PMID-29858687 – Carnosine and Advanced Glycation End Products Systematic Review
Baye E, Ukropcova B, Ukropec J, et al. "Carnosine and advanced glycation end products: a systematic review," Amino Acids, 2018;50(9):1159-1171.
Quick Reference
| Property | Value |
|---|---|
| PMID | 29858687 |
| DOI | 10.1007/s00726-018-2592-9 |
| Year | 2018 |
| Journal | Amino Acids |
| Study Type | Systematic Review |
| Evidence Level | I |
| Sample | 39 studies (in vitro, animal, human) |
| Peptide(s) Studied | Carnosine |
Key Findings
- All but 2 of 39 included studies demonstrated that carnosine can prevent the formation of advanced glycation end products (AGEs)
- Carnosine prevents AGE formation through multiple mechanisms: (1) reduction of blood glucose, (2) prevention of early glycation (Amadori product formation), (3) reversal of previously formed AGEs
- Carnosine acts as a "sacrificial peptide" — reacting with reactive carbonyl species (methylglyoxal, glyoxal) before they can modify proteins
- Carnosine inhibits protein cross-linking, a key aging mechanism driven by AGE accumulation
- Anti-glycation effect observed across in vitro, animal (diabetic rodent models), and limited human data
- The histidine residue in carnosine is critical for its anti-glycation activity (imidazole ring reactivity with carbonyl groups)
- Carnosine may be particularly relevant for diabetic complications where AGE formation is accelerated
Study Design
Systematic review following PRISMA guidelines. Searched PubMed, CINAHL, Cochrane Library for studies examining carnosine's effects on AGE formation. Included in vitro, animal, and human studies without language restriction. Assessed mechanisms, dose-response, and clinical relevance.
Limitations
- Heterogeneous study designs and models limit pooled analysis
- Most evidence is in vitro or animal; limited human clinical data
- Oral carnosine bioavailability is affected by serum carnosinase (degradation enzyme)
- Dose equivalence between model systems and human supplementation unclear
- Publication bias possible (negative results underreported)
Clinical Relevance
This systematic review provides strong mechanistic evidence for carnosine as an anti-glycation agent, which is directly relevant to aging and diabetic complications. AGE accumulation is a hallmark of biological aging (crosslinked collagen, atherosclerosis, nephropathy, retinopathy) and carnosine's ability to prevent and even reverse AGE formation makes it a mechanistically sound anti-aging supplement. The challenge of oral bioavailability (due to serum carnosinase) has led to interest in carnosinase-resistant analogs and higher-dose supplementation strategies.
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