Dienel Gerald A, Rothman Douglas L, Mangia Silvia
Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Department of Cell Biology and Physiology, University of New Mexico School of Medicine, Albuquerque, New Mexico, USA.
J Neurochem. 2025 Jun;169(6):e70111. doi: 10.1111/jnc.70111.
Glucose is the major, obligatory fuel for the brain, and nearly all glucose is oxidized in the awake, resting state. However, during activation, much of the glucose is not oxidized even though adequate oxygen is available, ATP demand is increased, and glycolysis generates less ATP than oxidation. The fate of the lactate produced by glycolysis is a highly debated topic, in part because its origin and fate in the living brain are difficult to measure. One idea has been that astrocytes generate lactate and shuttle it to neurons as a major fuel, but critical elements of the shuttle model are not validated, and there is no compelling evidence to support shuttling coupled with oxidation in vivo. Metabolic brain imaging reveals rapid loss of labeled metabolites of glucose from activated tissue that is mediated by lactate transporters and gap junctional trafficking among astrocytes. Lactate is highly labeled by [C- and C]glucose, it is diffusible, and it is quickly released to blood and the perivascular-lymphatic drainage system. During intense sensory stimulation, astrocytic glycogen is consumed at half the rate of glucose by all brain cells; it is a major fuel. The oxygen-carbohydrate metabolic mismatch increases when glycogen is included in the calculation, revealing that glycogen is not oxidized. Although the energetics of brain activation is complex, metabolic modeling with comparison to a wide range of experimental data relating metabolism to neurotransmission strongly supports two concepts: (i) glycogenolysis in astrocytes spares blood-borne glucose for activated neurons, and (ii) the increase in cerebral blood flow in excess of oxygen consumption removes protons produced by glycolytic metabolism to maintain tissue pH, pO, and pCO homeostasis. Several studies have identified processes and situations that involve neuronal aerobic glycolysis, and a better understanding of the roles of glycolysis in neuron-astrocyte interactions and functional metabolism in the normal and diseased brain is required.
葡萄糖是大脑主要的、必不可少的燃料,在清醒、静息状态下,几乎所有葡萄糖都会被氧化。然而,在大脑激活过程中,即便有充足的氧气供应,大量葡萄糖也不会被氧化,同时ATP需求增加,且糖酵解产生的ATP比氧化产生的少。糖酵解产生的乳酸的去向是一个备受争议的话题,部分原因在于其在活体大脑中的来源和去向难以测定。一种观点认为,星形胶质细胞产生乳酸并将其作为主要燃料转运给神经元,但转运模型的关键要素尚未得到验证,而且也没有令人信服的证据支持在体内转运与氧化相结合的情况。代谢性脑成像显示,由乳酸转运体和星形胶质细胞之间的缝隙连接介导,活化组织中葡萄糖标记代谢物迅速流失。乳酸被[C-和C]葡萄糖高度标记,具有扩散性,并迅速释放到血液和血管周围淋巴引流系统中。在强烈的感觉刺激期间,所有脑细胞消耗星形胶质细胞糖原的速度是消耗葡萄糖速度的一半;糖原是一种主要燃料。当计算中包括糖原时,氧-碳水化合物代谢不匹配现象加剧,这表明糖原没有被氧化。尽管大脑激活的能量学很复杂,但与一系列将代谢与神经传递相关联的实验数据进行比较的代谢模型有力地支持了两个概念:(i)星形胶质细胞中的糖原分解为活化的神经元节省了血液中的葡萄糖,(ii)脑血流量增加超过氧消耗,清除了糖酵解代谢产生的质子,以维持组织pH、pO和pCO的稳态。多项研究已经确定了涉及神经元有氧糖酵解的过程和情况,需要更好地理解糖酵解在正常和患病大脑中神经元-星形胶质细胞相互作用和功能代谢中的作用。
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