Short-term exposure of human serum albumin to glucose in vitro results in the formation of fructosyllysine residues. Using short-term glucose-modified albumin the interactions with human monocytes and with the human monocyte-like cells U937, MonoMac 6, HL60, and THP1 were studied. Short-term glycated albumin was specifically bound by monocytes, U937 and MonoMac 6 cells, but not by HL60 and THP1 cells. This specific binding of short-term glycated albumin was inhibited by fructosyllysine, but not by hexitollysine. Short-term glycated albumin did not compete for binding of albumin, modified by advanced glycation end products. Scatchard analysis of the binding data indicated that there are 10,000 binding sites per cell in monocytes or U937 cells and 2000 sites per cell on MonoMac 6 cells with affinity constants of 9 x 10(6) M-1. Specific binding of short-term glycated albumin to human monocytes was observed in 29% of the 101 human subjects investigated. Ligand-receptor cross-linking and ligand blotting experiments revealed two binding proteins of 100 to 110 and 190 kDa in SDS-PAGE after membrane protein solubilization of U937 and MonoMac 6 cells. The binding of short-term glycated albumin to MonoMac 6 cells induced the production of the cytokines IL-1 and TNF.
The ability of short-term in vitro glycated albumin to react with monocytes or the monocyte-like cells U937 is due to the Amadori adduct fructosyllysine. Two binding proteins of about 100 and 200 kDa have been previously described to interact specifically with the monocyte-like cell line U937. Detergent extracts from U937 cell membranes were used to purify the 100kDa protein by ion exchange chromatography, fructosyllysine-Sepharose affinity chromatography and SDS-PAGE. Six amino acids from the N-terminal end and two peptide sequences of 14 and 15 amino acids were identical with the N-terminus and the positions 349 to 362 and 610 to 624 of the major nuclear protein nucleolin. However, ligand blotting experiments with nuclear extracts from U937 and RIN cells showed no binding of glycated albumin with nucleolin. The reported amino acid sequences of the 100kDa fructosyllysine specific binding protein do not show any homologies with AGE-receptors. This receptor protein as a nucleolin-like polypeptide belongs to the superfamily of RNA-binding proteins.
A differing individual expression of fructosyllysine-specific receptors has been found on the monocytes of 90 insulin-dependent diabetic patients and 101 healthy control subjects. The degree of receptor expression is neither age- nor sex-dependent; however, in the diabetic group it correlates significantly with the severity and age of onset of diabetic microangiopathy. To interpret the results of the human study, spontaneously diabetic and non-diabetic BB/OK rats were used to estimate tissue content of glucose-modified proteins and capillary basement membrane thickness in relation to the receptor expression on macrophages. In non-diabetic and diabetic rats no correlation was found between receptor expression and tissue content (i.e. artery, nerve) of fructosyllsine and fluorescent advanced glycation end products. However, animals which express the fructosyllysine receptor showed a greater increase in muscle capillary basement membrane thickness. There are indications that fructosyllysine receptor expression is positively associated with indices of diabetic complications such as microangiopathy and/or capillary basement membrane thickening.
Nonenzymatic glycation of fibrinogen is species independent and depends only on the glucose concentration in the incubation mixture under selected in vitro conditions. An increased fibrin monomer aggregation in the presence of Ca2+ ions and a decreased proteolytic susceptibility of nonenzymatically glycated fibrinogens may favour the development of thrombophilic states. Blocking of lysine residues as well as restricted conformational changes induced by glucose attachment may be responsible for these effects. Fibrin stabilization by factor XIII is not impaired by nonenzymatic glycation of fibrinogen. Attachment of aortic endothelial cells to fibrin films from glycated fibrinogens is diminished. This phenomenon may be the result of blocked plasminogen activator binding sites in fibrin by nonenzymatic glycation. These effects may contribute in vivo to the accumulation of fibrin in those tissues most frequently affected by diabetic complications.
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