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1、GLIA55:1280–1286(2007)Hypoglycemia,BrainEnergetics,andHypoglycemicNeuronalDeathSANGWONSUH,1,2AARONM.HAMBY,1,21,2*ANDRAYMONDA.SWANSON1DepartmentofNeurology,UniversityofCalifornia,SanFrancisco,California,and2VeteransAffairsMedicalCenter,SanFrancisco,Ca
2、liforniaKEYWORDSofinsulin.Intheseexperiments,thefallinbloodglucoseglucose;zinc;astrocyte;PARP-1;glycogen;energy;EEGcorrelatedwithacerebraldysfunctionthatrangedfrommildbehavioralimpairmenttocoma(Cooperetal.,1974).ABSTRACTSubsequentworkinthisfieldhassup
3、portedtheideaHypoglycemiaisacommonandseriousproblemamongthatbrainhasauniquerequirementforcontinuousglu-diabeticpatientsreceivingtreatmentwithinsulinorothercosedelivery.Allothertissues,includingtheheart,canglucose-loweringdrugs.Moderatehypoglycemiaimp
4、airsneurologicalfunction,andseverehypoglycemialeadstofunctionnormallyduringseverehypoglycemia.However,deathofselectivelyvulnerableneurons.Recentadvancesanopenquestionremainsastothecompartmentalizationhaveshednewlightontheunderlyingprocessesthatcauseo
5、fglucosemetabolismonceithaspassedoutofthecircu-neuronaldeathinhypoglycemiaandthefactorsthatmaylationandintothebrainparenchyma.Althoughitwasrenderspecificneuronalpopulationsespeciallyvulnerablelongassumedthatneuronsdirectlyandautonomouslytohypoglycemia
6、.Inadditiontoitsclinicalimportance,themetabolizeglucosetosustainfunction,morerecentstu-pathophysiologyofhypoglycemiaisanindicatorofthediessuggestthatglucosemayfirstbemetabolizedinuniquebioenergeticpropertiesofthecentralnervoussys-astrocytestolactateor
7、otherintermediates,whicharetem,inparticularthemetaboliccouplingofneuronalandthenshuttledtoneurons(PellerinandMagistretti,1994).astrocytemetabolism.Thisreviewwillfocusonrelation-shipsbetweenbioenergeticsandbraindysfunctioninhypo-Ithasalsobeenproposedt
8、hatbrainglycogen,whichisglycemia,theneuronalcelldeathprogramtriggeredbylocalizedalmostexclusivelytoastrocytes(Koizumi,1974),hypoglycemia,andtheroleofastrocytesintheseprocesses.mayserveasalocalglucosestoreforlatermobilizationasVC2007Wiley-Liss,Inc.ane
