3-deoxyglucosone is a uremic toxin with unknown causes in uremia. It is commonly found in diabetic patients due to high levels of glucose. Glucose enters the liver through GLUT1 transporter. In the liver it goes through two possible reactions which could cause the accumulation of 3-deoxyglucosone as a uremic toxin. There are two pathways to synthesize 3-deoxyglucosone: The polyol pathway or the maillard reaction pathway. The polyol pathway is where glucose is catalyzed into sorbitol by aldose reductase then sorbitol is catalyzed into Fructose by sorbitol dehydrogenase. Fructose then is synthesized into fructose-3-phosphate by a fructosamine enzyme. 3-Deoxyglucosone is then synthesized by fructose-3-phosphate through the biotransformer expected enzyme Alkaline phosphatase, tissue-nonspecific isozyme. The maillard reaction pathway is a non-enzymatic reaction which outside the body happens through heating. An amino acid like arginine or lysine are combined with glucose to make a schiff base and water. The schiff base is unstable so it becomes the stable amadori product. The stable amadori product loses the amino acid to synthesize a 3-deoxyglucosone. 3-deoxyglucosone is transported into the blood where it accumulates. It is unknown why 3-deoxyglucosone is synthesized in uremia patients, since it is not present in the urine of healthy people. It normally is synthesized and accumulates with high serum glucose due to diabetes. 3-deoxyglucosone causes cell apoptosis and neurotoxicity.

Metabolism and Physiological Effects of 3-Deoxyglucosone References