Too sweet: Problems of protein glycation in the eye

Laboratory and epidemiological data indicate that high blood sugar levels and/or consuming high glycemia diets are linked to multiple age-related diseases, including age-related macular degeneration, cataract, Parkinson's disease, Alzheimer's disease, diabetic retinopathy, and, apparently glaucoma. High concentrations of blood sugar and perturbations of the systems that regulate blood sugar lead to the accumulation of advanced-glycation end products (AGEs). AGEs are toxic compounds that are formed from the combination of sugars and their metabolites with biomolecules in a non-enzymatic biochemical reaction called glycation. In vitro and in vivo data indicate that high sugar consumption is associated with accumulation of AGEs in a variety of human tissues. Hyperglycemia, along with an oxidative environment and limited cell proliferation in many ocular tissues, encourages formation and precludes dilution of AGEs and associated damage by cell division. These circumstances make many eye tissues vulnerable to glycation-derived damage. Here, we summarize research regarding glycation-induced ocular tissue dysfunction and its contribution to the onset and development of eye disorders. We also discuss how management of carbohydrate nutrition may provide a low-cost way to ameliorate the progression of AGEs-related diseases, including age related macular degeneration and some cataracts, as they do for cardiovascular disease and diabetes. •Elevated blood sugar levels are associated with the accumulation of cytotoxic AGEs.•Environmental oxidative stress in the eye contribute to the processes of oxidation that accelerate the AGEs formation and, making ocular tissues especially vulnerable to the glycative toxicity.•Emerging evidence points out a significant role for AGEs in the etiology of multiple age-related disorders, including ocular diseases.•The basis of the glycation process can be modified by altering the dietary glycemic status per se, thus optimizing blood glucose levels.