Summary:
Hyperglycaemia is considered to be the key causal factor in the development of diabetic complications. Poor
glycemic control a significant changes of erythrocyte membrane fluidity, erythrocyte deformability and antioxidant
status. Nonenzymatic glycation and glycoxidation with cascade of free radical reactions, oxidative and
carbonyl stressmay play an important role in the development diabetic micro- and macrovascular complications.
The serum levels of specific and nonspecific advanced glycation end products (s-AGEs) have been found elevated
in type 1 and type 2 diabetic patients. Levels of s-AGEs. may serve as useful biochemical marker for monitoring
progression of diabetic complications and pathological processes. Accumulation of AGEs on tissue proteins
increases with pathogenesis of diabetic complications and atherosclerosis. AGEs are believed to induce cellular
oxidative stress through the interaction with specific cellular receptors. Carbonyl stress-induced tissue damage
is caused by AGE precursors formed by hyperglycaemia, hyperlipidemia, nonenzymatic glycation, peroxidation
of lipids and metabolis processes. The toxic effects of AGE precursors can not be directly antagonized by
antioxidants. Only a small number of biological carbonyl scavengers like glutathione have been identified to
date. For therapeutic intervention, nucleophilic compounds as aminoguanidine, pyridoxamine, OPB-9195,
2,3-diaminophenazone, carnosine and tenilsetam give promising results. These potential therapeutics have been
proposed to trap AGE precursors. Studies in vitro showed that these AGE inhibitors have also the antioxidant
and chelating activity. Angiotensin converting enzyme (ACE) and angiotensin II receptor antagonists also
significantly attenuate AGE production. These drugs do not trap AGE precursors, but impact on the production
of AGE precursors by chelating transition metals and inhibiting various oxidative steps in the process of
glycoxidation, including the formation of free radicals. Finally, supplementation with antioxidants and antioxidant
systems could be a complementary treatment in diabetic patients.
Key words:
hyperglycaemia, free radicals, early and advanced glycation, carbonyl stress, oxidative stress,
diabetic complications
|