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Advanced glycation end products in the skin are enhanced in COPD
Authors:Susan JM Hoonhorst  Adèle T Lo Tam Loi  Jorine E Hartman  Eef D Telenga  Maarten van den Berge  Leo Koenderman  Jan Willem J Lammers  H Marike Boezen  Dirkje S Postma  Nick HT ten Hacken
Institution:1. University of Groningen, University Medical Center Groningen, Department of Pulmonary Diseases, Groningen, the Netherlands;2. University of Groningen, University Medical Center Groningen, GRIAC research institute, Groningen, the Netherlands;3. University Medical Center Utrecht, Department of Respiratory Medicine, Utrecht, the Netherlands;4. University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands
Abstract:

Background

Cigarette smoking is the main cause of chronic obstructive pulmonary disease (COPD) inducing oxidative stress and local tissue injury, resulting in pulmonary inflammation. Advanced glycation end products (AGEs) are produced by glycation and oxidation processes and their formation is accelerated in inflammatory conditions. In this study we assessed whether AGE accumulation in the skin is elevated in COPD and associates with disease severity.

Methods

202 mild-to-very-severe COPD patients and 83 old (40–75 years) and 110 young (18–40 years) healthy smokers and never-smokers were included. AGEs were measured by skin autofluorescence (SAF). Demographic variables, smoking habits, co-morbidities and lung function values were obtained.

Results

COPD patients (FEV1 = 55% predicted) had significantly higher SAF values than old and young healthy controls: 2.5 vs. 1.8 and 1.2 (arbitrary units, p < 0.05). No differences in SAF values were found between GOLD stages I-IV (2.4, 2.3, 2.5, 2.5 respectively). Lower function (FEV1/FVC, MEF50/FVC, RV/TLC) and higher number of packyears were significantly associated with SAF (p < 0.05).

Conclusions

SAF is increased in mild-to-very severe COPD patients compared with healthy controls. Interestingly, SAF was not associated with disease severity as values were comparable between different GOLD stages (stage I-IV) of COPD. This may suggest that AGEs play a role in the induction phase of COPD in susceptible smokers. Future studies should further investigate the mechanisms underlying AGEs formation and accumulation in COPD.
Keywords:COPD  chronic obstructive pulmonary disease  AGE  advanced glycation end product  RAGE  receptor of advanced glycation end products  SAF  skin autofluorescence  FEV1  forced expiratory volume in one second  FVC  forced vital capacity  MEF50  maximum expiratory flow at 50 % of vital capacity  RV  residual volume  TLC  total lung capacity  GOLD  global initiative for chronic obstructive lung disease  AU  arbitrary units  sRAGE  soluble receptor of advanced glycation end products  mRAGE  membrane bound receptor of advanced glycation end products
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