Oxygen and brain death; back from the brink.
Jacqueline K LimbergPublished in: Experimental physiology (2020)
The human brain has evolved into an unusually large, complex and metabolically expensive organ that relies entirely on a continuous supply of O2 and glucose. It has traditionally been assumed that its exorbitant energy budget, combined with little to no energy reserves, renders it especially vulnerable to anoxia and ischaemia, with substrate depletion and progression towards cell death largely irreversible and rapid. However, new and exciting evidence suggests that neurons can survive for longer than previously thought, highlighting an unexpected resilience and underappreciated capacity for functional recovery that has changed the way we think about brain cell death. Nature has the potential to unlock some of the mysteries underlying ischaemic survival, with select vertebrates having solved the problem of anoxia-hypoxia tolerance over millions of years of evolution. Better understanding of their survival strategies, including remarkable adaptations in brain physiology and redox homeostasis, might help to identify new therapeutic targets for human diseases characterized by O2 deprivation, ischaemia-reperfusion injury and ageing.
Keyphrases
- cell death
- resting state
- cerebral ischemia
- white matter
- endothelial cells
- functional connectivity
- cell cycle arrest
- acute myocardial infarction
- climate change
- type diabetes
- multiple sclerosis
- free survival
- blood glucose
- blood brain barrier
- coronary artery disease
- depressive symptoms
- subarachnoid hemorrhage
- spinal cord injury
- brain injury
- cell proliferation
- quantum dots
- acute ischemic stroke
- metabolic syndrome
- weight loss
- pi k akt
- percutaneous coronary intervention
- induced pluripotent stem cells
- glycemic control
- structural basis