中国神经再生研究(英文版) ›› 2022, Vol. 17 ›› Issue (7): 1397-1403.doi: 10.4103/1673-5374.330592

• 综述:脑损伤修复保护与再生 •    下一篇

脑缺血再灌注损伤低糖干预必要性的再思考

  

  • 出版日期:2022-07-15 发布日期:2022-01-15

Rethinking the necessity of low glucose intervention for cerebral ischemia/reperfusion injury

Jiahua Xie*, Farooqahmed S. Kittur, P. Andy Li, Chiu-Yueh Hung   

  1. Department of Pharmaceutical Sciences, Biomanufacturing Research Institute & Technology Enterprise, North Carolina Central University, Durham, NC, USA
  • Online:2022-07-15 Published:2022-01-15
  • Contact: Jiahua Xie, PhD, jxie@nccu.edu.
  • Supported by:
    This work was supported by a grant from the National Institute of General Medical Sciences (SC1GM111178) to JX.

摘要: https://orcid.org/0000-0003-2786-0281 (Jiahua Xie) 

Abstract: Glucose is the essential and almost exclusive metabolic fuel for the brain. Ischemic stroke caused by a blockage in one or more cerebral arteries quickly leads to a lack of regional cerebral blood supply resulting in severe glucose deprivation with subsequent induction of cellular homeostasis disturbance and eventual neuronal death. To make up ischemia-mediated adenosine 5′-triphosphate depletion, glucose in the ischemic penumbra area rapidly enters anaerobic metabolism to produce glycolytic adenosine 5′-triphosphate for cell survival. It appears that an increase in glucose in the ischemic brain would exert favorable effects. This notion is supported by in vitro studies, but generally denied by most in vivo studies. Clinical studies to manage increased blood glucose levels after stroke also failed to show any benefits or even brought out harmful effects while elevated admission blood glucose concentrations frequently correlated with poor outcomes. Surprisingly, strict glycaemic control in clinical practice also failed to yield any beneficial outcome. These controversial results from glucose management studies during the past three decades remain a challenging question of whether glucose intervention is needed for ischemic stroke care. This review provides a brief overview of the roles of cerebral glucose under normal and ischemic conditions and the results of managing glucose levels in non-diabetic patients. Moreover, the relationship between blood glucose and cerebral glucose during the ischemia/reperfusion processes and the potential benefits of low glucose supplements for non-diabetic patients are discussed. 

Key words: blood-brain barrier, blood glucose, cerebral glucose, glucose intervention, glucose transporter, glycosylation, induced hyperglycemia, ischemic penumbra, ischemic stroke, non-diabetic patients