Current therapeutic interventions in the glycation pathway: evidence from clinical studies. Issue 8 (25th January 2013)

• Record Type: Journal Article
• Authors: Engelen, L.; Stehouwer, C. D. A.; Schalkwijk, C. G.
• Is Part Of: Diabetes, obesity & metabolism. Volume 15:Issue 8(2013:Aug.)
• Page Start: 677
• Page End: 689
• Publication Date: 2013-01-25
• Subjects: Diabetes -- Periodicals; Obesity -- Periodicals; Metabolism -- Disorders -- Periodicals; Clinical pharmacology -- Periodicals; 616.462
• DOI: 10.1111/dom.12058
• Languages: English
• ISSNs: 1462-8902

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>The increased formation of advanced glycation endproducts (AGEs) constitutes a potential mechanism of hyperglycaemia‐induced micro‐ and macrovascular disease in diabetes. <italic>In vitro</italic> and animal experiments have shown that various interventions can inhibit formation and/or actions of AGEs, in particular the specific AGE inhibitor aminoguanidine and the AGEs crosslink breaker alagebrium, and the B vitamins pyridoxamine and thiamine, and the latter's synthetic derivative, benfotiamine. The potential <italic>clinical</italic> value of these interventions, however, remains to be established. The present review provides, from the clinical point of view, an overview of current evidence on interventions in the glycation pathway relating to (i) the clinical benefits of specific AGE inhibitors and AGE breakers and (ii) the potential AGE‐inhibiting effects of therapies developed for purposes unrelated to the glycation pathway. We found that safety and/or efficacy in clinical studies with the specific AGE inhibitor, aminoguanidine and the AGE breaker, alagebrium, appeared to be a concern. The <italic>clinical</italic> evidence on the potential AGE‐inhibiting effects of B vitamins is still limited. Finally, current evidence for AGE inhibition by therapies developed for purposes unrelated to glycation is limited due to a large heterogeneity in study designs and/or measurement techniques, which have often been sub‐optimal. We conclude that, clinical evidence on interventions to inhibit formation and/or action of AGEs is currently weak and unconvincing.</p> </abstract>