Insulin/IGF Axis and the Receptor for Advanced Glycation End Products: Role in Meta-inflammation and Potential in Cancer Therapy

Endocr Rev. 2023 Jul 11;44(4):693-723. doi: 10.1210/endrev/bnad005.

Abstract

In metabolic conditions such as obesity and diabetes, which are associated with deregulated signaling of the insulin/insulin-like growth factor system (IIGFs), inflammation plays a dominant role. In cancer, IIGFs is implicated in disease progression, particularly during obesity and diabetes; however, further mediators may act in concert with IIGFs to trigger meta-inflammation. The receptor for advanced glycation end-products (RAGE) and its ligands bridge together metabolism and inflammation in obesity, diabetes, and cancer. Herein, we summarize the main mechanisms of meta-inflammation in malignancies associated with obesity and diabetes; we provide our readers with the most recent understanding and conceptual advances on the role of RAGE at the crossroad between impaired metabolism and inflammation, toward disease aggressiveness. We inform on the potential hubs of cross-communications driven by aberrant RAGE axis and dysfunctional IIGFs in the tumor microenvironment. Furthermore, we offer a rationalized view on the opportunity to terminate meta-inflammation via targeting RAGE pathway, and on the possibility to shut its molecular connections with IIGFs, toward a better control of diabetes- and obesity-associated cancers.

Keywords: RAGE; cancer; diabetes; insulin/IGF system; meta-inflammation; obesity.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Glycation End Products, Advanced / metabolism
  • Humans
  • Inflammation / metabolism
  • Insulin
  • Neoplasms* / metabolism
  • Obesity / metabolism
  • Receptor for Advanced Glycation End Products / metabolism
  • Somatomedins*
  • Tumor Microenvironment

Substances

  • Glycation End Products, Advanced
  • Insulin
  • Receptor for Advanced Glycation End Products
  • Somatomedins
  • AGER protein, human