Hypoglycemic encephalopathy

Hasebe, Masashi; Shibue, Kazuhisa; Honjo, Sachiko; Hamasaki, Akihiro

doi:10.1093/qjmed/hcac125

Cited by 1 publication

(2 citation statements)

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“…Further, we found that neuronal damage was an adverse reaction induced by the DDIs between PRL and the ART drugs. Low levels of glucose can cause irreversible damage to the CNS 38 . We also found that the longer the neurons had low glucose levels, the lower the survival rate of the neurons.…”

Section: Discussionsupporting

confidence: 49%

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Drug–drug interactions between propofol and ART drugs: Inhibiting neuronal activity by affecting glucose metabolism

Li,

Zheng,

Long

et al. 2023

CNS Neurosci Ther

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BackgroundThe use of two or more drugs carries the potential risk of drug–drug interactions (DDIs), which may result in adverse reactions. Some human immunodeficiency virus (HIV)‐infected patients who receive antiretroviral therapy (ART) may require general anesthesia with propofol (PRL) before undergoing surgical treatment. Both PRL and ART drugs may lead to neuronal dysfunction, which can be accompanied by energy metabolism disorders. Neurons take in glucose mainly through glucose transporter 3 (Glut3) which is specifically expressed on the cell membranes of neurons. However, to date, no study has examined whether the DDIs of PRL and ART drugs interfere with glucose metabolism and Glut3 expression in neurons.MethodsAn in vitro model was constructed using the primary cultures of neurons. PRL and ART drugs (EFV, AZT, and 3TC), were added at different concentrations (low, medium, and high). The neurons were exposed to the drugs for 1, 4, 8, and 12 h. The optimal drug concentration and exposure time were selected. The cellular survival rate, glucose concentration, electrophysiology, and the expression of Glut3 were detected.ResultsThere were no significant changes in the cellular survival rates of the neurons that were exposed to both PRL and ART drugs at low concentrations for 1 h. However, the survival rates of the neurons decreased significantly as the drug concentrations and durations increased. The glucose concentration of the neurons that were exposed to both PRL and the ART drugs was significantly decreased. The glucose concentration of the neurons was not affected by any individual drug. The amplitude of the action potential and the expression of Glut3 were decreased in the neurons that were exposed to both PRL and ART drugs.ConclusionsThe main adverse reactions induced by the DDIs between PRL and the ART drugs were decreased glucose metabolism and neuronal damage, which were caused by inhibiting the expression of Glut3. More importantly, we found that decreases in glucose metabolism predated neuronal damage.

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Section: Discussionsupporting

confidence: 49%

“…Low levels of glucose can cause irreversible damage to the CNS. 38 We also found that the longer the neurons had low glucose levels, the lower the survival rate of the neurons. There was no significant damage to the neurons exposed to low concentrations of PRL and ART drugs for 1 h, but the glucose levels did begin to decrease.…”

Section: Discussionmentioning

confidence: 59%