Diabetes, Vol 48, Issue 9 1842-1849, Copyright © 1999 by American Diabetes Association
Autoantibody against N(epsilon)-(carboxymethyl)lysine: an advanced glycation end product of the Maillard reaction
R Shibayama, N Araki, R Nagai and S Horiuchi
Department of Biochemistry, Kumamoto University School of Medicine, Japan.
Prolonged incubation of proteins with reducing sugar produces advanced
glycation end products (AGEs), which are implicated as factors for aging
and diabetic complications. We previously demonstrated the presence of
N(epsilon)-(carboxymethyl)lysine (CML), one of the main AGE structures, in
human and animal tissues using a monoclonal anti-CML antibody (6D12). These
findings suggest that CML structures present in vivo could serve as
immunogens to generate autoantibodies. This suggestion was tested in the
present study. First, plasma samples from diabetic rats reacted positively
with AGE bovine serum albumin (BSA). These reactivities increased with the
duration of diabetic states and were inhibited specifically by CML-BSA.
Second, a fraction purified from plasma of diabetic patients, which bound
to AGE-BSA, showed a positive reaction to CML-BSA and furthermore also to
human lens proteins, which are known to undergo CML modification in vivo.
Finally, patients with renal failure caused by diabetes or nondiabetic
pathologies had a higher autoantibody activity against CML structure than
that in normal subjects or diabetic patients without renal failure. These
results indicate that CML accumulated in vivo serves as an immunological
epitope to generate an autoantibody specific for CML that might be used as
a potential marker for diabetic nephropathy or chronic renal failure.