Targeted reduction of advanced glycation improves renal function in obesity

Kidney Int. 2011 Jul;80(2):190-8. doi: 10.1038/ki.2011.57. Epub 2011 Mar 16.

Abstract

Obesity is highly prevalent in Western populations and is considered a risk factor for the development of renal impairment. Interventions that reduce the tissue burden of advanced glycation end-products (AGEs) have shown promise in stemming the progression of chronic disease. Here we tested if treatments that lower tissue AGE burden in patients and mice would improve obesity-related renal dysfunction. Overweight and obese individuals (body mass index (BMI) 26-39 kg/m(2)) were recruited to a randomized, crossover clinical trial involving 2 weeks each on a low- and a high-AGE-containing diet. Renal function and an inflammatory profile (monocyte chemoattractant protein-1 (MCP-1) and macrophage migration inhibitory factor (MIF)) were improved following the low-AGE diet. Mechanisms of advanced glycation-related renal damage were investigated in a mouse model of obesity using the AGE-lowering pharmaceutical, alagebrium, and mice in which the receptor for AGE (RAGE) was deleted. Obesity, resulting from a diet high in both fat and AGE, caused renal impairment; however, treatment of the RAGE knockout mice with alagebrium improved urinary albumin excretion, creatinine clearance, the inflammatory profile, and renal oxidative stress. Alagebrium treatment, however, resulted in decreased weight gain and improved glycemic control compared with wild-type mice on a high-fat Western diet. Thus, targeted reduction of the advanced glycation pathway improved renal function in obesity.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Cross-Over Studies
  • Diet
  • Glycation End Products, Advanced / administration & dosage
  • Glycation End Products, Advanced / adverse effects*
  • Humans
  • Inflammation / prevention & control
  • Kidney / drug effects
  • Kidney / physiopathology*
  • Kidney Diseases / chemically induced
  • Kidney Diseases / diet therapy*
  • Kidney Diseases / drug therapy
  • Male
  • Mice
  • Mice, Knockout
  • Middle Aged
  • Obesity / diet therapy*
  • Obesity / drug therapy
  • Obesity / physiopathology*
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic / deficiency
  • Receptors, Immunologic / drug effects*
  • Thiazoles / pharmacology
  • Thiazoles / therapeutic use
  • Young Adult

Substances

  • Glycation End Products, Advanced
  • Receptor for Advanced Glycation End Products
  • Receptors, Immunologic
  • Thiazoles
  • alagebrium