腎と骨代謝 Vol.14 No.1(5)


特集名 透析アミロイドーシス --update
題名 AGE化現象と透析アミロイドーシスの臨床
発刊年月 2001年 01月
著者 本宮 善恢 翠悠会診療所
著者 丸山征郎 (株)エイアンドティー試薬開発グループ
著者 吉田 治義 鹿児島大学医学部臨床検査医学
【 要旨 】 本病態へのβ2-mの関与が示されて15年経った今も,amyloidogenesisの内景はブラックボックスであり,臨床上のマーカーも知られていない.そのいずれとも関連してAGE化現象は注目されている.生体でのAGE産生は本来のMaillard反応を介する経路と介さない経路に分かれるが,透析では後者が主であり,蛋白のリジン側鎖でのカルボキシメチレーションはそのAGE化現象を反映する.現時点ではamyloidogenesisとCML化を含め,AGE化現象は未だ点と点であるが,他のアミロイド疾患(Alzheimer病,AAアミロイドーシス)でもAGE化現象の関与が確認されつつある.
Theme Dialysis -- related amyloidosis -- update
Title Advanced glycation on proteins and clinical profile of dialysis related amyloidosis
Author Yoshihiro Motomiya Suiyukai Clinic
Author Hisahiko Iwamoto R&D for Diagnostics, A&T Corporation
Author Haruyoshi Yoshida Department of Clinical Laboraroty, Faculty of Medicine, Kagoshima University
[ Summary ] It has been no less than 15 years since an essential involvement of beta2-m in dialysis related amyloidosis (DRA) was reported. However, the details of neither pathomechanism nor monitoring markers, for DRA, are yet understood. However, in relation to both of these factors advanced glycation of proteins is considered to be the most important. Advanced glycation end products (AGEs) are formed in vivo, via Maillard reaction and/or non-Maillard reactions, but the latter process is most dominant in clinical dialysis settings. Car boxymethylation of lysine residue on proteins is one of the typical modifications in that process. No links between AGEs, including carboxymethyllysine with amyloidogenesis have so far been found, though current investigations are providing new links to the in volvement of AGEs in other Amyloid diseases, such as Alzheimer disease and AA amyloidosis.
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