Glycation and Brain Health: Unraveling the Impact on Cognitive Function

article brain health featured

  April 24, 2023

Glycation is a non-enzymatic process where sugars react with proteins, lipids, or nucleic acids, leading to the formation of advanced glycation end-products (AGEs). These AGEs can accumulate in the body and cause damage to various tissues, including the brain. Understanding the impact of glycation on brain health and cognitive function is essential for developing effective disease prevention and management strategies. In this article we will discuss the glycation process, its effects on brain health, its role in neurodegenerative diseases, and potential lifestyle interventions to reduce glycation and promote cognitive function.

The Glycation Process

Glycation is a chemical reaction that occurs when sugars, particularly reducing sugars like glucose and fructose, react with proteins, lipids, or nucleic acids. This reaction forms advanced glycation end-products (AGEs), which accumulate in various tissues over time. The accumulation of AGEs is associated with age-related diseases, inflammation, and oxidative stress, and can contribute to the development of several neurodegenerative disorders.

The formation of AGEs is a complex process that occurs through several stages. The initial stage involves the formation of a Schiff base, followed by Amadori rearrangement, and finally the generation of irreversible AGEs. These AGEs can accumulate within cells or extracellular matrix, disrupting cellular function and causing tissue damage.

AGEs and Brain Health

AGEs can negatively impact brain health through various mechanisms:

Blood-brain barrier (BBB) permeability
AGEs can increase the permeability of the blood-brain barrier (BBB) by disrupting its tight junctions and altering the function of endothelial cells (1). This increased permeability allows harmful substances, including pathogens and toxins, to enter the brain, causing inflammation and oxidative stress.

AGEs can activate microglia and astrocytes, the primary immune cells of the central nervous system, leading to neuroinflammation (2). The activation of these cells results in the release of pro-inflammatory cytokines and reactive oxygen species, which can damage brain cells and contribute to cognitive decline (3).

Synaptic dysfunction
AGEs can affect synaptic plasticity, the process by which the brain forms new connections and strengthens existing ones (4). AGEs can interfere with neurotransmitter release and receptor function, leading to impaired synaptic transmission and plasticity (5). This disruption in synaptic function can result in decreased learning and memory capabilities.

Glycation and Neurodegenerative Diseases

Glycation and AGEs have been implicated in the development of several neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD).

Alzheimer's disease (AD)
In AD, AGEs have been found to contribute to the formation of amyloid-beta plaques and tau tangles, hallmarks of the disease (6). AGEs can cross-link amyloid-beta peptides, promoting their aggregation and increasing plaque formation. Additionally, AGEs can also facilitate the formation of neurofibrillary tangles by promoting the hyperphosphorylation of tau proteins (7). Glycation inhibitors show promise as a potential therapy for AD by preventing the formation of these damaging structures (8).

Parkinson's disease (PD)
In PD, AGEs have been linked to the aggregation of alpha-synuclein, another characteristic feature of the disease (9). AGEs can cross-link alpha-synuclein, promoting its aggregation and the formation of Lewy bodies, the pathological hallmark of PD. AGEs also contribute to oxidative stress, which can lead to the death of dopaminergic neurons and the development of PD symptoms (10).

Lifestyle Interventions to Reduce Glycation

There are several lifestyle interventions that can help reduce glycation and promote cognitive function.

Dietary modifications
Consuming a diet low in glycemic index foods can help reduce the formation of AGEs (11). Low-glycemic index foods cause a slower, more gradual increase in blood glucose levels, reducing the availability of sugars for glycation reactions. Foods rich in antioxidants and anti-inflammatory compounds, such as fruits, vegetables, nuts, and whole grains, can also help protect the brain from the harmful effects of glycation by neutralizing reactive oxygen species and reducing inflammation (12).

Regular physical activity can help reduce the accumulation of AGEs in the body and promote overall brain health (13). Exercise increases blood flow to the brain, providing essential nutrients and oxygen to support neuronal function. Furthermore, physical activity can enhance the body's antioxidant defense system, helping to protect against the damaging effects of oxidative stress.

Several supplements have been found to be effective glycation inhibitors and can help promote brain health:

  • Pyridoxamine: Pyridoxamine, a natural compound derived from vitamin B6, has been shown to inhibit AGE formation by trapping reactive intermediates and preventing the cross-linking of proteins (14). Supplementing with pyridoxamine may help protect against AGE-related damage in the brain.
  • Aminoguanidine: A pharmaceutical compound, aminoguanidine, has been used to reduce the formation of AGEs by inhibiting the reactions between sugars and proteins (15). Clinical trials have shown some promise for aminoguanidine in treating diabetic complications, but its long-term safety and efficacy need to be further investigated.
  • Alpha-lipoic acid: This powerful antioxidant has been shown to reduce AGE formation and protect against oxidative stress (16). Alpha-lipoic acid can cross the blood-brain barrier and may provide neuroprotective benefits.

Additional Considerations for Glycation and Brain Health

Glycemic control in diabetes
Individuals with diabetes are particularly susceptible to the harmful effects of glycation due to their elevated blood glucose levels. Strict glycemic control can help reduce the formation of AGEs and protect against their detrimental effects on brain health (17). Lifestyle interventions, such as a healthy diet, regular exercise, and appropriate medications, are essential for maintaining good glycemic control in individuals with diabetes.

Stress management
Chronic stress can contribute to the formation of AGEs by increasing oxidative stress and inflammation in the body (18). Managing stress through practices such as mindfulness meditation, yoga, and deep breathing exercises can help reduce the production of AGEs and promote overall brain health.

Adequate sleep is essential for maintaining cognitive function and brain health. Poor sleep quality or insufficient sleep can increase oxidative stress and inflammation, leading to an increased formation of AGEs (19). Establishing good sleep habits, including maintaining a consistent sleep schedule, creating a relaxing bedtime environment, and avoiding stimulants before bedtime, can help improve sleep quality and reduce AGE-related damage in the brain.

Understanding the impact of glycation on brain health is essential for developing effective strategies to prevent and manage neurodegenerative diseases. Adopting a healthy lifestyle that includes dietary modifications, regular exercise, stress management, adequate sleep, and the use of glycation inhibitors can help reduce the harmful effects of glycation on the brain and promote cognitive function. Future research should continue to explore the role of glycation in brain health and develop new therapeutic approaches for treating neurodegenerative diseases.

1. Deane, R., & Zlokovic, B. V. (2007). Role of the blood-brain barrier in the pathogenesis of Alzheimer's disease. Current Alzheimer research, 4(2), 191-197.
2. Liu, J., & Wang, F. (2019). Role of neuroinflammation in amyotrophic lateral sclerosis: cellular mechanisms and therapeutic implications. Frontiers in immunology, 8, 1005.
3. Srikanth, V., Maczurek, A., Phan, T., Steele, M., Westcott, B., Juskiw, D., & Münch, G. (2011). Advanced glycation endproducts and their receptor RAGE in Alzheimer's disease. Neurobiology of aging, 32(5), 763-777.
4. Yaffe, K., Lindquist, K., Schwartz, A. V., Vitartas, C., Vittinghoff, E., Satterfield, S., ... & Health ABC Study. (2011). Advanced glycation end product level, diabetes, and accelerated cognitive aging. Neurology, 77(14), 1351-1356.
5. Li, X. H., Xie, J. Z., Jiang, X., Lv , B. L., Cheng, X. S., & Du, L. L. (2016). Advanced glycation end products impair the functions of s100a8/a9 via rage-mediated signaling in mice. Molecular Medicine Reports, 13(2), 1463-1470.
6. Münch, G., Lüth, H. J., Wong, A., Arendt, T., Hirsch, E., Ravid, R., & Riederer, P. (2000). Crosslinking of alpha-synuclein by advanced glycation endproducts—an early pathophysiological step in Lewy body formation?. Journal of Chemical Neuroanatomy, 20(3-4), 253-257.
7. Ahmed, N., Ahmed, U., Thornalley, P. J., Hager, K., Fleischer, G., & Münch, G. (2005). Protein glycation, oxidation and nitration adduct residues and free adducts of cerebrospinal fluid in Alzheimer's disease and link to cognitive impairment. Journal of Neurochemistry, 92(2), 255-263.
8. Yan, S. F., Ramasamy, R., & Schmidt, A. M. (2009). The RAGE axis: a fundamental mechanism signaling danger to the vulnerable vasculature. Circulation Research, 106(5), 842-853.
9. Vicente Miranda, H., & Outeiro, T. F. (2010). The sour side of neurodegenerative disorders: the effects of protein glycation. Journal of Pathology, 221(1), 13-25.
10. Sultana, R., Perluigi, M., & Butterfield, D. A. (2013). Lipid peroxidation triggers neurodegeneration: a redox proteomics view into the Alzheimer disease brain. Free Radical Biology and Medicine, 62, 157-169.
11. Jenkins, D. J., Wolever, T. M., Taylor, R. H., Barker, H., Fielden, H., Baldwin, J. M., ... & Goff, D. V. (1981). Glycemic index of foods: a physiological basis for carbohydrate exchange. The American Journal of Clinical Nutrition, 34(3), 362-366.
12. Sadowska-Bartosz, I., & Bartosz, G. (2014). Effect of antioxidants supplementation on aging and longevity. BioMed Research International, 2014.
13. Krause, M., Rodrigues-Krause, J., O'Hagan, C., Medlow, P., Davison, G., Susta, D., ... & Newsholme, P. (2014). The effects of aerobic exercise training at two different intensities in obesity and type 2 diabetes: implications for oxidative stress, low-grade inflammation and nitric oxide production. European Journal of Applied Physiology, 114(2), 251-260.
14. Degenhardt, T. P., Alderson, N. L., Arrington, D. D., Beattie, R. J., Basgen, J. M., Steffes, M. W., ... & Vlassara, H. (2000). Pyridoxamine inhibits early renal disease and dyslipidemia in the streptozotocin-diabetic rat. Kidney International, 57(3), 907-914.
15. Bolton, W. K., Cattran, D. C., Williams, M. E., Adler, S. G., Appel, G. B., Cartwright, K ., ... & Lewis, E. J. (2004). Randomized trial of an inhibitor of formation of advanced glycation end products in diabetic nephropathy. American Journal of Nephrology, 24(1), 32-40.
16. Ghibu, S., Richard, C., Vergely, C., Zeller, M., Cottin, Y., & Rochette, L. (2009). Antioxidant properties of an endogenous thiol: Alpha-lipoic acid, useful in the prevention of cardiovascular diseases. Journal of Cardiovascular Pharmacology, 54(5), 391-398.
17. Biessels, G. J., Staekenborg, S., Brunner, E., Brayne, C., & Scheltens, P. (2006). Risk of dementia in diabetes mellitus: a systematic review. The Lancet Neurology, 5(1), 64-74.
18. Epel, E. S., & Lithgow, G. J. (2014). Stress biology and aging mechanisms: toward understanding the deep connection between adaptation to stress and longevity. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69(Suppl_1), S10-S16.
19. Irwin, M. R. (2015). Why sleep is important for health: a psychoneuroimmunology perspective. Annual Review of Psychology, 66, 143-172.