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2015 ; 4
(2
): e26949
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English Wikipedia
Pharmacologic Approaches Against Advanced Glycation End Products (AGEs) in
Diabetic Cardiovascular Disease
#MMPMID26393232
Nenna A
; Nappi F
; Avtaar Singh SS
; Sutherland FW
; Di Domenico F
; Chello M
; Spadaccio C
Res Cardiovasc Med
2015[May]; 4
(2
): e26949
PMID26393232
show ga
CONTEXT: Advanced Glycation End-Products (AGEs) are signaling proteins associated
to several vascular and neurological complications in diabetic and non-diabetic
patients. AGEs proved to be a marker of negative outcome in both diabetes
management and surgical procedures in these patients. The reported role of AGEs
prompted the development of pharmacological inhibitors of their effects, giving
rise to a number of both preclinical and clinical studies. Clinical trials with
anti-AGEs drugs have been gradually developed and this review aimed to summarize
most relevant reports. EVIDENCE ACQUISITION: Evidence acquisition process was
performed using PubMed and ClinicalTrials.gov with manually checked articles.
RESULTS: Pharmacological approaches in humans include aminoguanidine,
pyridoxamine, benfotiamine, angiotensin converting enzyme inhibitors, angiotensin
receptor blockers, statin, ALT-711 (alagebrium) and thiazolidinediones. The most
recent promising anti-AGEs agents are statins, alagebrium and thiazolidinediones.
The role of AGEs in disease and new compounds interfering with their effects are
currently under investigation in preclinical settings and these newer anti-AGEs
drugs would undergo clinical evaluation in the next years. Compounds with
anti-AGEs activity but still not available for clinical scenarios are ALT-946,
OPB-9195, tenilsetam, LR-90, TM2002, sRAGE and PEDF. CONCLUSIONS: Despite most
studies confirm the efficacy of these pharmacological approaches, other reports
produced conflicting evidences; in almost any case, these drugs were well
tolerated. At present, AGEs measurement has still not taken a precise role in
clinical practice, but its relevance as a marker of disease has been widely
shown; therefore, it is important for clinicians to understand the value of new
cardiovascular risk factors. Findings from the current and future clinical trials
may help in determining the role of AGEs and the benefits of anti-AGEs treatment
in cardiovascular disease.