title: Vascular effects of ultrafine particles in persons with type 2 diabetes.
abstract: BACKGROUND
  Diabetes confers an increased risk for cardiovascular effects of airborne particles.
  
  
  OBJECTIVE
  We hypothesized that inhalation of elemental carbon ultrafine particles (UFP) would activate blood platelets and vascular endothelium in people with type 2 diabetes.
  
  
  METHODS
  In a randomized, double-blind, crossover trial, 19 subjects with type 2 diabetes inhaled filtered air or 50 µg/m³ elemental carbon UFP (count median diameter, 32 nm) by mouthpiece for 2 hr at rest. We repeatedly measured markers of vascular activation, coagulation, and systemic inflammation before and after exposure.
  
  
  RESULTS
  Compared with air, particle exposure increased platelet expression of CD40 ligand (CD40L) and the number of platelet-leukocyte conjugates 3.5 hr after exposure. Soluble CD40L decreased with UFP exposure. Plasma von Willebrand factor increased immediately after exposure. There were no effects of particles on plasma tissue factor, coagulation factors VII or IX, or D-dimer.
  
  
  CONCLUSIONS
  Inhalation of elemental carbon UFP for 2-hr transiently activated platelets, and possibly the vascular endothelium, in people with type 2 diabetes.
authors.affiliation: Department of Medicine, University of Rochester Medical Center, Rochester, New York 14642, USA.
authors.forename: Judith C
authors.initials: JC
authors.lastname: Stewart
authors.forename: David C
authors.initials: DC
authors.lastname: Chalupa
authors.forename: Robert B
authors.initials: RB
authors.lastname: Devlin
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Frasier
authors.forename: Li-Shan
authors.initials: LS
authors.lastname: Huang
authors.forename: Erika L
authors.initials: EL
authors.lastname: Little
authors.forename: Steven M
authors.initials: SM
authors.lastname: Lee
authors.forename: Richard P
authors.initials: RP
authors.lastname: Phipps
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Pietropaoli
authors.forename: Mark B
authors.initials: MB
authors.lastname: Taubman
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Utell
authors.forename: Mark W
authors.initials: MW
authors.lastname: Frampton
mesh_terms: D000328:Adult; D000367:Age Factors; D000393:Air Pollutants / Q000633:toxicity*; D001808:Blood Vessels / Q000187:drug effects*; D023201:CD40 Ligand / Q000097:blood; D002244:Carbon / Q000633:toxicity*; D003029:Coagulants / Q000633:toxicity*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D052638:Particulate Matter / Q000633:toxicity*; D012737:Sex Factors; D056647:Systemic Vasculitis / Q000139:chemically induced; D055815:Young Adult; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D000393:Air Pollutants; D003029:Coagulants; D019007:P-Selectin; D052638:Particulate Matter; D014841:von Willebrand Factor; D023201:CD40 Ligand; D002244:Carbon
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