Fructose reacts spontaneously with proteins in the brain to form advanced glycation end products (AGE) that may elicit neuroinflammation and cause brain pathology, including Alzheimer’s disease. We investigated whether fructose is eliminated by oxidative metabolism in neocortex. Injection of [14C]fructose or its AGE-prone metabolite [14C]glyceraldehyde into rat neocortex in vivo led to formation of 14C-labeled alanine, glutamate, aspartate, GABA, and glutamine. In isolated neocortical nerve terminals, [14C]fructose labeled glutamate, GABA, and aspartate, indicating uptake of fructose into nerve terminals and oxidative fructose metabolism in these structures. Hexokinase 1, which channels fructose into glycolysis, was highly expressed, and enzyme activity was similar with fructose or glucose as substrates, whereas the fructose-specific ketohexokinase was weakly expressed. The fructose transporter Glut5 was expressed at only ~4% of the level of neuronal glucose transporter Glut3, suggesting transport across plasma membranes of brain cells as the limiting factor in removal of extracellular fructose. Fructose may be formed from glucose through the polyol pathway. The genes encoding enzymes of this pathway, aldose reductase and sorbitol dehydrogenase, were expressed in rat neocortex. We conclude that fructose is transported into neocortical cells, including nerve terminals, and that it is metabolized and thereby detoxified primarily through hexokinase activity.
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