Glucosensing neurons in the ventromedial hypothalamic nucleus (VMN) and hypoglycemia-associated autonomic failure (HAAF).
Glucosensing neurons in the ventromedial hypothalamic nucleus (VMN) and hypoglycemia-associated autonomic failure (HAAF).
复制标题
下丘脑腹内侧核（VMN）中的葡萄糖感应神经元和低血糖相关的自主神经衰竭（HAAF）。
DOI：
10.1002/dmrr.404
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Routh,VanessaH
中科院分区：
文献类型：
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作者：
Routh,VanessaH
由于葡萄糖是大脑的首选燃料，因此低血糖对大脑是一种严重的威胁。因此，必须感知血糖的降低，并产生适当的激素和神经内分泌反应，以将血糖恢复到安全水平（即对低血糖的反调节反应（CRR））。复发性低血糖会损害这些保护机制，导致可能危及生命的疾病，称为低血糖相关自主神经功能衰竭（HAAF）。在HAAF期间，血糖阈值被重置，使得葡萄糖水平必须在CRR启动之前进一步下降。大脑在感知低血糖和启动CRR方面起着关键作用。此外，许多神经元可以感知血浆和细胞外葡萄糖的变化。然而，中枢葡萄糖感知被整合以有效启动CRR的方式尚不清楚。此外，该系统在HAAF期间受损的机制也是未知的。下丘脑腹内侧核（VMN）中的葡萄糖感受神经元在葡萄糖稳态中具有整合功能。首先，它们感知葡萄糖。其次，VMN接收来自其他葡萄糖传感区域的输入。最后，VMN投射到与调节交感肾上腺系统相关的区域，该交感肾上腺系统介导CRR。这篇综述讨论了VMN葡萄糖敏感神经元相对于他们的能力，发挥作用，在调节的CRR和HAAF的产生。还考虑了后脑中的葡萄糖感受神经元以及外周葡萄糖感受器。版权所有© 2003年约翰威利父子有限公司。
Hypoglycemia is a profound threat to the brain since glucose is its preferred fuel. Thus, decreases in plasma glucose must be sensed and appropriate hormonal and neuroendocrine responses generated to restore glucose to safe levels (i.e. counterregulatory responses (CRR) to hypoglycemia). Recurrent hypoglycemia impairs these protective mechanisms, resulting in a potentially life‐threatening condition known as hypoglycemia‐associated autonomic failure (HAAF). During HAAF, the glycemic threshold is reset so that glucose levels must fall further before the CRR is initiated. The brain plays a critical role in sensing hypoglycemia and initiating the CRR. Additionally, many neurons may sense changes in plasma and extracellular glucose. However, the way in which central glucose sensing is integrated to lead to effective initiation of the CRR is unknown. Furthermore, the mechanisms by which this system becomes impaired during HAAF are also unknown. Glucosensing neurons in the ventromedial hypothalamic nucleus (VMN) are poised to serve an integrative function in glucose homeostasis. First, they sense glucose. Second, the VMN receives input from other glucose‐sensing areas. Finally, the VMN projects to areas linked to the regulation of the sympathoadrenal system that mediates the CRR. This review discusses VMN glucosensing neurons relative to their capacity to play a role in the regulation of the CRR and the generation of HAAF. Glucosensing neurons in the hindbrain as well as peripheral glucosensors are also considered. Copyright © 2003 John Wiley & Sons, Ltd.