Identification of RAGE Inhibitors from Curcuma caesia Roxb: Implications in Treatment against Diabetic Complications

Introduction: Diabetic nephropathy (DN) is a progressive renal complication that significantly contributes to end-stage renal disease. Hyperglycaemia contributes to the formation of advanced glycation end-products (AGEs). The interaction between AGEs and their receptor (RAGE) plays a key role in the progression of DN. RAGE activation increases oxidative stress and promotes inflammation, thereby evoking cellular and molecular damage. Together, these events result in kidney injury and varying degrees of proteinuria. This study aims to evaluate the drug-like properties of potential natural compounds derived from Curcuma caesia and their potential effectiveness against DN. Methods: This study investigates the antioxidant properties of Curcuma caesia (CC) rhizome extracts, alongside in silico methodologies including molecular docking, QSAR, and ADMET analysis to identify potential metabolites. Results: In this study, we examined the potential of phytochemicals identified from the rhizome extracts of Curcuma caesia (CC) that may mimic AGEs and inhibit RAGE activation. We assessed whether these phytochemicals could prevent ROS accumulation and inflammation, thereby providing renoprotection in a diabetic milieu. Using molecular docking and ADMET analysis, we identified two compounds, Lappaol A and Piperaduncin B, in the methanolic extract of CC, which demonstrated a stronger affinity for interacting with RAGE than the AGE compound MODIC and the RAGE inhibitor Azeliragon. Discussion: Since the interaction between AGEs and RAGE contributes to major pathological events in the development of DN, inhibiting this interaction could be a valuable therapeutic strategy against DN and other AGE-mediated pathologies such as retinopathy and neuropathy. Virtual screening of the identified compounds revealed that Lappaol A and Piperaduncin B effectively bind to RAGE and may interrupt RAGE activation, thereby potentially slowing the progression of DN. Conclusion: These natural compounds exhibited promising drug-like characteristics against the target protein RAGE and may serve as lead compounds for the development of RAGE inhibitors. The study recommends further in vitro and in vivo investigations to assess the therapeutic potential of these identified compounds in the treatment of diabetic nephropathy.