We have investigated the regulation of the expression of two growth factors found in vascular smooth muscle, transforming growth factor a (TGFa) and basic fibroblast growth factor (bFGF). Cells cultured in medium containing 30 mM glucose exhibited a 2-fold increase in TGFa mRNA and a 3-fold increase in bFGF mRNA compared with cells grown in normal (5.5 mM) glucose. Glucosamine was more potent than glucose, leading to a 6-fold increase in TGFa mRNA. TGFa protein levels were also increased by glucosamine treatment, and the predominant species present was the membrane-bound precursor form of TGFa. To examine further the regulation of growth factors by sugars, cultured rat aortic smooth muscle cells were transfected with a plasmid construct consisting of a 1.2-kilobase-pair fragment of the TGFa promoter linked to a luciferase reporter gene. Increasing the concentration ofglucose in the culture medium from 5.5 mM to 30 mM led to a rapid, 1.7-fold increase in the activity of the TGFa promoter. Glucosamine was much more potent than glucose in this stimulation, with 2 mM gluamine causing a 12-fold increase in TGFa promoter activity. Insulin had no effect on luciferase activity in either the presence or the absence of added sugars. The glucose response element of the TGFa gene maps to a 130-base-pair segment that includes three potential binding sites for the transcription factor Spl. We conclude that high glucose concentrations such as are reached in diabetes mellitus can stimulate the transcription of the genes for growth factors in vascular smooth muscle cells. This signaling pathway apparently involves the metabolism of glucose to glucosamine. This effect could be representative of nutritional regulation of a family of genes and could contribute to the toxicity of hyperglycemia and the vascular complications of diabetes.Vascular smooth muscle cell proliferation is an early event in the pathogenesis of atherosclerosis, and growth factors have been hypothesized to play an important role in the control of this process (1). For example, platelet-derived growth factor is expressed in atherosclerotic lesions and is found in macrophages in all phases ofthe development of those lesions (2). Growth factors synthesized by the vascular smooth muscle cells themselves may also be involved in the pathogenesis of vascular disease. Thus, the exposure of vascular smooth muscle cells to growth factors could be determined by the plasma concentration of a growth factor, by delivery from blood-derived cells, or by the production rate of the growth factor by cells within the vessel wall. To examine whether the synthesis of growth factors might be sensitive to environmental conditions, we studied two growth factors known to be expressed in vascular smooth muscle cells, transforming growth factor a (TGFa; refs. 3 and 4) and basic fibroblast growth factor (bFGF; refs. 5 and 6). In addition, because the promoter for the TGFa gene has been cloned and characterized (7, 8), we studied in more detail the transcriptional regulation of the ...