The Role of AGE/RAGE Signaling in Diabetes-Mediated Vascular Calcification

J Diabetes Res. 2016:2016:6809703. doi: 10.1155/2016/6809703. Epub 2016 Jul 28.

Abstract

AGE/RAGE signaling has been a well-studied cascade in many different disease states, particularly diabetes. Due to the complex nature of the receptor and multiple intersecting pathways, the AGE/RAGE signaling mechanism is still not well understood. The purpose of this review is to highlight key areas of AGE/RAGE mediated vascular calcification as a complication of diabetes. AGE/RAGE signaling heavily influences both cellular and systemic responses to increase bone matrix proteins through PKC, p38 MAPK, fetuin-A, TGF-β, NFκB, and ERK1/2 signaling pathways in both hyperglycemic and calcification conditions. AGE/RAGE signaling has been shown to increase oxidative stress to promote diabetes-mediated vascular calcification through activation of Nox-1 and decreased expression of SOD-1. AGE/RAGE signaling in diabetes-mediated vascular calcification was also attributed to increased oxidative stress resulting in the phenotypic switch of VSMCs to osteoblast-like cells in AGEs-induced calcification. Researchers found that pharmacological agents and certain antioxidants decreased the level of calcium deposition in AGEs-induced diabetes-mediated vascular calcification. By understanding the role the AGE/RAGE signaling cascade plays diabetes-mediated vascular calcification will allow for pharmacological intervention to decrease the severity of this diabetic complication.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism*
  • Glycation End Products, Advanced / metabolism*
  • Humans
  • MAP Kinase Signaling System
  • NADPH Oxidase 1
  • NADPH Oxidases / metabolism
  • NF-kappa B / metabolism
  • Oxidative Stress
  • Protein Kinase C / metabolism
  • Receptor for Advanced Glycation End Products / metabolism*
  • Signal Transduction
  • Superoxide Dismutase-1 / metabolism
  • Transforming Growth Factor beta / metabolism
  • Vascular Calcification / etiology
  • Vascular Calcification / metabolism*
  • alpha-2-HS-Glycoprotein / metabolism
  • p38 Mitogen-Activated Protein Kinases / metabolism

Substances

  • Glycation End Products, Advanced
  • NF-kappa B
  • Receptor for Advanced Glycation End Products
  • SOD1 protein, human
  • Transforming Growth Factor beta
  • alpha-2-HS-Glycoprotein
  • Superoxide Dismutase-1
  • NADPH Oxidase 1
  • NADPH Oxidases
  • NOX1 protein, human
  • Protein Kinase C
  • p38 Mitogen-Activated Protein Kinases