Anti-inflammation in diabetes: a reality and a clinical relevant issue

In the authorative PLOS ONE an experiment is described suggesting how important anti-inflammatory compounds could be in diabetes.

The accumulation of advanced glycation end products (AGEs) with aging and especially in diabetes are associated with increased levels of inflammation [22] and may be a cause of the chronic pro-inflammatory stateAGEs are formed by non-enzymatic glycation, resulting in oxidation of proteins and lipids. Diabetes, cardiovascular disease and chronic kidney disease are associated with increased levels of AGEs.

We quote:

AGEs are formed by non-enzymatic glycation, resulting in oxidation of proteins and lipids. Diabetes, cardiovascular disease and chronic kidney disease are associated with increased levels of AGEs [23]. The major source of AGEs in both diabetics and normal individuals is the diet [24]. Nε-carboxymethyl lysine (CML) is formed by reactions of carbonyl precursors like methylglyoxal (MG) with carbohydrates and lipids, and the associated protein alterations are irreversible [25]. AGEs accumulate in the major long—lived proteins of the IVD including aggrecan and collagen preventing their repair and turnover [26]. Non-enzymatic crosslinking of human annulus fibrosus (AF) tissue with MG increased AF tensile stiffness [27], supporting the concept that accumulation of AGEs with aging and degeneration in the IVD increases stiffness and brittleness making the tissue more susceptible to mechanical damage [28]. Systemic levels of AGEs can be reduced by dietary restriction of AGE intake[29] or a non-absorbable drug that binds AGEs in the intestine and eliminates them in the stool, or through drugs that prevent AGE formation like aspirin [30][31], benfotiamine [32], and pyridoxamine [33].

They proved that intervertebral disk degeneration, cause of much low back pain is related to inflammation and can be counteracted by food components with an anti-inflammatory action.

Palmitoylethanolamide is the best researched anti-inflammatory compound available as a food supplement, and many diabetes patients already noticed the benefit, especially in diabetes neuropathy and pain of this supplement.

The authors comcluded:

To our knowledge, this is the first study to show that DM induced pathological changes in lumbar IVDs and vertebrae and that an important mechanism for these changes is AGE accumulation and increased inflammation. The specific localized accumulation of morphological defects and deposition of pro-inflammatory tissues in the NP may be important factors in the initiation of IVD degeneration more broadly than in this mouse DM model. This conclusion is strengthened by the fact that loss in disc height, decreased vertebral bone mass, altered NP morphology and reduced GAG content was prevented by treatment with drugs that reduce inflammation and AGEs. From these observations we conclude that the oral ingestion of AGE inhibitory and anti-inflammatory drugs provide a safe and efficacious treatment that may slow the progression of diabetes-induced changes within the spine, and this is also the first study to demonstrate effective treatment of spine diseases via oral medications in young animals. These findings have potentially broad impact due to the tremendous prevalence of both diabetes and back pain, as well as the known accumulation of AGEs in aging IVDs.

Souce: Illien-Junger S, Grosjean F, Laudier DM, Vlassara H, Striker GE, Iatridis JC. Combined anti-inflammatory and anti-age drug treatments have a protective effect on intervertebral discs in mice with diabetes. PLoS One. 2013 May 17;8(5):e64302. doi: 10.1371/journal.pone.0064302. Print 2013.

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