The receptor for AGEs (RAGE) is linked to proinflammatory pathology in a range of tissues. The objective of this study was to assess the potential modulatory role of RAGE in diabetic retinopathy.

Diabetes was induced in wild-type (WT) and Rage ^−/− mice (also known as Ager ^−/− mice) using streptozotocin while non-diabetic control mice received saline. For all groups, blood glucose, HbA_1c and retinal levels of methylglyoxal (MG) were evaluated up to 24 weeks post diabetes induction. After mice were killed, retinal glia and microglial activation, vasopermeability, leucostasis and degenerative microvasculature changes were determined.

Retinal expression of RAGE in WT diabetic mice was increased after 12 weeks (p < 0.01) but not after 24 weeks. Rage ^−/− mice showed comparable diabetes but accumulated less MG and this corresponded to enhanced activity of the MG-detoxifying enzyme glyoxalase I in their retina when compared with WT mice. Diabetic Rage ^−/− mice showed significantly less vasopermeability, leucostasis and microglial activation (p < 0.05–0.001). Rage ^−/− mice were also protected against diabetes-related retinal acellular capillary formation (p < 0.001) but not against pericyte loss.

Rage ^−/− in diabetic mice is protective against many retinopathic lesions, especially those related to innate immune responses. Inhibition of RAGE could be a therapeutic option to prevent diabetic retinopathy.