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Adverse Effects of Dietary Glycotoxins on Wound Healing in Genetically Diabetic Mice

  1. Melpomeni Peppa1,
  2. Harold Brem2,
  3. Paul Ehrlich3,
  4. Jian-Gang Zhang2,
  5. Weijing Cai1,
  6. Zhu Li1,
  7. Anca Croitoru4,
  8. Swan Thung4 and
  9. Helen Vlassara1
  1. 1Division of Experimental Diabetes and Aging, Department of Geriatrics, Mount Sinai School of Medicine, New York, New York
  2. 2Angiogenesis and Wound Healing Laboratory, Department of Surgery, Mount Sinai School of Medicine, New York, New York
  3. 3Division of Plastic Surgery, Hershey Medical Center, Hershey, Pennsylvania
  4. 4Department of Pathology, Mount Sinai School of Medicine, New York, New York
  1. Address correspondence and reprint requests to Helen Vlassara, Mount Sinai School of Medicine, Box 1640, New York, NY 10029. E-mail: helen.vlassara{at}mssm.edu

Abstract

Advanced glycoxidation end products (AGEs) are implicated in delayed diabetic wound healing. To test the role of diet-derived AGE on the rate of wound healing, we placed female db/db (+/+) (n = 55, 12 weeks old) and age-matched control db/db (+/−) mice (n = 45) on two diets that differed only in AGE content (high [H-AGE] versus low [L-AGE] ratio, 5:1) for 3 months. Full-thickness skin wounds (1 cm) were examined histologically and for wound closure. Serum 24-h urine and skin samples were monitored for Nε-carboxymethyl-lysine and methylglyoxal derivatives by enzyme-linked immunosorbent assays. L-AGE-fed mice displayed more rapid wound closure at days 7 and 14 (P < 0.005) and were closed completely by day 21 compared with H-AGE nonhealed wounds. Serum AGE levels increased by 53% in H-AGE mice and decreased by 7.8% in L-AGE mice (P < 0.04) from baseline. L-AGE mice wounds exhibited lower skin AGE deposits, increased epithelialization, angiogenesis, inflammation, granulation tissue deposition, and enhanced collagen organization up to day 21, compared with H-AGE mice. Reepithelialization was the dominant mode of wound closure in H-AGE mice compared with wound contraction that prevailed in L-AGE mice. Thus, increased diet-derived AGE intake may be a significant retardant of wound closure in diabetic mice; dietary AGE restriction may improve impaired diabetic wound healing.

Footnotes

    • Accepted July 22, 2003.
    • Received March 31, 2003.
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