Fig. 8.

Effects of high glucose on inflamed human vascular smooth muscle cells. (a and b) Under low or high extracellular glucose and in the absence of cytokine activation, the cell regulates the entry of glucose. (c) However, activation with IL1β augments GLUT-dependent glucose uptake ①, enhances PPP activity ② and GSH levels ③, and activates NADPH oxidase ④ and pro-inflammatory signalling ⑤. (d) When the cytokine activation coexists with high concentrations of extracellular glucose, the increased glucose entering the cell ① is partially diverted through an over-stimulated PPP ②, resulting in a pro-oxidant environment ③ that cannot be counterbalanced by a reduced regeneration of GSH ④, leading to enhanced inflammation and ultimately to tissue damage ⑤