Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage

Objective: Hypoglycemia is a common adverse event and can injure central nervous system (CNS) white matter (WM). We determined if glutamate receptors were involved in hypoglycemic WM injury. Methods: Mouse optic nerves (MON), CNS WM tracts, were maintained at 37°C with oxygenated artificial cerebro...

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Main Authors: Yang, Xin, Hamner, Margaret A., Brown, Angus M., Evans, Richard D., Ye, Zu-Cheng, Chen, Shengdi, Ransom, Bruce R.
Format: Article
Published: Wiley 2014
Online Access:https://eprints.nottingham.ac.uk/35413/
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author Yang, Xin
Hamner, Margaret A.
Brown, Angus M.
Evans, Richard D.
Ye, Zu-Cheng
Chen, Shengdi
Ransom, Bruce R.
author_facet Yang, Xin
Hamner, Margaret A.
Brown, Angus M.
Evans, Richard D.
Ye, Zu-Cheng
Chen, Shengdi
Ransom, Bruce R.
author_sort Yang, Xin
building Nottingham Research Data Repository
collection Online Access
description Objective: Hypoglycemia is a common adverse event and can injure central nervous system (CNS) white matter (WM). We determined if glutamate receptors were involved in hypoglycemic WM injury. Methods: Mouse optic nerves (MON), CNS WM tracts, were maintained at 37°C with oxygenated artificial cerebrospinal fluid (ACSF) containing 10 mM glucose. Aglycemia was produced by switching to 0 glucose ACSF. Supra-maximal compound action potentials (CAPs) were elicited using suction electrodes and axon function was quantified as the area under the CAP. Amino acid release was measured using HPLC. Extracellular [lactate] was measured using an enzyme electrode. Results: About 50% of MON axons were injured after 60 min of aglycemia (90% after 90 min); injury was not affected by animal age. Blockade of NMDA-type glutamate receptors improved recovery after 90 min of aglycemia by 250%. Aglycemic injury was increased by reducing [Mg2+]o or increasing [glycine]o, and decreased by lowering pHo, expected results for NMDA receptor-mediated injury. Extracellular pH increased during aglycemia, due to a drop in [lactate-]o. Aglycemic injury was dramatically reduced in the absence of [Ca2+]o. Extracellular aspartate, a selective NMDA receptor agonist, increased during aglycemia. Interpretation: Aglycemia injured WM by a unique excitotoxic mechanism involving NMDA receptors (located primarily on oligodendrocytes). During WM aglycemia, the selective NMDA agonist, aspartate, is released, probably from astrocytes. Injury is mediated by Ca2+ influx through aspartate-activated NMDA receptors made permeable by an accompanying alkaline shift in pHo caused by a fall in [lactate-]o. These insights have important clinical implications.
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spelling nottingham-354132020-05-04T16:46:51Z https://eprints.nottingham.ac.uk/35413/ Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage Yang, Xin Hamner, Margaret A. Brown, Angus M. Evans, Richard D. Ye, Zu-Cheng Chen, Shengdi Ransom, Bruce R. Objective: Hypoglycemia is a common adverse event and can injure central nervous system (CNS) white matter (WM). We determined if glutamate receptors were involved in hypoglycemic WM injury. Methods: Mouse optic nerves (MON), CNS WM tracts, were maintained at 37°C with oxygenated artificial cerebrospinal fluid (ACSF) containing 10 mM glucose. Aglycemia was produced by switching to 0 glucose ACSF. Supra-maximal compound action potentials (CAPs) were elicited using suction electrodes and axon function was quantified as the area under the CAP. Amino acid release was measured using HPLC. Extracellular [lactate] was measured using an enzyme electrode. Results: About 50% of MON axons were injured after 60 min of aglycemia (90% after 90 min); injury was not affected by animal age. Blockade of NMDA-type glutamate receptors improved recovery after 90 min of aglycemia by 250%. Aglycemic injury was increased by reducing [Mg2+]o or increasing [glycine]o, and decreased by lowering pHo, expected results for NMDA receptor-mediated injury. Extracellular pH increased during aglycemia, due to a drop in [lactate-]o. Aglycemic injury was dramatically reduced in the absence of [Ca2+]o. Extracellular aspartate, a selective NMDA receptor agonist, increased during aglycemia. Interpretation: Aglycemia injured WM by a unique excitotoxic mechanism involving NMDA receptors (located primarily on oligodendrocytes). During WM aglycemia, the selective NMDA agonist, aspartate, is released, probably from astrocytes. Injury is mediated by Ca2+ influx through aspartate-activated NMDA receptors made permeable by an accompanying alkaline shift in pHo caused by a fall in [lactate-]o. These insights have important clinical implications. Wiley 2014-04-10 Article PeerReviewed Yang, Xin, Hamner, Margaret A., Brown, Angus M., Evans, Richard D., Ye, Zu-Cheng, Chen, Shengdi and Ransom, Bruce R. (2014) Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage. Annals of Neurology, 75 (4). pp. 492-507. ISSN 0364-5134 http://onlinelibrary.wiley.com/doi/10.1002/ana.24050/abstract doi:10.1002/ana.24050 doi:10.1002/ana.24050
spellingShingle Yang, Xin
Hamner, Margaret A.
Brown, Angus M.
Evans, Richard D.
Ye, Zu-Cheng
Chen, Shengdi
Ransom, Bruce R.
Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title_full Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title_fullStr Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title_full_unstemmed Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title_short Novel hypoglycemic injury mechanism: N-methyl-D-aspartate receptor-mediated white matter damage
title_sort novel hypoglycemic injury mechanism: n-methyl-d-aspartate receptor-mediated white matter damage
url https://eprints.nottingham.ac.uk/35413/
https://eprints.nottingham.ac.uk/35413/
https://eprints.nottingham.ac.uk/35413/