Noriyuki Tatemichi

Immunohistochemical detection of imidazolone, a novel advanced glycation end product, in kidneys and aortas of diabetic patients.

To investigate the role of the Maillard reaction in the pathogenesis of diabetic complications, we produced several clones of monoclonal antibodies against advanced glycation end products (AGEs) by immunizing mice with AGE-modified keyhole limpet hemocyanin, and found that one clone (AG-1) of the anti-AGE antibodies reacted specifically with imidazolones A and B, novel AGEs. Thus, the imidazolones, which are the reaction products of the guanidino group of arginine with 3-deoxyglucosone (3-DG), a reactive intermediate of the Maillard reaction, were found to be common epitopes of AGE-modified proteins produced in vitro. We determined the erythrocyte levels of imidazolone in diabetic patients using ELISA with the monoclonal anti-imidazolone antibody. The imidazolone levels in the erythrocytes of diabetic patients were found to be significantly increased as compared with those of healthy subjects. Then we studied the localization of imidazolone in the kidneys and aortas obtained from diabetic patients by immunohistochemistry using the antibody. Specific imidazolone immunoreactivity was detected in nodular lesions and expanded mesangial matrix of glomeruli, and renal arteries in an advanced stage of diabetic nephropathy, as well as in atherosclerotic lesions of aortas. This study first demonstrates the localization of imidazolone in the characteristic lesions of diabetic nephropathy and atherosclerosis. These results, taken together with a recent demonstration of increased serum 3-DG levels in diabetes, strongly suggest that imidazolone produced by 3-DG may contribute to the progression of long-term diabetic complications such as nephropathy and atherosclerosis.

IMIDAZOLONE, A NOVEL ADVANCED GLYCATION END PRODUCT, IS PRESENT AT HIGH LEVELS IN KIDNEYS OF RATS WITH STREPTOZOTOCIN-INDUCED DIABETES

We produced a monoclonal antibody to imidazolones A and B, novel advanced glycation end products formed from the reaction of 3‐deoxyglucosone (3‐DG) with the guanidino group of arginine. Liquid chromatography/mass spectrometry demonstrated that the formation of imidazolone A by incubating 3‐DG with arginine is very rapid, reaching a maximum concentration within 24 h, but the formation of imidazolone B is very slow and low in quantity even after 2 weeks. Thus, at physiological conditions the formation of imidazolone A is dominant, while that of imidazolone B is negligible. Immunochemistry demonstrated that the imidazolone content in the kidneys of streptozotocin‐induced diabetic rats was significantly higher than in the control rats. Serum levels of 3‐DG in the diabetic rats were also significantly higher than in control rats. 3‐DG attacks the arginine residues of the tissue proteins, producing imidazolone at high levels in the kidneys affected by diabetic nephropathy.

Serum Levels of 3-Deoxyglucosone and Tissue Contents of Advanced Glycation End Products Are Increased in Streptozotocin-Induced Diabetic Rats with Nephropathy

To investigate a role of the Maillard reaction in the pathogenesis of diabetic nephropathy, we measured serum levels of 3-deoxyglucosone (3-DG), a potent protein cross-linking intermediate of the Maillard reaction, and tissue contents of advanced glycation end products (AGEs) in streptozotocin (STZ)-induced diabetic rats. We quantified serum 3-DG using gas chromatography/mass spectrometry, and measured AGE contents in tissues using a competitive enzyme-linked immunosorbent assay with a monoclonal anti-AGE antibody. The STZ-induced diabetic rats showed nephropathy with proteinuria, hypoproteinemia, hyperlipidemia and reduced creatinine clearance. Serum levels of 3-DG in the STZ-induced diabetic rats (mean +/- 3.46 +/- 0.23 mumol/l) were significantly (p < 0.01) higher than those in control rats (1.23 +/- 0.13 mumol/l). AGE contents in the kidney and the lens obtained from the STZ-induced diabetic rats (398 +/- 45 and 816 +/- 200 arbitrary units, respectively) were also significantly (p < 0.01) higher than those in the control rats (122 +/- 10 and 299 +/- 50 arbitrary units, respectively). The results indicate that increased levels of serum 3-DG and renal tissue. AGEs may be related to the occurrence of diabetic nephropathy.

Serum pancreatic stone protein in pancreatic diseases.

SummarySerum pancreatic stone protein (PSP) was determined in sera of pancreatic and nonpancreatic diseases using enzyme immunoassay specific to human PSP to study the diagnostic and pathophysiological significance of PSP. Serum PSP in acute pancreatitis (mean±SD=1075.4±2849.1 ng/mL,n=33) was significantly higher than that in controls (78.6±31.8 ng/mL,n=37,p<0.01), chronic pancreatitis (156.8±82.8 ng/mL,n=32,p<0.05), and pancreatic cancer (148.468.8 ng/mL,n=26,p<0.05). No significant difference was found between noncalcified and calcified chronic pancreatitis. Serum PSP levels were significantly higher in chronic renal failure under hemodialysis (1796.0±1492.9 ng/mL) than in other diseases such as peptic ulcer, liver cirrhosis, gallstone, and diabetes mellitus. Low but significant correlation was obtained between serum PSP and serum immunoreactive trypsin (r=0.22,p<0.05). Increased serum PSP levels in acute pancreatitis and chronic renal failure suggest that serum PSP levels reflect reflux from pancreatic secretion, release from damaged pancreatic acinar cells, or retention in circulation, and can be useful for diagnosis of acute pancreatitis, but not chronic calcified pancreatitis.

Urinary trehalase activity in chronic glomerulonephritis

To determine the diagnostic role of urinary trehalase in chronic glomerular disease, urinary trehalase activity and other urinary markers such as N-acetyl-beta-D-glucosaminidase (NAG), alanine aminopeptidase (AAP), alkaline phosphatase (ALP), gamma-glutamyltranspeptidase (gamma-GTP), lactate dehydrogenase (LDH), lysozyme and beta 2-microglobulin (BMG) were measured in patients with chronic glomerulonephritis, nephrotic syndrome and chronic renal failure. Urinary trehalase activity was significantly increased in chronic glomerular disease, especially nephrotic syndrome, as compared with that in the healthy subjects. The highest incidence of elevated excretion was observed for trehalase with 52% in chronic glomerular disease, followed by NAG. Urinary trehalase activities in the patients were significantly correlated with the urinary levels of protein, NAG and AAP and total score of tubular damage, but not correlated with urinary levels of BMG or lysozyme. In patients with chronic glomerulonephritis and nephrotic syndrome, there was no significant difference in urinary trehalase activities between with and without hematuria. These results indicate that in some patients with chronic glomerular disease, there is tubular involvement as substantiated by elevation of the other urinary enzymes and BMG. Urinary trehalase is elevated more often in these types of disease than other markers of tubular damage.

Lack of contribution of circulatory kinin elevated by captopril to induce hypotension in normotensive and hypertensive rats.

Captopril (10 mg/kg, i.p.) increased the arterial bradykinin (BK) level (Art-BK) of non-treated Sprague-Dawley rats (SD), determined by an ELISA, from 10.8 +/- 3.2 pg/ml to 32.9 +/- 5.4 pg/ml significantly (p < 0.05, n = 6). Intravenous infusion of BK (100-3000 ng/kg/min) dose-dependently increased heart rate (HR) and decreased mean blood pressure (MBP), the former at lower doses than the latter, and the hypotensive response became significant at 3000 ng/kg/min. Art-BK determined during infusion of the lowest dose of BK (100 ng/kg/min) was 12 times the endogenous Art-BK after captopril administration. In spontaneously hypertensive rats, Wistar Kyoto rats, and deoxycorticosterone acetate-salt treated hypertensive rats, Art-BK (450-1280 pg/ml) determined during intravenous BK-infusion (1000-3000 ng/kg/min), which induced significant hypotension, was 20 to 100 times the endogenous Art-BK (4.5-64 pg/ml) with captopril treatment. These results suggest that the increased Art-BK due to inhibition of kinin degradation by captopril could not account for the hypotension due to this angiotensin converting enzyme inhibitor in normotensive and hypertensive rats.

Enzyme immunoassay for urinary albumin at low concentration in diabetes mellitus.

Microalbuminuria, an increased excretion of urinary albumin undetectable by Albustix test strips, appears to predict the late development of diabetic nephropathy at a stage that albuminuria might be reduced by good metabolic control Once albuminuria is detected by Albustix, it indicates the likelihood of diabetic nephropathy. Microalbuminuria is also related to an increased prevalence of proliferative retinopathy, blindness, and peripheral neuropathy. It is therefore important to detect microalbuminuria by a sensitive, rapid and simple method. Microalbuminuria can be measured by radial immunodiffusion, immunoelectrophoresis, radioimmunoassay, enzyme immunoassay, latex-bead immunoagglutination, turbidimetric immunoassay and dye-binding. The disadvantages of radioimmunoassays are: short shelf life, isotope-related health and safety hazards, and the expense of equipment used to measure gamma-emitting isotopes. Our aim in this study was to develop a simple, rapid and sensitive one-step sandwich enzyme immunoassay using anti-human albumin monoclonal antibodies for screening microalbuminuria.

Optimal conditions for collection of blood samples for assay of α2-macroglobulin trypsin complex-like substance (MTLS)

We have developed an enzyme‐linked immunosorbent assay (ELISA) for the specific quantification of α2‐macroglobulin‐trypsin complex‐like substance (MTLS). To exclude artifacts in measured values of MTLS, the conditions for collection of blood samples are critical. In the present study, we have determined the optimal conditions for blood collection and investigated the role of MTLS as a clinical tool for diagnosis in pancreatitis.