Advanced Glycation End Product Accumulation in Subjects with Open-Angle Glaucoma with and without Exfoliation.

Tomoki Shirakami,Mikihiro Yamanaka,Masaki Tanito,Jo Fujihara,Akira Obana,Yuko Gohto,Yotaro Matsuoka

doi:10.3390/antiox9080755

Abstract

Advanced glycation end products (AGEs), which are the products of a non-enzymatic reaction between reducing sugars and other macromolecules, are critical in aging, as well as metabolic and degenerative diseases. To assess the involvement of AGEs in glaucoma, skin autofluorescence (sAF) level, which is a measurement of AGEs’ accumulation, was compared among Japanese patients with glaucoma (316 with primary open-angle glaucoma (PG) and 127 exfoliation syndrome and glaucoma (EG)) and controls (133 nonglaucomatous controls) (mean age 71.6 ± 12.8 years, 254 men and 322 women). The sAF values were estimated from the middle fingertip using a 365 nm light-emitting diode for excitation and detection at 440 nm emission light. The estimated AGE values (arbitrary unit) were 0.56 ± 0.15, 0.56 ± 0.11, and 0.61 ± 0.11 in the control, PG, and EG groups, respectively (p < 0.0001, analysis of variance); and were significantly higher in the EG group than the control (p = 0.0007) and PG (p < 0.0001) groups. After adjustment for various demographic parameters by multivariate analyses, male sex (standard β = 0.23), EG (0.19), and diabetes (0.09) were associated with higher AGE levels; PG (−0.18) and smoking (−0.19) were associated with lower AGE levels. Age, visual acuity, intraocular pressure, glaucoma medications, lens status, and systemic hypertension were not associated with AGEs. The high AGE level in EG suggested that specific oxidation and glycation mechanisms underlie the glaucoma pathogenesis associated with pseudoexfoliation syndrome.

Highlights

Progressive optic neuropathy and visual field loss characterize glaucoma, a leading cause of irreversible blindness worldwide [1] including Japan [2]
The lower level of blood antioxidant capacity was associated with higher Intraocular pressure (IOP) values in patients with glaucoma and control subjects [12] and with worse visual field defects in open-angle glaucoma (OAG) [13,14]
We measured the Advanced glycation end products (AGEs) levels in patients with primary OAG (PG) and EG and compared them with controls to assess the possible involvement of AGEs in the glaucoma pathogenesis and found that patients with

Summary

Introduction

Progressive optic neuropathy and visual field loss characterize glaucoma, a leading cause of irreversible blindness worldwide [1] including Japan [2]. In open-angle glaucoma (OAG) such as primary OAG (PG) and glaucoma secondary to pseudoexfoliation syndrome (EX), reduction of aqueous humor outflow at the trabecular meshwork (TM) is the main reason for the IOP elevation [4]. This can be the result of TM cells dysfunction and changes in the amount and quality of the extracellular matrix in the TM [5]. The lower level of blood antioxidant capacity was associated with higher IOP values in patients with glaucoma and control subjects [12] and with worse visual field defects in OAG [13,14]. We reported that supplementation with French maritime pine bark/bilberry fruit extracts, which are natural antioxidants compounds, could further reduce the IOP in Japanese patients with controlled PG [15]

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Conclusion