+APR+CME_SUPPL/Sugar-Sag--What-Is-Skin-Glycation--and-How-Do-You-Combat-It-_Figure1.png)
the use of cigarettes, reducing consumption of alcoholic beverages, and lessening exposure to environmental pollutants and UV light, as these are all exogenous sources of AGEs.1-5
Emerging Investigative Agents and the Role of Nutraceuticals
Several promising pharmacologic approaches are being studied, all aimed at processes that target AGEs and the chemical steps that lead to their formation. Current classes of agents under study include carbonyl-trapping agents, which aim to reduce carbonyl stress; metal ion chelators or free radical scavengers, which work to block sugar oxidation; crosslinking reversal agents, which undo cross-linked AGEs; and the use of RAGE antagonists (eg, anti-RAGE antibodies, soluble decoy RAGE, and small molecule inhibitors) to lessen the effects of free radical-mediated stress and inflammation in tissues.1-5 However, these approaches are still in their early development phases, and much work remains to establish their place as emerging treatments to target AGEs.
Several promising pharmacologic approaches are being studied, all aimed at processes that target AGEs and the chemical steps that lead to their formation. Current classes of agents under study include carbonyl-trapping agents, which aim to reduce carbonyl stress; metal ion chelators or free radical scavengers, which work to block sugar oxidation; crosslinking reversal agents, which undo cross-linked AGEs; and the use of RAGE antagonists (eg, anti-RAGE antibodies, soluble decoy RAGE, and small molecule inhibitors) to lessen the effects of free radical-mediated stress and inflammation in tissues.1-5 However, these approaches are still in their early development phases, and much work remains to establish their place as emerging treatments to target AGEs.
Topical formulations containing plant-based compounds have been studied for their antioxidant and antiglycation properties in the skin.1-3,5 Such compounds may be derived from licorice root (eg, glycyrrhetinic acid) and wild fruits (eg, anthocyanins, flavonoids).26,27 Blueberry extract is another organic source rich in antioxidants and has been studied for its potential beneficial role in several diseases, including type 2 diabetes (T2D).28 In one small study of 20 female patients with T2D, a topical formulation containing blueberry extract and C-xyloside (a glycosaminoglycan stimulator) significantly improved several parameters of skin aesthetics including fine lines (P=.01), firmness (P=.0011), radiance (P<.001), tone (P=.014), smoothness (P<.001), creping (P<.004), and overall appearance (P<.001).29 However, researchers were unable to measure changes in AGEs due to the short duration of the study (12 weeks).29 Further trials are needed to analyze this topical formulation over extended periods and capture potential meaningful changes in skin AGEs.
Another emerging strategy to prevent excessive skin glycation due to AGEs includes the use of exogenous collagen. In a recent study of 31 Japanese patients aged 47
