Key words endothelial progenitor cell; high glucose; autophagy; oxidative stress; diabetes; mitochondria In patients with diabetes mellitus, cardiovascular dysfunction is one of the major complications, accounting for upto 80% of deaths. 1) Not only for the mortality, it is also a main cause for the disability in diabetes, where impaired peripheral circulation results in delayed wound healing and lower limb amputation. 2) Nevertheless, the complete mechanisms of the vascular pathogenesis in diabetic condition remain to be established.The role of endothelial progenitor cells (EPCs) in the vascularization has been identified, 3) suggesting that impaired EPC function may contribute to vascular complications under disease states. Of note, clinical observations demonstrated that the number of circulating EPCs is decreased, and their functions are impaired in diabetes. 4,5) In vivo diabetic animal studies revealed that EPC functions of mobilization, differentiation and tube formation are disrupted, 5,6) implying that EPC dysfunction could be critical for defective diabetic angiogenesis. Although several studies have given explanations including increased oxidative stress and impaired nitric oxide signaling, 7) the mechanisms underlying diabetic EPC dysfunction are still largely unknown.Autophagy, a homeostatic process that involves in organelle recycling and protein degradation, is essential for normal cellular physiology. It is upregulated in response to extra-or intra-cellular signals such as starvation and endoplasmic reticulum (ER) stress, to preserve the balance between biosynthesis and turnover. 8) The importance of autophagy has been highlighted based on the observation that defective autophagy plays a significant role in human pathologies. 9) Nevertheless, autophagy plays a double-sided role in pathological states, and excessive autophagy is linked to cellular dysfunction, preceding cell death. 9) Detrimental intracellular changes such as impaired mitochondrial function, oxidative stress, and accumulation of protein aggregates can result in autophagic cell damage. 9,10) Interestingly, impaired function of vascular cells can also be mediated by autophagy. Autophagy in endothelial cells was induced by methylglyoxal, a metabolite specific to diabetes. 11) Despite the important role of EPCs in angiogenesis and vascular regeneration, studies regarding the autophagic regulation in EPCs are very limited. Wang et al. recently observed that hypoxia induced autophagy in EPCs,12) suggesting the role of autophagy in survival of the transplanted EPCs. To our best knowledge, the autophagic alteration in EPCs under pathological conditions has not been investigated.Here, we demonstrated that pathological stress of high glucose (HG) condition increased the autophagic marker in bonemarrow derived EPCs (BM-EPCs), which is correlated to the functional impairment. Mitochondrial damage and generation of oxidative stress were increased in HG-exposed EPCs. With this study, we believe that an important evidence for the role of autopha...