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Query: UMLS:C0042373 (
vascular disease
)
17,070
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A variety of signs and symptoms constituting the uraemic syndrome may be related to the retention and accumulation of uraemic toxins. Several identified (and yet unidentified) uraemic toxins of low molecular weight are removed at least in part by dialysis therapy resulting in marked improvement of multiple organ dysfunctions and clinical symptoms. However, many abnormalities persist due to the high protein binding of several uraemic toxins or their high molecular weight associated with inadequate dialysis clearance. Moreover, carbamoylation of amino acids and proteins in uraemia as well as metabolic acidosis contribute to the functional and metabolic abnormalities of the uraemic state. Uraemia interferes with the function of polymor-phonuclear leukocytes by deranging their cellular biochemistry and biology. P-cresol and several newly identified granulocyte inhibitory proteins are responsible for reduced chemotaxis, oxidative activity, intracellular killing of bacteria, and glucose consumption by polymorphonuclear leukocytes. Hyperhomocysteinaemia is an independent risk factor for
vascular disease
in end-stage renal disease patients. Uraemic toxins interfere with calcitriol synthesis and concentration or activity of the calcitriol receptor. Advanced glycolysation end-products (AGEs) accumulate as a result of impaired renal excretion. AGE peptides may represent a modern-day version of "middle molecule" toxicity or uraemia. Of potential clinical importance are
pentosidine
-, imidazolone- and carboxymethyllysine-modifications of beta 2-microglobulin with respect to the development of uraemia associated amyloidosis. Several uraemic toxins also affect nitric oxide pathway. Particularly, dimethyl-L-arginine (ADMA) is a potent inhibitor of nitric oxide synthesis. Parathyroid hormone satisfies the strict criteria of an uraemic toxin. Many uraemic symptoms can be attributed to the excess of parathyroid hormone in patients with chronic renal failure. Finally, recent investigations indicate, that one or more dialyzable uraemic toxin(s) suppress(es) appetite and may contribute to malnutrition in uraemia.
...
PMID:Genesis of the uraemic syndrome: role of uraemic toxins. 978 69
The formation of Maillard products is increased in the diabetes mellitus. These advanced glycated end products (AGEs) alter metabolic functions of macromolecules and increase free radical formation while decreasing free radical-scavenging enzyme activity. The elimination of AGEs is insured by the macrophage cells equipped with appropriate receptors (RAGE) and cleared by kidneys. The knowledge of these molecular mechanisms had allowed the emergence of biochemical analytes such as 3-deoxyglucosone,
pentosidine
, and carboxymethyl-lysine, as markers of the ris of micro- and macro-
angiopathy
, the main chronic complications of the diabetes mellitus.
...
PMID:[Role of Maillard products in the chronic complications of diabetes mellitus. Bioclinical applications]. 980 17
The advanced stage of the glycation process (also called the "Maillard reaction") that leads to the formation of advanced glycation end-products (AGEs) plays an important role in the pathogenesis of
angiopathy
in diabetic patients and in the aging process. AGEs elicit a wide range of cell-mediated responses that might contribute to diabetic complications,
vascular disease
, renal disease, and Alzheimer's disease. Recently, it has been proposed that AGE are not only created from glucose per se, but also from dicarbonyl compounds derived from glycation, sugar autoxidation, and sugar metabolism. However, this advanced stage of glycation is still only partially characterized and the structures of the different AGEs that are generated in vivo have not been completely determined. Because of their heterogeneity and the complexity of the chemical reactions involved, only some AGEs have been characterized in vivo, including N-carboxymethyllysine (CML),
pentosidine
, pyrraline, and crosslines. In this article, we provide a brief overview of the pathways of AGE formation and of the immunochemical methods for detection of AGEs, and we also provide direct immunological evidence for the existence of five distinct AGE classes (designated as AGE-1 to -5) within the AGE-modified proteins and peptides in the serum of diabetic patients on hemodialysis. We also propose pathways for the in vivo formation of various AGEs by glycation, sugar autoxidation, and sugar metabolism.
...
PMID:Alternative routes for the formation of immunochemically distinct advanced glycation end-products in vivo. 1189 79
The advanced stage of the glycation process (one of the post-translational modifications of proteins) leads to the formation of advanced glycation end-products (AGEs) and plays an important role in the pathogenesis of
angiopathy
in diabetic patients, in aging, and in neurodegenerative diseases. However, it is still not clear which AGEs subtypes play a pathogenetic role and which of several AGEs receptor mediate AGEs effects on cells. We have provided direct immunochemical evidence for the existence of six distinct AGEs structures (AGEs-1 to -6) within the AGEs-modified proteins and peptides that circulate in the serum of diabetic patients. Recently we demonstrated for the first time that glyceraldehyde-derived AGEs (AGEs-2) and glycolaldehyde-derived AGEs (AGE-3) have diverse biological activities on vascular wall cells, mesangial cells, Schwann cells, malignant melanoma cells and cortical neurons. We also demonstrated for the first time that acetaldehyde (AA)-derived AGEs (AA-AGE) have cytotoxic activity on cortical neurons and the AA-AGE epitope was detected in human brain of alcoholics. These results indicate that of the various types of AGEs structures that can form in vivo, the toxic AGEs (TAGE) structures (AGEs 2, 3, and AA-AGE), but not non-toxic AGEs (N-carboxymethyllysine,
pentosidine
, pyrraline etc.) are likely to play an important role in the pathophysiological processes associated with AGEs formation.
...
PMID:TAGE (toxic AGEs) hypothesis in various chronic diseases. 1528 66
Recent work has shown that high-density lipoprotein (HDL) isolated from human atherosclerotic lesions and the blood of patients with established coronary artery disease contains elevated levels of 3-nitrotyrosine and 3-chlorotyrosine. A higher nitrotyrosine content in lipoprotein is significantly associated with diminished cholesterol efflux capacity of the lipoprotein. Since accelerated atherogenesis is a key complication of diabetes mellitus, and nitrosative stress has recently been implicated in diabetic pathology, we set out to demonstrate an increase in the circulating levels of nitrated apolipoprotein A (apoA)-I in type 2 diabetic patients and its putative correlation with metabolic biomarkers. In this work we addressed this hypothesis in a case-control study with 30 type 2 diabetic patients and 30 age-matched control subjects. Nitrated apoA-I was 3280+/-1910 absorbance peak area/apoA-I (g/L) for diabetic patients and 2320+/-890 for control subjects (p<0.037). This represents a 50% increase in circulating nitrated apoA-I in diabetic patients to age-matched controls. Diabetic patients also showed increases of a similar magnitude in circulating advanced glycation endproducts measured as
pentosidine
fluorescence (44.16+/-16.26 vs. 30.84+/-12.86 AU; p<0.01) and in circulating lipoperoxides (46.0+/-18.0 vs. 37.2+/-18.0 nmol/L; p<0.03). No significant correlation was found between nitration of apoA-I and glycosylated hemoglobin or any of the other parameters measured. If proven in subsequent functional and in vivo studies, increased nitrated apoA-I would represent another mechanism by which nitrosative stress participates in diabetic macro-
angiopathy
.
...
PMID:Circulating levels of nitrated apolipoprotein A-I are increased in type 2 diabetic patients. 1600 55
Coronary artery calcification is an index of the severity of atherosclerotic
vascular disease
, and may predict future adverse cardiovascular events in uremic patients undergoing hemodialysis (HD). HD patients are exposed to oxidative stress, and show high plasma levels of advanced glycation end products (AGEs). The association between oxidative stress, AGEs, established cardiovascular risk factors, and coronary artery calcification score (CACS) was studied in 225 HD patients (123 male, 102 female patients). CACS was measured by using multi-detector row computed tomography. Age, systolic blood pressure, calcium, calcium x phosphate, malondialdehyde, lipid peroxides, and
pentosidine
were significantly and positively correlated with CACS. Duration on HD tended to be positively correlated with CACS. From the independent variables included in the forward stepwise multiple linear regression analysis, only age, systolic blood pressure, lipid peroxides, calcium, and
pentosidine
were independently associated with CACS. The odds ratios for past history of coronary artery disease and the presence of diabetes mellitus for high CACS (> or =100) were 6.25 (95% confidence interval; 1.83-21.4) and 2.03 (95% confidence interval; 1.02-4.05), respectively. The plasma
pentosidine
was significantly and positively correlated with indoxyl sulfate. In conclusion, in addition to such traditional cardiovascular risk factors as past history, diabetes mellitus, aging, systolic blood pressure and calcium overload, oxidative stress (lipid peroxides), and AGE (
pentosidine
) are associated with extensive coronary artery calcification in HD patients. Lipid peroxidation and glycoxidation may be involved in the pathogenesis of coronary artery calcification.
...
PMID:Oxidative stress, advanced glycation end product, and coronary artery calcification in hemodialysis patients. 1672 88
Advanced glycation end-products (AGEs) have been found to be critically involved in initiation or progression of diabetes secondary complications (nephropathy, retinopathy, neuropathy, and
angiopathy
). Various hyper-glycating carbonyl compounds such as 3-deoxyglucosone (3-DG) are produced in pathophysiological conditions that form AGEs in high quantity both in vivo and in vitro. In the first stage of this study, we glycated histone H2A protein by 3-DG, and the results showed the formation of various intermediates and AGEs as well as structural changes in the protein. In the second stage, we studied the immunogenicity of native and 3-DG-glycated H2A protein in female rabbits. The modified H2A was highly immunogenic, eliciting high titer immunogen-specific antibodies, while the unmodified form was almost nonimmunogenic. Antibodies against standard carboxymethyllysine (CML) and
pentosidine
were detected in the immunized female rabbits, which demonstrates the immunogenic nature of AGEs (CML and
pentosidine
) as well. The results show both structural perturbation and AGEs have the capacity of triggering the immune system due to the generation of neoepitopes that render the molecule immunogenic. This study shows the presence of autoantibodies against 3-DG-modified H2A, CML, and
pentosidine
in the sera of type 2 diabetes patients having secondary complications. Autoantibodies against damaged H2A and AGEs may be significant in the assessment of initiation/progression of secondary complications in type 2 diabetes mellitus patients or may be used as a marker for early detection of secondary complications in diabetes.
...
PMID:Prevalence of Autoantibodies against 3-DG-Glycated H2A Protein in Type 2 Diabetes. 2860 Oct 68