Insulin induces dephosphorylation of eukaryotic initiation factor 2α and restores protein synthesis in vulnerable hippocampal neurons after transient brain ischemia

Brain reperfusion causes prompt, severe, and prolonged protein synthesis suppression and increased phosphorylation of eukaryotic initiation factor 2 alpha [eIF2 alpha(P)] in hippocampal CAl and hilar neurons. The authors hypothesized that eIF2 alpha(P) dephosphorylation would lead to recovery of protein synthesis. Here the effects of insulin, which activates phosphatases, were examined by immunostaining for eIF2 alpha(P) and autoradiography of in vivo S-35 amino acid incorporation. Rats resuscitated from a 10-minute cardiac arrest were given 0, 2, 10 or 20 U/kg of intravenous insulin, underwent reperfusion for 90 minutes, and were perfusion fixed. Thirty minutes before perfusion fixation, control and resuscitated animals received 500 mu Ci/kg of S-35 methionine/cysteine. Alternate 30-mu m brain sections were autoradiographed or immunostained for eIF2 alpha(P). Controls had abundant protein synthesis and no eIF2 alpha(P) in hippocampal neurons. Untreated reperfused neurons in the CAl, hilus, and dentate gyrus had intense staining for eIF2 alpha(P) and reduced protein synthesis; there was little improvement with treatment with 2 or 10 U/kg of insulin. However, with 20 U/kg of insulin. these neurons recovered protein synthesis and were free of eIF2 alpha(P). These results show that the suppression of protein synthesis in the reperfused brain is reversible; they support a causal association between eIF2 alpha(P) and inhibition of protein synthesis, and suggest a mechanism for the neuroprotective effects of insulin.