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Dietary Advanced Glycation Endproducts and the Gastrointestinal Tract

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Dietary Advanced Glycation Endproducts and the Gastrointestinal Tract nutrients Review Dietary Advanced Glycation Endproducts and the Gastrointestinal Tract Timme van der Lugt 1,2,* , Antoon Opperhuizen 1,2, Aalt Bast 1,3 and Misha F. Vrolijk 3 1 Department of Pharmacology and Toxicology, Maastricht University, 6229 ER Maastricht, The Netherlands; [email protected] 2 Office for Risk Assessment and Research, Netherlands Food and Consumer Product Safety Authority (NVWA), 3540 AA Utrecht, The Netherlands 3 Campus Venlo, Maastricht University, 5911 BV Venlo, The Netherlands; [email protected] (A.B.); [email protected] (M.F.V.) * Correspondence: [email protected] Received: 27 August 2020; Accepted: 11 September 2020; Published: 14 September 2020 Abstract: The prevalence of inflammatory bowel diseases (IBD) is increasing in the world. The introduction of the Western diet has been suggested as a potential explanation of increased prevalence. The Western diet includes highly processed food products, and often include thermal treatment. During thermal treatment, the Maillard reaction can occur, leading to the formation of dietary advanced glycation endproducts (dAGEs). In this review, different biological effects of dAGEs are discussed, including their digestion, absorption, formation, and degradation in the gastrointestinal tract, with an emphasis on their pro-inflammatory effects. In addition, potential mechanisms in the inflammatory effects of dAGEs are discussed. This review also specifically elaborates on the involvement of the effects of dAGEs in IBD and focuses on evidence regarding the involvement of dAGEs in the symptoms of IBD. Finally, knowledge gaps that still need to be filled are identified. Keywords: inflammatory bowel disease; dietary advanced glycation endproducts; gastrointestinal tract; inflammation; digestion 1. Introduction Inflammatory bowel diseases (IBD) is the most commonly used term for a group of chronic inflammatory conditions of the gastrointestinal tract, of which ulcerative colitis (UC) and Crohn’s disease (CD) are the two main types. Over the past years, these inflammatory diseases have emerged as a public health challenge. The prevalence of IBD has been increasing substantially over the last decades. In 2017, approximately 6–8 million people suffered from IBD [1]. Although the aetiology of IBD has been extensively investigated, the exact pathogenesis is still not fully known. Multiple factors are involved in the pathogenesis of IBD, such as environmental factors, immunological factors, genetic susceptibility, and diet [2]. Not only in the Western world, but also in newly industrialised parts of the world such as Brazil and Taiwan, the incidence of IBD is increasing [3]. This suggests the important role of the environment in the development of the disease. More specifically, the introduction of the Western diet in those areas has been suggested as a potential explanation of increased IBD incidence [1,4]. The Western diet typically includes high levels of sugars and fats and is usually highly processed. During food processing, new compounds are introduced to food and process contaminants are being formed. Additionally, food products are often enriched with sugars and fats; proteins are often added to obtain foods that may help build muscle. All of these can potentially impact human health. The processes that food products undergo often include industrial heat treatments, such as sterilization, but also cooking and baking at home. During thermal treatment of foods which contain Nutrients 2020, 12, 2814; doi:10.3390/nu12092814 www.mdpi.com/journal/nutrients Nutrients 2020, 12, 2814 2 of 28 Nutrients 2020, 12, x FOR PEER REVIEW 2 of 26 ofproteins foods which and carbohydrates, contain proteins the Maillardand carbohydrates, reaction (MR) the can Maillard occur. reac Thistion is a (MR) chemical can reactionoccur. This between is a chemicalreducing reaction sugars andbetween amino reducing acids that sugars is responsible and amino for acids the browning that is responsible of food. The for MRthe isbrowning an intricate of food.reaction The withMR multipleis an intricate parallel reaction and sequential with multiple steps, parallel as presented and sequential in Figure 1steps,, during as presented which many in Figuredifferent 1, during compound which groups many are different formed. compound These compounds groups are are formed. also known These as MRcompounds products are (MRPs), also knownwhich includeas MR Amadoriproducts products, (MRPs), earlywhich glycation include products, Amadori advanced products, glycation early glycation endproducts products, (AGEs), advancedand melanoidins. glycation Especially endproducts AGEs (AGEs), have gained and melanoidins. a lot of attention Especially in recent AGEs years have due togained their potentiala lot of attentionnegative in eff recentect on years human due health. to their Existing potential literature negati onve AGEseffect on mostly human focuses health. on Existing endogenously literature formed on AGEs mostly focuses on endogenously formed AGEs, which form when endogenous sugars react AGEs, which form when endogenous sugars react with endogenous proteins at 37 ◦C. The health witheffects endogenous of endogenous proteins AGEs, at including37 °C. The chronic health inflammation, effects of endogenous tissue damage, AGEs, sti ffincludingening of collagen,chronic inflammation,and enhancement tissue of damage, oxidative stiffening stress, have of beencollagen, studied andthoroughly enhancement [5]. of In oxidative addition tostress, the endogenous have been studiedformation, thoroughly AGEs can [5]. also In addition be formed to inthe food endogenous during processing. formation, These AGEs AGEs can also are be then formed considered in food as duringdietary processing. AGEs (dAGEs). These Di AGEsfferences are then in the considered health effects as betweendietary AGEs endogenous (dAGEs). AGEs Differences and dAGEs in the are health effects between endogenous AGEs and dAGEs are expected due to the different manner of expected due to the different manner of formation between both: Endogenous AGEs are formed at 37 ◦C formationwith endogenous between carbohydrates both: Endogenous and endogenousAGEs are formed proteins at 37 over °C with a longer endogenous period of carbohydrates time, while dAGEs and endogenousare formed withproteins exogenous over a longer proteins period and of carbohydrates time, while dAGEs in a shorter are formed period with of time exogenous and under proteins more andextreme carbohydrates conditions, in e.g., a highershorter temperatures. period of time Consequently, and under dimorefferent extreme subsets ofconditions, molecules e.g., are expected higher temperatures.to be formed. Consequently, This was also different shown in subsets a recent of reviewmolecules by Liangare expected et al. (2019), to be formed. who summarized This was also the shownoccurrence in a recent of different review AGEs by inLiang food et and al. in(2019) the body., who Insummarized contrast tothe the endogenous occurrence AGEs,of different dAGEs AGEs have inbeen food less and well in the studied body. and In contrast several to questions the endogenous about these AGEs, dAGEs dAGEs remain, have includingbeen less well what studied their e ffandects severalmay be, questions if and how about they these are absorbed dAGEs remain, in the human includ intestinaling what tract.their effects The latter may is be, especially if and how important they aresince absorbed absorption in the of human these dAGEsintestinal is necessarytract. The latte in orderr is especially to have systemic important eff sinceects. absorption Some excellent of these and dAGEsthorough is necessary reviews have in order already to have been systemic published ef onfects. the Some systemic excellent effects and of dAGEsthorough [6– 9reviews]. In contrast, have alreadyit is still been disputed, published to what on the extent systemic and in effects what form,of dAGE dAGEss [6–9]. are In absorbed. contrast, Independentit is still disputed, of absorption, to what extentdAGEs and enter in what the humanform, dAGEs gastrointestinal are absorbed. (GI) Independent tract after ingestion. of absorption, Studies dAGEs into the enter local the e humanffects of gastrointestinal (GI) tract after ingestion. Studies into the local effects of dAGEs in the GI tract are dAGEs in the GI tract are scarce and it is therefore not known what the local effects of dAGES in the GI scarce and it is therefore not known what the local effects of dAGES in the GI tract are. Our research tract are. Our research group recently found that dAGEs evoke an inflammatory response in vitro. group recently found that dAGEs evoke an inflammatory response in vitro. Due to these potential Due to these potential pro-inflammatory effects of dAGEs, it can be questioned whether dAGEs could pro-inflammatory effects of dAGEs, it can be questioned whether dAGEs could be involved in the be involved in the inflammatory responses for instance in IBD patients. Therefore, the present review inflammatory responses for instance in IBD patients. Therefore, the present review focusses on the focusses on the effects of dAGEs in the GI tract and identifies knowledge gaps that still need to be filled. effects of dAGEs in the GI tract and identifies knowledge gaps that still need to be filled. Figure 1. Simplified overview on advanced glycation endproducts (AGEs) formation via the Maillard Figure 1. Simplified overview on advanced glycation endproducts (AGEs) formation via the Maillard reaction
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