A common cardiovascular complication of diabetes is an increase in the vascular escape rate of albumin, generally interpreted as an increase in microvascular permeability [1±3]. One of the more recent theories to explain this endothelial dysfunction focuses on the accumulation in blood and tissues of the advanced glycation end products (AGEs) formed from protein modification by glucose [4]. The AGE hypothesis holds that chronic diabetes-accelerated chemical modification of proteins, lipids and other molecules by reducing sugars alters their structure and function, inducing cellular Diabetologia (2001) Abstract Aims/hypothesis. Alterations in vascular permeability and oxidative stress are characteristics of endothelial dysfunction in diabetic vascular disease. Since AGE-proteins have been hypothesized to mediate these effects, we studied the effects of AGE-bovine serum albumin on endothelial monolayer permeability and intracellular glutathione. Methods. AGE-BSA was prepared by incubating BSA for 30 days at 37 C with 0.5 mol/l glucose and 0.2 mol/l phosphate buffer, pH 7.4. Permeability to fluorescently labelled BSA was assessed in a bovine pulmonary artery endothelial cell monolayer preparation. Glutathione was measured by an enzymatic assay. Results. AGE-BSA concentrations greater than 3 to 4 mmol/l produced maximal increases in permeability (6±8 times basal) within 3 to 4 h of incubation with the cells. This effect persisted for at least 48 h. However, BSA incubated in the absence of glucose produced similar effects. Dialysis of the AGE-BSA showed that low molecular weight components contained the permeability-increasing activity. Phosphate buffer used to prepare the AGE-BSA, at concentrations equivalent to those present in phosphate-buffered saline and in the AGE preparation (~5 mmol/l), produced similar permeability increases at equivalent incubation times. Metal chelators (0.5 mmol/l) or inclusion of fetal bovine serum (10±20 %) blocked these permeability increases. These increases in permeability were associated with a decrease in endothelial glutathione, both inhibited by 10 mmol/l N-acetylcysteine, and a loss of cell-tocell and cell-to-matrix adhesion molecules. Conclusion/interpretation. Trace amounts of redoxactive metal ions in biological buffers could induce oxidative stress and alterations in cellular functions attributed to AGE-proteins in vitro. It is important to use metal-free phosphate and bicarbonate buffers in studies on cell biology in vitro, especially in serum-free media. [Diabetologia (2001