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Journal of Endocrinological Investigation

, Volume 31, Issue 6, pp 558–562 | Cite as

Immunogenicity of advanced glycation end products in diabetic patients and in nephropathic non-diabetic patients on hemodialysis or after renal transplantation

  • A. M. Buongiorno
  • S. Morelli
  • E. Sagratella
  • R. Cipriani
  • S. Mazzaferro
  • S. Morano
  • M. Sensi
Original Articles

Abstract

Advanced glycation end products (AGE) increase as a consequence of diabetic hyperglycemia and, in nephropathic patients, following renal function loss. Protein-bound AGE behave as immunogens, inducing formation of specific antibodies (Ab-AGE). In this work AGE immunogenicity was studied in 42 diabetic patients, 26 nephropathic patients on hemodialysis and 26 patients with end-stage renal disease who underwent kidney transplantation and in 20 normal subjects. Non-oxidation-derived AGE (nox-AGE), oxidation-derived AGE (ox-AGE) and Ab-AGE were measured by competitive or direct enzyme-linked immunosorbent assay (ELISA) and circulating immune complexes (CIC) by C1q ELISA. Nox-AGE increased significantly in all patient groups (p≤0.05 to ≤0.0001) except in patients on hemodialysis for less than 6 yr. Ox-AGE were only significantly increased in patients transplanted more than 3 yr previously (p<0.05). Ab-AGE were significantly lower than controls in both diabetic groups and in patients on hemodialysis for more than 6 yr (p<0.005 to <0.0001) and not unlike controls in the other groups. These results demonstrate that hemodialysis or renal tranplantation can, initially, reduce either nox- or ox-AGE levels, which however go back to being high in time. Renal transplantation fails to normalize nox-AGE. More importantly, plasma Ab-AGE levels are reduced or unchanged in all patient groups in comparison with controls, despite higher circulating AGE levels. This suggests the importance of tissue-bound AGE as Ab-AGE targets. Additional interventions are needed to control AGE levels in treated nephropathic patients. The search and quantification of specific Ab-AGE would give more meaningful results if performed over specific tissue specimens.

Key-words

Advanced glycation end products (AGE) diabetes mellitus anti-AGE antibodies hemodialysis renal transplantation 

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Copyright information

© Italian Society of Endocrinology (SIE) 2008

Authors and Affiliations

  • A. M. Buongiorno
    • 1
  • S. Morelli
    • 1
  • E. Sagratella
    • 1
  • R. Cipriani
    • 2
  • S. Mazzaferro
    • 2
  • S. Morano
    • 2
  • M. Sensi
    • 2
  1. 1.Department of Hematology, Oncology and Molecular MedicineNational Institute of HealthItaly
  2. 2.Department of Clinical SciencesUniversity of Rome “Sapienza”RomeItaly

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