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High glucose induces human endothelial dysfunction through an Axl-dependent mechanism

Chien-Hsing Lee1, Yi-Shing Shieh23, Fone-Ching Hsiao1, Feng-Chih Kuo1, Chih-Yuan Lin4, Chang-Hsun Hsieh1 and Yi-Jen Hung1*

Author Affiliations

1 Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, #325, Section 2, Cheng-Gong Rd., Nei-Hu, Taipei, Taiwan

2 School of Dentistry, National Defense Medical Center, Taipei, Taiwan

3 Department of Oral Diagnosis and Pathology, Tri-Service General Hospital, Taipei, Taiwan

4 Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

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Cardiovascular Diabetology 2014, 13:53  doi:10.1186/1475-2840-13-53

Published: 26 February 2014



The receptor tyrosine kinase Axl and its ligand growth arrest-specific protein 6 (Gas6) are involved in the diabetic vascular disease. The aim of this study was to explore the role of Gas6/Axl system in high glucose (HG)-induced endothelial dysfunction.


We investigated the effect of various glucose concentrations on Axl signaling in human microvascular endothelial cells (HMEC-1 s).


Human plasma Gas6 value inversely correlated with glucose status, endothelial markers. HG decreased Gas6/Axl expression and increased intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression in HMEC-1 s. HG significantly decreased HMEC-1 s cell viability and tube formation and promoted monocyte-EC adhesion. Down-regulation of Akt phosphorylation was found in HG culture. Axl transfection significantly reversed HG-induced Akt phosphorylation, VCAM-1 expression and endothelial dysfunction. We also found additive changes in Axl-shRNA-infected HMEC-1 cells in HG culture. Furthermore, Axl overexpression in HMEC-1 s significantly reversed HG-induced vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGFR2) expression. In addition, significantly lower Axl and VEGFR2 expression in arteries were found in diabetic patients as compared with non-diabetic patients.


This study demonstrates that HG can alter Gas6/Axl signaling and may through Akt and VEGF/VEGFR2 downstream molecules and suggests that Gas6/Axl may involve in HG-induced EC dysfunction.

Diabetes; Endothelial cell; Gas6/Axl