Downstream, VEGF signaling activates PKC, an enzyme involved in endothelial permeability, then hyperglycemia promotes dysfunction in its pathway, leading to increased NADPH oxidase and MMP2, further promoting cytokine expression and oxidative stress (Shao and Bayraktutan, 2013; Dorfman and Thaler, 2015). The gene discussed is MMP2; the disease is Hyperglycemia.