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Several thrombogenic abnormalities are associated with diabetes. Since endothelial dysfunction occurs at early stages of disease, it may reflect pathophysiological changes that are responsible for alterations in vascular structure, growth and modifications of adhesivity to platelets and leukocytes, leading to atherosclerosis and thrombosis. Predisposing factors of vascular diseases, such as diabetes, are also associated with endothelial dysfunction. Restoration or replacement of endothelium-related factors like nitric oxide impede the progression of vascular thrombogenic diseases, and prevent the action of vasoconstrictor factors such as endothelin or other prothrombotic factors such as plasminogen-activator inhibitor-1. Since high glucose concentration in blood is the hallmark of diabetes and because the vascular lesions of atherosclerosis are localized in large artheries, we have cultured endothelial cells from the human aorta. Two endothelial cell strains from the same aortic tract that show different characteristics and behavior in high glucose were isolated. Such findings reflect the importance to have well characterized and standardized cell culture systems to carry out experiments to study the glucose-dependent atherosclerotic process in vitro. Our cell strains may represent a useful in vitro model to study the complex pathophysiology of diabetes-related atherosclerosis.

Vascular endothelial cells play an important role in coagulation regulation of vascular tone and in a variety of synthetic and metabolic functions. Endothelial cells also have a pivotal role in immunological diseases atherogenesis and tumor angiogenesis. Endothelial cells are often used as system to study the pathophysiology of late complications in diabetes mellitus atherosclerotic damages and leukocyte adhesion in inflammatory diseases. Most of the studies have been performed on primary arterial and venous endothelial cell cultures with problems such as availability of autoptic material and reproducibility of cell cultures. We have isolated and characterized a novel system of proliferating long-term cultures of human aortic endothelial cells that maintain their differentiated characteristics for many generations in vitro. They produce antithrombotic and thrombotic factors such as t-PA and PAI-1 and respond to TNFalpha, an important factor correlated with the inflammatory process by modifying growth characteristics by producing cytokines such as GM-CSF by expressing ICAM-1 on the surface and by producing large amounts of nitric oxide and endothelin. This new system may be very useful to understand and study the molecular mechanisms involved in many vascular alteration pathologies and in the aging process.