THE EFFECT OF ACUTE HYPOGLYCEMIA ON THE CEREBRAL NMDA RECEPTOR IN NEWBORN PIGLETS

The effects of acute insulin-induced hypoglycemia on the cerebral NMDA receptor in the newborn were examined by determining [H-3]MK-801 binding as an index of NMDA receptor function in 6 control and 7 hypoglycemic piglets. In hypoglycemic animals, the glucose clamp technique with constant insulin infusion was used to maintain a blood glucose concentration of 1.2 mmol/l for 120 min before obtaining cerebral cortex for further analysis; controls received a saline infusion. Concentrations of glucose, lactate, ATP, and PCr were measured in cortex, and Na+,K+-ATPase activity was determined in a brain cell membrane preparation. [H-3]MK-801 binding was evaluated by: (1) saturation binding assays over the range of 0.5-50 nM [H-3]MK-801 in the presence of 100 mu M glutamate and glycine; and (2) binding assays at 10 nM [H-3]MK-801 in the presence of glutamate and/or glycine at 0, 10, or 100 mu M. Blood and brain glucose concentrations were significantly lower in hypoglycemic animals than controls. There was no change in brain ATP with hypoglycemia, but PCr was decreased 80% compared to control (P < 0.05). Na+,K+-ATPase activity was 13% lower in hypoglycemic animals (P < 0.05). Based on saturation binding data, hypoglycemia had no effect on the number of functional receptors (B-max), but the apparent affinity was significantly increased, as indicated by a decrease in the K-d (dissociation constant) from the control value of 8.1 +/- 1.6 nM to 5.5 +/- 2.1 nM (P < 0.05). Augmentation of [H-3]MK-801 binding by glutamate and glycine alone or in combination was also significantly greater in the hypoglycemic animals. These data suggest that acute hypoglycemia may enhance the excitotoxic effects of glutamate in the newborn.