The Dark Side of Entrepreneurship

Abstract

Proteins or lipids exposed to reducing sugars become non-enzymatically glycated and oxidized. Initially, reversible early glycation adducts form, the best known of which is haemoglobin A 1c (used for long-term monitoring of glucose control in patients with diabetes). Following complex molecular rearrangements, the irreversible advanced glycation end products (AGEs) develop. These constitute a heterogeneous class of structures of yellow-brown color, with a propensity to form crosslinks, that generate reactive oxygen intermediates and interact with particular cell surface structures. Although the yellow-brown glucose modified structures were long recognized in food chemistry for their role in spoilage (The Maillard reaction), it was the insight of Anthony Cerami in 1977 that led to considering the pathobiological implications of non-enzymatic glycation. Work described in this issue of Nature Medicine by Lei et al. continues to build on Cerami's fundamental insight.