Significance of endothelial progenitor cells in subjects with diabetes.

D iabetes complications represent a huge burden for patients and health services. The fight against each single complication has led to significant improvements in diabetes care, especially for microvascular complications, yet macroangiopathy remains a major source of morbidity and mortality. A common approach for the prevention and treatment of diabetes complications relies on the understanding of their complex pathophysiology. A unifying biochemical theory suggests that oxidative stress underlies subsequent cellular damage pathways, which leads to diabetes complications, but common supracellular mechanisms are still unclear. Endothelial progenitor cells (EPCs) are circulating immature cells that contribute to vascular homeostasis and compensatory angiogenesis. During the last decade, data have become available indicating that alterations in EPCs may have an important causative role in the development and progression of virtually all diabetes complications. In this review, we will focus on the mechanisms of EPC reduction and dysfunction associated with diabetes by discussing their role in each single complication and possible therapeutic interventions.