Monocytes of patients with diabetes were under ER stress. A: The gene expression profiles of representative vulnerable CD14+ monocytes obtained from five patients with diabetes and five healthy volunteers were analyzed using a DNA microarray. Unsupervised hierarchic clustering using 17,184 filtered genes produced two clusters that separated the patients with diabetes from the healthy volunteers without exception. B and C: The gene expression levels of the ER stress markers, such as CHOP and BiP, on CD14+ monocytes and CD4+ T-cells obtained from 33 patients with diabetes and 28 healthy volunteers were analyzed using RTD-PCR. B: The expression levels of CHOP and BiP in monocytes of patients with diabetes were significantly upregulated, compared with the monocytes of healthy volunteers. Data are expressed as means ± SEM. *P < 0.05, **P < 0.01. C: The expression levels of CHOP and BiP in T-cells of patients with diabetes were similar to those of healthy volunteers. Data are expressed as means ± SEM. D: Monocytes were obtained from three healthy volunteers and three patients with diabetes (healthy volunteer 1: 64-year-old man, A1C 5.7%; healthy volunteer 2: 66-year-old man, A1C 4.9%; healthy volunteer 3: 68-year-old woman, A1C 5.6%; diabetic patient 1: 56-year-old man, A1C 9.1%; diabetic patient 2: 64-year-old woman, A1C 8.2%; diabetic patient 3: 71-year-old man, A1C 10.2%) and examined using electron microscopy. In the three patients with diabetes, the concentric, continuous, and regular layer structures of the ER were corrupted, with fewer ribosomes on the ER membrane compared with the ER of the healthy volunteer. ER, endoplasmic reticulum; M, mitochondrion; N, nucleus. Scale bars indicate 100 nm.CD14+ monocytes are vulnerable and functionally impaired under endoplasmic reticulum stress in patients with type 2 diabetes. Komura T, Sakai Y, Honda M, Takamura T, Matsushima K, Kaneko S - Diabetes (2009). Not Altered. CC.