that ALEs are RAGE binders. Unfortunately, the cellular assay that was set up is efficiently in determining Nf-κB dependent pro-inflammatory activity, but not if it is RAGE dependent.

Thesis (Ph. D.)--University of California, San Diego, 2008.
Title from first page of PDF file (viewed September 3, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 104-126).

Die Interaktion von S100-Proteinen mit dem Rezeptor für advanced glycation endproducts (RAGE) wird als hoch relevant bei der Entstehung, Manifestation und Progression verschiedener entzündlicher Erkrankungen sowie bei der Tumorigenese gewertet. Das tiefergehende Verständnis der Interaktion von S100-Proteinen mit RAGE in vivo stellt eine wissenschaftliche Herausforderung dar und ist ein Ansatz für therapeutische Interventionen. Darüber hinaus stellen Untersuchungen zum Metabolismus von extrazellulär zirkulierenden S100-Proteinen in vivo einen vielversprechenden Forschungsansatz zur Analyse von S100-Protein-assoziierten Erkrankungen dar. Die einzigartigen Eigenschaften der Positronen-Emissions-Tomographie (PET) als nicht-invasives bildgebendes Verfahren erlauben die Darstellung und quantitative Erfassung biochemischer Prozesse mit der Möglichkeit zelluläre und molekulare Reaktionswege aufzuzeigen sowie in vivo-Mechanismen von Krankheiten im Kontext eines physiologischen Umfeldes darzulegen. Ziel der vorliegenden Arbeit war es, Fluor-18-markierte S100-Proteine (18F-S100) herzustellen, diese biochemisch, radiochemisch und radiopharmakologisch zu charakterisieren und deren Metabolismus und Interaktion mit RAGE in vivo mittels Kleintier-PET am Tiermodell zu untersuchen. Es wurden die mit RAGE interagierenden S100-Proteine S100A1, S100A12 und S100B in biologisch funktioneller Form hergestellt. Dazu wurden die entsprechenden S100-Gene in den prokaryotischen Expressionsvektor pGEX-6P-1 kloniert. Mit diesen Konstrukten wurden E. coli-Zellen transformiert, aus denen nachfolgend die S100-Proteine isoliert und gereinigt werden konnten. Es konnte eine Reinigung unter nativen, milden Bedingungen etabliert werden, die es ermöglichte, S100A1, S100A12 und S100B in biologisch aktiver Form und in hohen Reinheitsgraden (&gt; 95%) für die nachfolgenden Experimente bereitzustellen. Diese S100-Proteine wurden über den 18F-tragenden Aktivester N-Succinimidyl-4-[18F]fluorbenzoesäure ([18F]SFB) radioaktiv markiert und charakterisiert. Dabei konnte sichergestellt werden, dass die 18F-S100-Proteine in vitro und in vivo stabil sind. Weiterhin konnte nachgewiesen werden, dass die radioaktive Markierung keine Beeinträchtigung auf die biologische Funktionalität der S100-Proteine hat. Dies wurde anhand von sRAGE-Bindungsuntersuchungen sowie Zell-Interaktionsuntersuchungen an konfluenten Endothelzellen (HAEC) und an zu Makrophagen differenzierten THP-1-Zellen (THP-1-Makrophagen) verifiziert. Für die Untersuchung der RAGE-Bindung war die Produktion des löslichen sRAGE bzw. die Generation von flRAGE-berexprimierenden Zellen erforderlich. Beide Konstrukte wurden in geeigneten Zellsystemen exprimiert und das sRAGE-Protein wurde in biologisch aktiver Form synthetisiert und gereinigt (Reinheitsgrad &gt; 97%). Die 18F-S100-Bindung an THP-1-Makrophagen und HAEC wurde in Gegenwart von glykierten LDL (glykLDL) sowie sRAGE signifikant inhibiert, was auf eine RAGE-Interaktion hinweist. Weiterhin konnten durch den Einsatz von Scavenger-Rezeptor-Liganden, wie z. B. Maleinanhydrid-modifiziertes BSA (malBSA) bzw. von Lektinen inhibierende Effekte erzielt werden. Dies ist ein Indiz für die 18F-S100-Interaktion mit Scavenger-Rezeptoren und Glykokonjugaten an der Zelloberfläche. Durch die Untersuchungen mittels konfokaler Laserscanning-Mikroskopie an THP-1-Makrophagen wurde eine Zellaufnahme des Fluoreszein-markierten S100A12 festgestellt. Weiterhin konnten Kolokalisationen mit Lektinen detektiert werden. Das metabolische Schicksal extrazellulär zirkulierender 18F-S100-Proteine in vivo wurde mit Hilfe dynamischer PET-Untersuchungen bzw. anhand von Bioverteilungs-Untersuchungen in männlichen Wistar-Ratten analysiert. Die Hauptakkumulation der Radioaktivität wurde in der Leber und in den Nieren detektiert. In diesen Organen findet der Metabolismus bzw. die glomeruläre Filtration der 18F-S100-Proteine statt. In den Untersuchungen zur Genexpression mittels Echtzeit-PCR sowie im immunchemischen Proteinnachweis am Western Blot wurde eine hohe Expression und Proteinbiosynthese des RAGE in der Lunge ermittelt. Die Lunge eignet sich daher als „Referenz“-Organ für eine funktionelle in vivo-Charakterisierung von RAGE mit 18FS100-Proteinen. Bei den durchgeführten PET-Untersuchungen konnte eine temporäre 18F-S100-Interaktion mit dem Lungengewebe festgestellt werden. Die Retention des 18FS100A12 in der Lunge wurde in Gegenwart von sRAGE inhibiert. Dies ist ein Hinweis dafür, dass 18F-S100-Proteine auch in vivo an RAGE binden können. Die Radioaktivitäts-Akkumulation in den Organen Leber und Milz, die eine Vielzahl von sessilen Makrophagen aufweisen, wurde durch die Applikation von malBSA inhibiert. Dies ist ein Indiz dafür, dass 18F-S100-Proteine in vivo mit Scavenger-Rezeptoren interagieren können. Die vorliegende Arbeit liefert deutliche Hinweise darauf, dass RAGE nicht der alleinige Rezeptor für 18F-S100-Proteine ist. Der Einsatz von 18F-S100-Proteinen als experimentelles Werkzeug in dynamischen PET-Untersuchungen birgt das Potential einer Charakterisierung von S100-Protein-assoziierten, pathophysiologischen Prozessen
Members of the S100 family of EF-hand calcium binding proteins play important regulatory roles not only within cells but also exert effects in a cytokine-like manner on definite target cells once released into extracellular space or circulating blood. Accordingly, increased levels of S100 proteins in the circulating blood have been associated with a number of disease states, e.g., diabetes, cancer, and various inflammatory disorders. As the best known target protein of extracellular S100 proteins, the receptor for advanced glycation endproducts (RAGE) is of significant importance. However, the role of extracellular S100 proteins during etiology, progression, and manifestation of inflammatory disorders still is poorly understood. One reason for this is the shortage of sensitive methods for direct assessment of the metabolic fate of circulating S100 proteins and, on the other hand, measurement of functional expression of extracellular targets of S100 proteins, e.g., RAGE in vivo. In this line, small animal PET provides a valuable tool for noninvasive imaging of physiological processes and interactions like plasma or vascular retention, tissue-specific receptor binding, accumulation or elimination in vivo. To address this question, human S100 proteins were cloned in the bacterial expression vector pGEX-6P-1, expressed in E. coli BL21, and purified by affinity chromatography and anion exchange chromatography. Purified S100A1, S100B and S100A12 proteins were then radiolabeled with the positron emitter fluorine-18 (18F) by N-succinimidyl-4-[18F]fluorobenzoate ([18F]SFB). Radiolabeling of S100 proteins resulted in radiochemical yields of 3-10% (corrected for decay) and effective specific radioactivities of 1 GBq/µmol, respectively. For investigations about RAGE binding soluble RAGE (sRAGE) was expressed and purified using pSecTag2B. A radioligand binding assay confirmed specific binding of 18F-S100A12, 18F-S100A1, and 18F-S100B to immobilized sRAGE, also showing an order of affinity with S100A12 &gt; S100A1 &gt; S100B. These results indicate that radioactive labelling of S100 proteins did not affect their overall affinity to RAGE. Cellular association studies in human THP-1 macrophages and human aortic endothelial cells (HAEC) showed specific binding of all 18F-S100 proteins to the non-internalizing RAGE as confirmed by inhibitory effects exerted either by other RAGE ligands, e.g., glycated LDL, or by soluble RAGE. Of interest, 18F-S100 proteins were also shown to interact with other putative binding sites, e.g. scavenger receptors as well as proteoglycans. In this line, uptake of 18F-S100 proteins in THP-1 and HAEC could be inhibited by various scavenger receptor ligands, in particular by maleylated BSA as well as by lectines (e.g. ConA and SBA). Confocal laser scanning microscopy analysis showed a major part of the fluoresceinated S100A12 bound to the surface of THP-1 macrophages. Beyond this, uptake of S100A12 could be determined indicating an interaction of S100A12 with both non-internalizing, e.g., RAGE, and internalizing receptors, e.g. scavenger receptors. By evaluation of the relative contribution of 18F-S100A12 association to RAGE-overexpressed CHO cells (using pIres2-AcGFP1), 18F-S100A12 showed a significantly higher association to CHO-RAGE cells compared with CHO-mock cells. Based on these findings and due to their crucial role in inflammatory disorders the metabolic fate of S100 proteins was further investigated in dynamic small animal Positron emission tomography (PET) studies as well as in biodistribution studies in Wistar rats in vivo. For interpretation of in vivo investigations in rats, expression of RAGE was analyzed by quantitative real time RT-PCR as well as western blotting in various organs. Lung tissue expressed the highest level of RAGE protein compared to the other tissues. PET studies in rats revealed a comparatively long mean residence time of circulating 18F-S100 proteins. A major contributor to this phenomenon seems to be a sustained temporary interaction with tissues overexpressing RAGE, e.g., the lung. On the other hand, renal clearance of 18F-S100 via glomerular filtration is a major elimination pathway. However, scavenger receptor-mediated pathways in the liver, the spleen and, to a minor extent, in the kidneys, also seem to contribute to the overall clearance. The presence of sRAGE revealed a decreased retention of 18F-S100A12 in the lung, indicating in vivo binding to RAGE. In vivo blocking studies using maleylated BSA demonstrated a strong inhibition of putative binding sites in rat tissues enriched in cells expressing scavenger receptors like liver and spleen. In conclusion, 18F-labeling of S100 proteins and the use of small animal PET provide a valuable tool to discriminate the kinetics and the metabolic fate of S100 proteins in vivo. Furthermore, the results strongly suggest an involvement of other putative receptors beside RAGE in distribution, tissue association and elimination of circulating proinflammatory S100 proteins. Moreover, the approach provides novel probes for imaging of functional expression of RAGE and scavenger receptors in peripheral inflammatory compartments

Dans un contexte de vieillissement de la population et d’accroissement des maladies chroniques liées à l’âge comme le diabète, de nouveaux biomarqueurs de l’état de santé à long terme doivent être étudiés. Les produits de glycation avancée (AGE) sont des molécules témoins de la charge métabolique accumulée au cours du temps, dénommée "mémoire métabolique". Les AGE jouent un rôle important dans les lésions à long terme dans le diabète et dans le déclin du métabolisme global lié au vieillissement. L’accumulation cutanée des AGE peut être mesurée par autofluorescence (AF) de manière instantanée et non invasive grâce à l’AGE-READER. Les objectifs de cette thèse étaient d’évaluer la valeur de l’AF cutanée des AGE en tant que marqueur de mémoire métabolique chez des personnes âgées de la cohorte des 3-Cités et parallèlement d’évaluer la valeur pronostique de l’AF pour les complications du diabète chez des patients porteurs de diabète de type 1. Chez les personnes âgées, nous avons montré que l’AF reflétait les statuts glycémique et rénal 10 ans avant la mesure. Chez les patients atteints de diabète de type 1, l’AF était associée à la présence d’une neuropathie 4 ans plus tard. De plus, dans cette même population, nous avons décrit l’évolution de l’AF sur 4 ans de suivi. Nous avons montré que les principaux déterminants de son évolution étaient la fonction rénale et le traitement par pompe à insuline. Enfin nous avons trouvé que l’augmentation de l’AF sur 4 ans de suivi était associée à la survenue de la maladie rénale. Ces travaux soulèvent de nouvelles perspectives de recherche quant à l’intérêt de l’AF à différents âges clés de la vie en tant que biomarqueur de pathologies qui évoluent sur des dizaines d’années
In the context of the ageing of the population and the increase of age related diseases such as diabetes, new biomarquers of the long-term health status should be considered. Advanced glycation end products (AGE) are molecules indicators of the metabolic burden over time, called “metabolic memory”. AGE play an important role in long term diabetes injuries and in the global decline of the metabolism related to ageing. Skin accumulation of AGE can be measured by autofluorescence instantly and non-invasivly with a tool called AGE-READER. The objectives of my dissertation were to evaluate the value of the skin autofluorescence (sAF) of AGE as marker of metabolic memory in elderly people from the 3-City cohort and in parallel, in patients with type 1 diabetes, evaluate the prognostic value of sAF for diabetes complications. In the elderly population, we showed that sAF reflected glycemic and renal status of 10 years before. In patients with type 1 diabetes, sAF was associated to the presence of neuropathy 4 years later. Moreover, in this same population, we described the evolution of sAF in 4 years of follow-up and we showed that the principal determinants of the evolution of sAF were kidney function and insulin pump therapy. Finally, we also found that increase of sAF in 4 years was associated with the occurrence of kidney disease. This work rises new research opportunities about the interest of sAF at differents key ages as biomarker of pathologies which evolve in several decades

Myocardial infarction (MI) persists as one of the leading causes of death worldwide. Often patients whom survive the initial injury will develop heart failure characterized by a dilated and functionally incompetent heart. Heart failure (HF) carries a worse prognosis than most cancers, and the only curative therapy to date is heart transplantation. A better understanding of the repair and remodeling processes post-MI, and the development of novel therapies are required to combat this burgeoning medical challenge. This thesis research sought to identify a novel mediator of the impaired cardiac remodeling that often occurs post-MI, and to characterize a biomaterial hydrogel therapy as a novel treatment. We investigated the role of methylglyoxal (MG), an important precursor to advanced glycation end-products (AGE), using a transgenic mouse model to over-express glyoxalase 1 (GLO1). GLO1 is the primary enzyme involved in metabolizing MG and preventing its accumulation. The role for MG and AGEs in MI and HF had been alluded to in the literature, yet no study to date has causally linked them with the loss of function and impaired remodeling of the post-MI heart. We also assessed an injectable hydrogel for the treatment of MI using a mouse model and evaluated the impact of delivery timing on its therapeutic efficacy. In this thesis, we confirmed that MG derived AGEs accumulate post-MI (Chapter 3.1). We show that preventing their accumulation, through GLO1 over-expression, mitigates the loss of function post-MI and positively influences remodeling through reducing final infarct sizes and end-systolic volumes. We demonstrate that this may possibly occur through improving the bone marrow response post-MI by restoring ECM-cell signaling. In Chapter 3.2, we present results of a study assessing the efficacy of a collagen based injectable hydrogel for the treatment of MI, and assessing the role that timing plays into the benefits associated with this therapy by studying 3 separate timepoints including 3 hours, 7 days and 14 days post-MI. We found that the injectable hydrogel preserved cardiac function and reduced infarct sizes. It also positively interacted with the host repair response by reducing chronic inflammation and cell death. The benefits of the therapy depended on when the material was delivered, and we found that the earliest timepoint (3 hours post-MI) proved most beneficial. In Chapter 3.3, we combined the knowledge gained from Chapters 3.1 and 3.2 and functionalized our hydrogel with a flavonoid, Fisetin, that has been shown to scavenge MG and increase the activity of GLO1. We show that this novel functionalized material may be able to restore some function in MI, particularly in settings of low baseline cardiac function. Taken together, the results of this thesis demonstrate that MG accumulates as a result of the ischemia and contributes to the impaired repair resolution and remodeling processes post-MI. This identifies MG as a possible novel target for the treatment of MI. Indeed, we also confirm the role that delivery timing plays into injectable hydrogels post-MI, and present promising results for a functionalized material design to intervene on MG production.

Background: L'invecchiamento è un inevitabile fattore di rischio in età avanzata che può influenzare l'insorgenza e la progressione di diverse malattie. Infatti, l'elevata incidenza di malattie cardiovascolari negli anziani è principalmente imputabile al fisiologico rimodellamento cardiaco associato ad un invecchiamento intrinseco. RAGE è un recettore capace di legare diverse molecole e coinvolto in molte malattie legate all'età. La sua isoforma solubile (sRAGE) agisce come un recettore decoy bloccando l'attivazione del recettore legato alla membrana, e suoi livelli circolanti sono stati trovati alterati in diverse patologie croniche ed acute. Il ruolo delle isoforme di RAGE durante l’invecchiamento e, in particolare, nell’invecchiamento cardiaco, non è mai stato studiato. Inoltre, la scoperta di biomarcatori affidabili in grado di valutare lo stato di salute individuale dei soggetti ha importanti applicazioni nel campo della prevenzione, della diagnosi e della gestione della malattia. In tale contesto, lo scopo di questo studio è stato quello di verificare se sRAGE sia un biomarcatore di invecchiamento e di rimodellamento cardiaco legato all’invecchiamento, e valutare il contributo delle isoforme RAGE nell’invecchiamento cardiaco. Risultati: È stato collezionato il siero di soggetti sani, di entrambi i sessi, di età compresa tra i 20 e i 92 anni ed i livelli di sRAGE sono stati valutati mediante ELISA. Abbiamo trovato una significativa diminuzione di sRAGE circolante nei maschi, mentre solo una tendenza nelle femmine. Di conseguenza, abbiamo osservato una forte correlazione di sRAGE con l'età cronologica nei soggetti maschi, ma non nei soggetti di sesso femminile. Topi maschi e femmine a diverse età (2.5-12-22 mesi, Giovani, adulti (MA) e Vecchi, rispettivamente) sono stati sottoposti a ecocardiografia 2D per determinare le dimensioni e la funzione del ventricolo sinistro (LV) durante l'invecchiamento. sRAGE serico diminuisce in maniera simile in entrambi i sessi tra il gruppo Giovani e il gruppo MA, e correla inversamente con le dimensioni e la funzione del LV, in particolare nei machi. Nessuna quantità rilevabile di RAGE è stata trovata nei lisati proteici del LV a tutte le età. Topi Rage-/- hanno mostrato un significativo aumento dei volumi e dei diametri del LV in diastole e in sistole, ed una concomitante diminuzione della frazione di eiezione (EF) e di accorciamento (FS), rispetto agli animali Rage+/+ di pari età durante l'invecchiamento con le più forti differenze presenti tra i gruppi MA. Inoltre, topi MA Rage-/- hanno mostrato la maggiore deposizione di collagene e l’aumento dell'espressione di geni marcatori di scompenso cardiaco (BNP e Ankrd1) rispetto alla controparte Rage+/+. Al contrario, nessuna differenza in termini di dimensioni dei cardiomiociti è stata osservata a qualsiasi età tra i due genotipi. Infine, l’analisi funzionale di annotazione del microarray, basata sull'interazione fra età-genotipo, ha rivelato che la mancanza cronica di RAGE influenza l'espressione di geni associati alla funzione contrattile, al processo di presentazione dell'antigene e dell'immunità adattativa, del pathway dell’insulina, della morte cellulare e dell’apoptosi. Abbiamo anche trovato una correlazione tra i volumi e i diametri del LV in diastole e in sistole e i geni differenzialmente espressi, i quali sono coinvolti in diversi processi come la contrazione muscolare, la fibrosi e la regolazione dell'apoptosi. Conclusioni: I nostri risultati indicano che sRAGE è un biomarcatore serico di invecchiamento sano e di rimodellamento cardiaco legato all'età, preferenzialmente nei maschi. L'assenza di RAGE aggrava l’avverso rimodellamento cardiaco legato all'età. Proponiamo che, tra le isoforme RAGE, sRAGE possa giocare un ruolo fondamentale nell’invecchiamento cardiaco.
Background: Aging is an unavoidable risk factor in later life that can influence the onset and progression of many diseases. In fact, the high incidence of cardiovascular diseases in the elderly is mainly attributable to cardiac remodelling associated to physiological intrinsic aging. RAGE is a multi-ligand receptor involved in many age-related disorders. Its soluble isoform (sRAGE) acts as a decoy receptor being able to block the activation of the membrane-bound receptor, and its circulation levels have been found altered in several chronic and acute pathologies. The role of RAGE isoforms in aging and, in particular, cardiac senescence has never been investigated. Moreover, the finding of reliable biomarkers able to assess individual health status of subjects has important applications in prevention, diagnosis, and disease management. In this context, the aim of this study was to ascertain whether sRAGE is a biomarker of aging and age-related cardiac remodelling, and evaluate the contribution of RAGE isoforms to cardiac aging. Results: Serum of male and female from 20 to 92 years old healthy subjects was collected and sRAGE levels were evaluated by ELISA. We found a significant decrease of circulating sRAGE in males while only a trend in females. Accordingly, we observed a strong correlation of sRAGE with chronological age in male but not in female subjects. Male and female mice at different age (2.5-12-22-months, Young, Middle Age (MA) and Old, respectively) undergone 2D-echocardiography to determine the left ventricle (LV) dimensions and function during aging. Serum sRAGE similarly declines from the Young to the MA group in both sexes, and inversely correlate with LV dimensions and function, preferentially in males. No detectable amount of RAGE protein was found in LV at all ages. Rage-/- mice displayed a significant increase of LV volumes and diameters in diastole and systole, and a concomitant decrease in ejection fraction (EF) and fractional shortening (FS), compared to age-matched wt animals during aging with the strongest differences present between the MA groups. Moreover, MA Rage-/- mice exhibited higher deposition of collagen and expression of heart failure marker genes (BNP and Ankrd1) in respect to the wt counterpart. Conversely, no differences in cardiomyocytes size were observed at any age between the two genotypes. Finally, microarray functional annotation analysis based on the interaction between age-genotype revealed that the chronic lack of RAGE affected the expression of genes associated to contractile fibre function, antigen presenting process and adaptive immunity, insulin pathway, cell death and apoptosis. We also found a correlation between LV volumes and diameters in diastole and systole and differentially expressed genes involved in several processes like muscle contraction, fibrosis, wound healing and regulation of apoptosis. Conclusions: Our results indicate that sRAGE is a serum biomarker of healthy aging and age-related cardiac remodeling, preferentially in males. The absence of RAGE in mice exacerbates adverse cardiac remodeling with age. We propose that, among RAGE isoforms, sRAGE may play a pivotal role in cardiac senescence.

AGEs accumulate in the Bruch's membrane with a detrimental effect on RPE function with age. Receptor for AGEs (RAGE) is hypothesised to have an important role in RPE dysfunction and AMD pathogenesis. It is reported to be highly expressed in the RPE and its activation leads to the induction of pro-inflammatory cytokines and oxidative stress in many other tissues. SI OOB is a ligand for RAGE and its role in retinal inflammation is not clear. This project investigated the link between RAGE activation by S100B and how this relates to RPE dysfunction and the pathogenesis of AMD. Serum analysis using ELISA showed that S100B was significantly elevated in nvAMD with no significant changes in sRAGE levels. Laser induced CNV in RAGE -/- and WT mice showed that the genetic depletion of RAGE results in smaller lesion size and concomitant infiltration of macrophages into the sub-retinal space. RAGE knock-down in endothelial cells (HMEC-l) was achieved by siRNA and SI OOB treatment almost abolished VEGF secretion and angiogenesis in RAGE knockdown cells compared to control cells which was measured by migration and tube formation. This demonstrates that RAGE is essential for SI OOB induced signal transduction and angiogenic activity. Signalling studies showed that MAPK and AKT were less phosphorylated in RAGE knocked-down cells compared to controls with SI OOB treatment resulting in less NFK,B activation and pro-inflammatory cytokines. Caspase-3 was activated after prolonged exposure to SI OOB indicating that SI 00-RAGE mediates RPE apoptosis. This data was further supported by microarray analysis of the same group of cells. Overall, this thesis supports the hypothesis that RAGE plays an important role in RPE dysfunction and several inflammation-mediated aspects of AMD. At least in part, RAGE activation is mediated through SI OOB . This axis could play a hitherto unrecognised role in RPE age-related dysfunction and, importantly, the pathogenesis of AMD.

Pre-gestational diabetes increases the risk of congenital malformation in the offspring and both morbidity and mortality in the diabetic mother and her offspring. During pregnancy, high glucose levels act as a teratogen through several cellular and biochemical pathways and increased production of reactive oxygen species (ROS) has a central role in diabetic embryopathy. The aim of this work was to investigate the importance of genetic predisposition for congenital malformations and to study the genes involved in the teratogenic process of diabetic pregnancy. The crossbreeding of two rat strains, with both low and high incidence of diabetes-induced malformations, indicated that strain-specific maternal factors, such as disturbed serum levels of amino acids, triglycerides, and β-hydroxybutyrate, were associated with malformation. In addition, disturbed fetal expression of genes involved in ROS defense and development (Shh, Bmp4, Ret and Gdnf) in mandible and heart, and decreased activity of Gapdh and Aldose Reductase were associated with the teratogenic process, and the trans-generational heredity of the mother determined the type of malformations induced by maternal diabetes. In rat embryos, a diabetic environment in utero changed the expression of genes involved in ROS defense (Nrf2, Gpx1 and Cat), development of mandible and heart (Msx2, Shh, Bmp4, Ret and Gdnf), and neural tube closure and apoptosis (Pax3 and p53). The changes were divergent with tissue-specific alterations of gene expression in developing mandible, heart anlage, and whole embryo. Disruption of the Receptor for Advanced Glycation End products (RAGE) had a protective effect against diabetic embryopathy in mice, and the blockage of RAGE diminished ROS production in the offspring: this supported oxidative stress being a necessary etiological component in diabetic embryopathy. Maternal metabolic state and genetic susceptibility influence fetal outcome in experimental diabetic pregnancy. Disturbed protection against oxidative stress and tissue-specific derangements in the expression of developmental genes play pivotal roles in the teratogenic mechanism, and enhanced levels of Advanced Glycation End products (AGE) and RAGE-induced oxidative stress are involved in diabetic dysmorphogenesis.

Das S100A4-Protein ist für die Manifestierung eines metastatischen Phänotyps bei vielen Tumorarten von enormer Bedeutung. Die Aufklärung der zugrunde liegenden Mechanismen und der Interaktionspartner von S100A4 stellt daher einen vielsprechenden Forschungsansatz dar, um neue Erkenntnisse über das Verhalten von Tumorzellen während des Metastasierungsprozesses zu erhalten. Darauf aufbauend können neue Ansatzpunkte für die Therapie metastasierender Krebserkrankungen gewonnen werden. In dieser Hinsicht ist das bisher einer Behandlung kaum zugängliche maligne Melanom als besonders aggressiver und frühzeitig metastasierender Tumor ein ideales Modell zur Aufklärung der zellulären und molekularen Prozesse, über die S100A4 seine Metastasen-fördernden Wirkungen ausübt. Das Ziel der vorliegenden Arbeit war die biochemische und radiopharmakologische Charakterisierung der S100A4-RAGE-Interaktion sowie die Untersuchung der Beteiligung von S100A4 an Prozessen der Metastasierungskaskade in vitro und in vivo. Dies erforderte die Herstellung von rekombinantem S100A4-Protein und die Generierung von stabil mit S100A4-transfizierten Melanomzellen, die damit eine heraufregulierte S100A4-Proteinbiosynthese aufweisen. Die Gewinnung von rekombinantem S100A4 in biologisch funktioneller Form unter Verwendung eines prokaryotischen Expressionssystems erfolgte mit einem Reinheitsgrad von ca. 92%. Das rekombinante S100A4-Protein wurde mit dem Aktivester N-Succinimidyl-4-[18F]fluorbenzoat radioaktiv markiert und charakterisiert. Es wurde die Interaktion zwischen S100A4 bzw. 18F-markiertem S100A4 und der löslichen RAGE-Isoform sRAGE mit einer moderaten Bindungsaffinität im µM-Bereich nachgewiesen. Des Weiteren erfolgte erstmals die Analyse der radiopharmakologischen Eigenschaften von 18F-S100A4 mittels Untersuchungen zur zellulären Assoziation sowie zur metabolischen Stabilität, Bioverteilung und zu In-vivo-Interaktionen mittels Kleintier-Positronen-Emissions-Tomographie in der Ratte. Die In-vitro-Experimente wurden an Endothelzellen (HAEC) und an stabil mit RAGE-transfizierten A375-, A375-mock bzw. nicht transfizierten A375-Melanomzellen durchgeführt. Die A375-hRAGE-Zellen zeigten eine deutlich heraufregulierte RAGE-Proteinbiosynthese während die Endothelzellen eine vergleichsweise geringe intrazelluläre RAGE-Proteinkonzentration aufwiesen. Bei den Melanomzellen kann aufgrund der höheren Assoziation von 18F-S100A4 an A375-hRAGE-Zellen auf eine selektive Bindung von 18F S100A4 an RAGE-Rezeptoren auf der Zelloberfläche geschlossen werden. Die Assoziation von 18F S100A4 an Endothelzellen war bei 37°C in Gegenwart von nicht markiertem rekombinantem S100A4 signifikant vermindert, dementsprechend findet eine spezifische Interaktion von 18F-S100A4 mit Zelloberflächenrezeptoren der Endothelzellen statt. Dieses Ergebnis und die insgesamt höhere Bindung von 18F S100A4 an Endothelzellen im Vergleich zur Assoziation an Melanomzellen lassen neben RAGE noch andere Rezeptoren wie z. B. internalisierende Scavenger-Rezeptoren vermuten. Die In-vivo-Stabilitätsuntersuchungen verdeutlichen einen proteolytischen Abbau von 18F S100A4, allerdings belegen das Vorhandensein von 67% intaktem 18F-S100A4-Protein nach einer Stunde, die Stabilität von 18F-S100A4 in vivo. Die Bioverteilungs- bzw. PET-Untersuchungen zeigen eine schnelle, innerhalb weniger Minuten stattfindende hohe Akkumulation in den Nieren und verdeutlichen somit die renale Ausscheidung von 18F S100A4. Die maßgeblichen Anreicherungen in Milz, Leber, Blut, Lunge und Nebennieren lassen Interaktionen mit Oberflächenrezeptoren dieser Gewebe erkennen. Die temporäre Retention von 18F-S100A4 in der Lunge, dem Hauptsyntheseorgan von RAGE, und die verminderte 18F-S100A4-Akkumulation in Gegenwart des spezifischen RAGE-Liganden glykLDL ist ein Hinweis dafür, dass S100A4 in vivo in der Lunge an RAGE bindet. Die Aktivitätsanreicherungen in Milz, Leber und Nebenniere deuten aufgrund der geringeren RAGE-Synthese in diesen Organen auf die Interaktion von 18F-S100A4 mit anderen Zelloberflächenrezeptoren z. B. aus der Familie der Scavenger-Rezeptoren hin. Die Beteiligung von S100A4 an Metastasierungsprozessen des malignen Melanoms wurde an stabil mit S100A4-transfizierten A375-Melanomzellen, die eine Heraufregulierung der humanen bzw. murinen S100A4-Proteinbiosynthese im Vergleich zu A375-mock- (Vektor-Kontrolle) und nicht-transfizierten A375-Zellen zeigen, untersucht. Die A375-hS100A4-Zellen sezernierten zudem eine signifikant höhere S100A4-Proteinkonzentration in das umgebende Zellkulturmedium im Vergleich zu den Kontrollen. In dieser Hinsicht konnte bei den A375-hS100A4-Zellen, vermutlich aufgrund der höheren extrazellulären S100A4-Konzentration, eine gesteigerte Proliferations-, Motilitäts-, Migrations- und Invasionsrate gegenüber den A375-mock- und A375-Zellen nachgewiesen werden. In diesem Zusammenhang stehen ebenso die gesteigerte RAGE-Proteinbiosynthese und die signifikant höhere Aktivität des Transkriptionsfaktors NF-κB bei A375-Zellen nach 24-stündiger Inkubation mit Kulturmedium der A375-hS100A4-Zellen. Demnach wirkt vermutlich das extrazelluläre S100A4-Protein als autokriner bzw. parakriner Regulator von RAGE und NF κB. Die subkutane Injektion der A375- und stabil transfizierten A375-Melanomzellen in Nacktmäuse führte zur Entwicklung subkutaner Tumore an der Injektionsstelle. Bereits zwei Wochen nach der Injektion etablierten die A375-hS100A4-Zellen die signifikant größeren Tumore im Vergleich zu den A375-mS100A4-, A375-mock und A375-Zellen. Nach Injektion der Zellen in die Schwanzvene der Nacktmäuse konnte keine Entwicklung von Metastasen im Tierkörper festgestellt werden. IN DER VORLIEGENDEN ARBEIT WURDE NACHGEWIESEN: • RAGE ist ein Rezeptor für das S100A4-Protein. Allerdings gibt es eindeutige Hinweise für weitere S100A4-Zielproteine an der Zelloberfläche. • Die bedeutende Rolle von extrazellulärem S100A4 bei wichtigen zellulären Metastasierungsprozessen sowie bei der Aktivierung von Signalproteinen wie NF-κB und RAGE beim malignen Melanom. Die weitere Aufklärung der S100A4-spezifischen Signalkaskaden und Rezeptoren bei metastasierenden Tumorerkrankungen sowie die Charakterisierung von S100A4 als klinischen Parameter bei Patienten mit malignem Melanom stellen hoch interessante Aspekte in der Krebsforschung dar.

Many diets of different compositions are available for use in animal experiments and have been used as standard, but they may induce adverse metabolic effects, compromising the comparison between the results of several studies. The literature records many reports of changes related to the use of these diets, however it lacks studies that compare metabolic effects of consumption of the different standard diets in animal experiments. Accordingly, the objective of this dissertation was to evaluate the metabolic effects of the consumption of diets considered standard widely used in animal research, being presented in the form of two articles: a review of the literature that gathers evidence yet little discussed by the scientific community on the feeding of laboratory animals; the second article refers to an experimental study with rats newly weaned, who received two types of diets: a commercial cereal-based, Nuvilab®, and another purified proposal by the American Institute of Nutrition, the AIN-93. Under the experimental conditions established, coefficients of protein and feeding efficiency presented significantly higher in group AIN-93 than in group Nuvilab®. The AIN-93 showed significantly higher lipid and protein digestibility than Nuvilab®. The different diets did not cause weight difference evolution of animals and histological analysis to the optical microscope of the kidneys, heart, spleen, stomach and small intestine showed no changes in the structures of these bodies, despite the different treatments. Animals fed the AIN-93 diet, regardless of age, had hepatic steatosis in frequency significantly higher than the animals that received the commercial Nuvilab®. The different diets did not cause influence on the absolute and relative weights of organs of animals, except for the absolute weight of the liver among younger animals and relative weight of the intestine among older animals. There was no influence of different diets on biochemical parameters evaluated, and the differences detected possibly resulting from the interaction between age and length of exposure of animals to diets. The markers of damage of kidney and liver function were similar and serum creatinine varied according to age. It was shown that both diets, AIN-93 and Nuvilab ®, are able to promote the growth of rats for a period of study considered subchronic. However, the occurrence of hepatic steatosis in animals fed the AIN-93 diet in pellets, reinforces the importance of tracking the standard protocols of experimentation and is indicative of nutritional inadequacies by imposing the need for further investigations to clarify which components or characteristics of this diet, widely used in animal experiments, may have contributed to this result. For instance, it is suggested that diets in the form of flour are used preferably those pellets, particularly on protocols to investigate metabolic effects.
Fundação de Amparo a Pesquisa do Estado de Alagoas
Várias dietas de diferentes composições estão disponíveis para o uso em experimentação animal e têm sido utilizadas como padrão, mas podem induzir efeitos metabólicos distintos, comprometendo a comparação entre os resultados dos diversos estudos. A literatura registra inúmeros relatos de alterações relacionadas ao uso dessas dietas, porém, há carência de estudos que comparem os efeitos metabólicos do consumo das diferentes dietas padrão utilizadas em experimentos animais. Assim sendo, o objetivo da presente dissertação foi avaliar as repercussões metabólicas do consumo de dietas consideradas padrão, amplamente utilizadas na pesquisa animal, sendo apresentada na forma de dois artigos: uma revisão da literatura, que reúne evidências ainda pouco debatidas pela comunidade científica relativas à alimentação de animais de laboratório, e um segundo artigo, que se refere a um estudo experimental com ratos Wistar recémdesmamados, que receberam dois tipos de dieta: uma comercial à base de cereais, Nuvilab®, e outra purificada proposta pelo American Institute of Nutrition, a AIN-93. Nas condições experimentais estabelecidas, coeficientes de eficiências protéica e alimentar apresentaram-se significativamente maiores no grupo AIN-93 que no grupo Nuvilab®. A AIN-93 apresentou digestibilidades lipídica e protéica significativamente maiores que a Nuvilab®. As diferentes dietas não causaram diferença na evolução ponderal dos animais e a análise histológica ao microscópio óptico dos rins, coração, baço, estômago e intestinos não evidenciou alterações nas estruturas desses órgãos, apesar dos diferentes tratamentos. Os animais alimentados com a dieta AIN-93, independente da idade, apresentaram esteatose hepática em uma frequência significativamente maior que os animais que receberam a comercial Nuvilab®. As diferentes dietas não exerceram influência sobre os pesos absoluto e relativo dos órgãos dos animais, com exceção do peso absoluto do fígado, entre os animais mais jovens, e do peso relativo do intestino, entre os animais mais velhos. Não se observou influência das diferentes dietas sobre os parâmetros bioquímicos avaliados, sendo as diferenças detectadas possivelmente resultantes da interação entre a idade e o tempo de exposição dos animais às dietas. Os marcadores de lesão e função hepática e renal foram similares e a creatinina sérica variou em função da idade. Demonstrou-se que ambas as dietas, AIN-93 e Nuvilab®, são capazes de promover o crescimento de ratos Wistar por um período de estudo considerado subcrônico. Porém, a ocorrência de esteatose hepática nos animais alimentados com a dieta AIN-93 peletizada, reforça a importância de monitoramento de protocolos padrão de experimentação e é indicativa de inadequações nutricionais, impondo a necessidade de investigações adicionais para esclarecer que componentes ou características dessa dieta, amplamente utilizada em experimentação animal, podem ter contribuído para tal resultado. Por hora, sugere-se que a dieta AIN-93 seja oferecida preferencialmente na forma de farinha, particularmente em protocolos que investiguem efeitos metabólicos.

Le glaucome est une maladie neurodégénérative qui se définit par une perte progressive en fibres nerveuses rétiniennes et un rétrécissement du champ visuel. Il s’agit de la première cause de cécité irréversible dans le monde et le principal facteur de risque est la pression intraoculaire (PIO). L’étude ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) est une étude épidémiologique qui a pour but de déterminer l’incidence des différentes pathologies oculaires liées à l’âge avec les facteurs nutritionnels, démographiques ou environnementaux dans une population représentative de la région de Bordeaux. En 2009-2010, 624 sujets âgés de plus de 74 ans ont bénéficié d’un examen ophtalmologique complet incluant un examen du nerf optique en rétinophotographie et en tomographie à cohérence optique spectral-domain (SD-OCT), d’une mesure la PIO au tonomètre à air et d’une évaluation des propriétés biomécaniques de la cornée. Une mesure de l’accumulation cutanée de produits de glycation avancée a été réalisée par autofluorescence. Le diagnostic de glaucome a été réalisé en utilisant les critères de la classification ISGEO (International Society for Epidemiologic and Geographical Ophthalmology). Les paramètres biomécaniques de la cornée étaient modifiés avec l’âge et chez les sujets ayant une histoire résidentielle à des latitudes plus exposées aux ultraviolets ambiants. L’épaisseur de cornée était plus élevée chez les sujets anciennement fumeurs. L’autofluorescence cutanée ≥ 2.7 UA (Unité Arbitraire) était indépendamment associée au glaucome. Les paramètres d’épaisseur en fibres nerveuses rétiniennes du SD-OCT présentaient de bonnes performances diagnostiques pour discriminer les sujets glaucomateux des témoins et la base normative présentait de bonnes performances discriminatives lorsqu’au moins un des paramètres était considéré comme anormal. Notre étude apporte des résultats originaux en termes de facteurs de risque de glaucome ou de déterminants des facteurs de risque de glaucome. De plus les performances diagnostiques du SD-OCT pourraient fournir des informations utiles pour optimiser les stratégies de dépistage du glaucome dans une population générale âgée
Glaucoma is a neurodegenerative disease defined by a progressive loss of optic nerve axons and retinal ganglion cells resulting in a characteristic enlargement of the optic nerve head cup and associated visual field defects. It remains the first cause of irreversible blindness worldwide and intraocular pressure (IOP) is the main risk factor. The ALIENOR (Antioxydants, Lipides Essentiels, Nutrition et maladies OculaiRes) study is a population-based study. It aims to assess the associations of age-related eye diseases with nutritional, demographic and environmental factors in a representative population of the Bordeaux area. In 2009-2010, 624 subjects, aged 74 years or more, underwent a complete eye examination, including an optic nerve head evaluation using retinophotography and a spectral-domain optical coherence tomography (SD-OCT), an IOP measurement using air-puff tonometry and an evaluation of biomechanical properties of the cornea. A measurement of skin accumulation of advanced glycation end-products was performed using an autofluorescence reader. Glaucoma diagnosis was made using ISGEO (International Society for Epidemiologic and Geographical Ophthalmology) criteria. Biomechanical properties of the cornea were modified by increasing age and in subjects having a higher lifetime ambient ultraviolet exposure. Central corneal thickness was thicker in former smokers. Skin autofluorescence values ≥ 2.7 AU (Arbitrary Unit) were independently associated with glaucoma. SD-OCT retinal nerve fiber layer thickness parameters had good diagnostic performances for discriminating glaucoma and control subjects and the normative database had good diagnostic performances if at least one parameter was considered abnormal by the machine. Our study provides new insights on glaucoma risk factors and determinants of glaucoma risk factors. Furthermore diagnostic performances of SD-OCT may provide valuable information in a screening strategy to optimize glaucoma detection in a general population of elderly people