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Review
. 2024 May 30;16(5):e61373.
doi: 10.7759/cureus.61373. eCollection 2024 May.

Advanced Glycation End Products-Induced Alzheimer's Disease and Its Novel Therapeutic Approaches: A Comprehensive Review

Affiliations
Review

Advanced Glycation End Products-Induced Alzheimer's Disease and Its Novel Therapeutic Approaches: A Comprehensive Review

Dhivya Kothandan et al. Cureus. .

Abstract

Advanced glycation end products (AGEs) accumulate in the brain, leading to neurodegenerative conditions such as Alzheimer's disease (AD). The pathophysiology of AD is influenced by receptors for AGEs and toll-like receptor 4 (TLR4). Protein glycation results in irreversible AGEs through a complicated series of reactions involving the formation of Schiff's base, the Amadori reaction, followed by the Maillard reaction, which causes abnormal brain glucose metabolism, oxidative stress, malfunctioning mitochondria, plaque deposition, and neuronal death. Amyloid plaque and other stimuli activate macrophages, which are crucial immune cells in AD development, triggering the production of inflammatory molecules and contributing to the disease's pathogenesis. The risk of AD is doubled by risk factors for atherosclerosis, dementia, advanced age, and type 2 diabetic mellitus (DM). As individuals age, the prevalence of neurological illnesses such as AD increases due to a decrease in glyoxalase levels and an increase in AGE accumulation. Insulin's role in proteostasis influences hallmarks of AD-like tau phosphorylation and amyloid β peptide clearance, affecting lipid metabolism, inflammation, vasoreactivity, and vascular function. The high-mobility group box 1 (HMGB1) protein, a key initiator and activator of a neuroinflammatory response, has been linked to the development of neurodegenerative diseases such as AD. The TLR4 inhibitor was found to improve memory and learning impairment and decrease Aβ build-up. Therapeutic research into anti-glycation agents, receptor for advanced glycation end products (RAGE) inhibitors, and AGE breakers offers hope for intervention strategies. Dietary and lifestyle modifications can also slow AD progression. Newer therapeutic approaches targeting AGE-related pathways are needed.

Keywords: ages; alzheimer’s disease; dementia; oxidative stress; rage.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. RAGE Structure
RAGE - receptors for advanced glycation end products; AGE - advanced glycation end products; Aβ - amyloid beta
Figure 2
Figure 2. Nonenzymatic Reactions of Reducing Sugars With the Protein Amino Group
AGEs - advanced glycation end products
Figure 3
Figure 3. Protein Glycation Process – AGE Formation Through the Maillard Reaction
AGEs - advanced glycation end products; IL - interleukin; TNF - tumor necrosis factor;
Figure 4
Figure 4. Activated Macrophages and AGE Production
PAMP - pathogen-associated molecular pattern molecules; DAMPs - damage-associated molecular patterns; RAGE - receptor for advanced glycation end products; HMGB1 - high-mobility group box 1; LPS - lipopolysaccharides

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