Aaron I. Vinik
Tanzania
Review Article
Charcot Neuroarthropathy may be the RAGE
Author(s): Kara A. Witzke and Aaron I. VinikKara A. Witzke and Aaron I. Vinik
Charcot neuroarthropathy (CNA) is a degenerative bone disease of unknown origin that occurs in the ankle and midfoot. While not exclusive to patients with diabetes, CNA will develop in about 0.1-2.5% of those with diabetes [1,2]. Recent work has focused on understanding the common link between inflammation induced by oxidative stress and the ensuing accumulation of advanced glycation end products (AGEs) leading to impaired bone mineral matrix mineralization and reduced bone strength in CNA. Collagen cross-linking is important for bone strength but non-enzymatic crosslinking results in an accumulation of AGEs in bone, accelerated by oxidative stress. AGEs stimulate apoptosis of osteoblastic cells mediated through RAGE, the pattern recognition receptor for AGE. AGE-RAGE interactions alter intracellular signaling via pro-inflammatory cytokines that further propagate diabetic complication.. View More»
