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Published online May 28, 2008
Diabetes 57:2461-2469, 2008
DOI: 10.2337/db07-1808
© 2008 by the American Diabetes Association
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Receptor for Advanced Glycation End Products (RAGE) Deficiency Attenuates the Development of Atherosclerosis in Diabetes

Aino Soro-Paavonen1, Anna M.D. Watson1, Jiaze Li1, Karri Paavonen1, Audrey Koitka1, Anna C. Calkin1, David Barit1, Melinda T. Coughlan1, Brian G. Drew2, Graeme I. Lancaster3, Merlin Thomas1, Josephine M. Forbes1, Peter P. Nawroth4, Angelika Bierhaus4, Mark E. Cooper1, and Karin A. Jandeleit-Dahm1

1 Albert Einstein Juvenile Diabetes Research Foundation Centre for Diabetes Complications, Diabetes Metabolism Division, Baker Heart Research Institute, Melbourne, Australia
2 Clinical Physiology Laboratory, Baker Heart Research Institute, Melbourne, Australia
3 Cellular and Molecular Metabolism Laboratory, Baker Heart Research Institute, Melbourne, Australia
4 Department of Medicine I and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany

Corresponding author: Karin Jandeleit-Dahm, karin.jandeleit-dahm{at}baker.edu.au

OBJECTIVE—Activation of the receptor for advanced glycation end products (RAGE) in diabetic vasculature is considered to be a key mediator of atherogenesis. This study examines the effects of deletion of RAGE on the development of atherosclerosis in the diabetic apoE–/– model of accelerated atherosclerosis.

RESEARCH DESIGN AND METHODS—ApoE–/– and RAGE–/–/apoE–/– double knockout mice were rendered diabetic with streptozotocin and followed for 20 weeks, at which time plaque accumulation was assessed by en face analysis.

RESULTS—Although diabetic apoE–/– mice showed increased plaque accumulation (14.9 ± 1.7%), diabetic RAGE–/–/apoE–/– mice had significantly reduced atherosclerotic plaque area (4.9 ± 0.4%) to levels not significantly different from control apoE–/– mice (4.3 ± 0.4%). These beneficial effects on the vasculature were associated with attenuation of leukocyte recruitment; decreased expression of proinflammatory mediators, including the nuclear factor-{kappa}B subunit p65, VCAM-1, and MCP-1; and reduced oxidative stress, as reflected by staining for nitrotyrosine and reduced expression of various NADPH oxidase subunits, gp91phox, p47phox, and rac-1. Both RAGE and RAGE ligands, including S100A8/A9, high mobility group box 1 (HMGB1), and the advanced glycation end product (AGE) carboxymethyllysine were increased in plaques from diabetic apoE–/– mice. Furthermore, the accumulation of AGEs and other ligands to RAGE was reduced in diabetic RAGE–/–/apoE–/– mice.

CONCLUSIONS—This study provides evidence for RAGE playing a central role in the development of accelerated atherosclerosis associated with diabetes. These findings emphasize the potential utility of strategies targeting RAGE activation in the prevention and treatment of diabetic macrovascular complications.


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