Diabetes induced vascular disease is an important cause of blindness, renal failure, and nerve damage. Four major signaling pathways have been implicated in this vascular damage, three of which are activated by increased availability of the glycolytic metabolites produced by the thiamine-dependent enzyme transketolase. In the February 18 Nature Medicine, Hans-Peter Hammes and colleagues from School of Clinical Medicine, Mannheim, Germany, show that benfotiamine — a lipid-soluble thiamine derivative — blocks the three transketolase dependent pathways of hyperglycaemic damage and prevents experimental diabetic retinopathy (Nature Medicine, DOI:10.1038/nm834, February 18, 2003).

Hammes et al. evaluated the effect of benfotiamine on transketolase activity in both cultured endothelial cells and animal tissues. They observed that this thiamine derivate prevented activation of the hexosamine pathway, the intracellular AGE formation pathway and the DAG-PKC pathway — all involved in hyperglycemia-induced vascular damage. In addition, they showed that benfotiamine also inhibited hyperglycemia-associated NF-κB...

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