Glycation-induced Amyloid Formation in Proteins: An Emerging Perspective to Explore Diabetes Associated Onset of Neurodegenerative Symptoms

Non-enzymatic protein glycation occurs spontaneously via the formation of sugar-protein Schiff adducts. The end products of this pathway are terminally misfolded proteins popularly known as Advanced Glycation End (AGE) Products. Glycated proteins account for a diverse spectrum of physiological maladies including arteriosclerosis, renal failure, diabetic complications, obesity, and neurological disorders. AGEs not only jeopardise the functionality of modified proteins but also induce the formation of Covalent protein cross-links. Glycation has the potential to induce the unfolding and refolding of globular proteins into cross-beta structures thus resembling many amyloid deposits like amyloid beta, tau protein, and prions. However, glycation-induced amyloid formation is not a generic property of proteins; instead, it is guided by the nature and conformation of the protein, the type of glycation agent as well as the solution conditions governing the glycation reaction. The half-lives of AGE adducts are prolonged by their impaired proteasomal clearance since glycation modifies the lysine residues and renders them unavailable for ubiquitination. AGEs are cleared via sequestration with specific cell surface receptors (RAGE); subsequently, downstream signalling events involving MAPK and NF-kappa B result in the activation of inflammatory response or the apoptotic pathway. This perspective article discusses the current developments in understanding the various facets of glycation-associated protein aggregation and the corresponding development of amyloid-like entities.