title: Recurrent/moderate hypoglycemia induces hippocampal dendritic injury, microglial activation, and cognitive impairment in diabetic rats.
abstract: BACKGROUND
  Recurrent/moderate (R/M) hypoglycemia is common in type 1 diabetes. Although mild or moderate hypoglycemia is not life-threatening, if recurrent, it may cause cognitive impairment. In the present study, we sought to determine whether R/M hypoglycemia leads to neuronal death, dendritic injury, or cognitive impairment.
  
  
  METHODS
  The experiments were conducted in normal and in diabetic rats. Rats were subjected to moderate hypoglycemia by insulin without anesthesia. Oxidative stress was evaluated by 4-Hydroxy-2-nonenal immunostaining and neuronal death was determined by Fluoro-Jade B staining 7 days after R/M hypoglycemia. To test whether oxidative injury caused by NADPH oxidase activation, an NADPH oxidase inhibitor, apocynin, was used. Cognitive function was assessed by Barnes maze and open field tests at 6 weeks after R/M hypoglycemia.
  
  
  RESULTS
  The present study found that oxidative injury was detected in the dendritic area of the hippocampus after R/M hypoglycemia. Sparse neuronal death was found in the cortex, but no neuronal death was detected in the hippocampus. Significant cognitive impairment and thinning of the CA1 dendritic region was detected 6 weeks after hypoglycemia. Oxidative injury, cognitive impairment, and hippocampal thinning after R/M hypoglycemia were more severe in diabetic rats than in non-diabetic rats. Oxidative damage in the hippocampal CA1 dendritic area and microglial activation were reduced by the NADPH oxidase inhibitor, apocynin.
  
  
  CONCLUSIONS
  The present study suggests that oxidative injury of the hippocampal CA1 dendritic region by R/M hypoglycemia is associated with chronic cognitive impairment in diabetic patients. The present study further suggests that NADPH oxidase inhibition may prevent R/M hypoglycemia-induced hippocampal dendritic injury.
authors: Department of Neurology, University of California at San Francisco and Veterans Affairs Medical Center, San Francisco, CA, USA.
authors: Seok Joon
authors: SJ
authors: Won
authors: Byung Hoon
authors: BH
authors: Yoo
authors: Tiina M
authors: TM
authors: Kauppinen
authors: Bo Young
authors: BY
authors: Choi
authors: Jin Hee
authors: JH
authors: Kim
authors: Bong Geom
authors: BG
authors: Jang
authors: Min Woo
authors: MW
authors: Lee
authors: Min
authors: M
authors: Sohn
authors: Jialing
authors: J
authors: Liu
authors: Raymond A
authors: RA
authors: Swanson
authors: Sang Won
authors: SW
authors: Suh
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D003072:Cognition Disorders / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D003712:Dendrites / Q000378:metabolism / Q000473:pathology*; D003921:Diabetes Mellitus, Experimental / Q000378:metabolism / Q000473:pathology; D006624:Hippocampus / Q000378:metabolism / Q000473:pathology*; D007003:Hypoglycemia / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008297:Male; D017628:Microglia / Q000378:metabolism / Q000473:pathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012008:Recurrence
chemical_list: D001786:Blood Glucose