Studies have reported the protective effect of estradiol (E2) against neuronal death induced by several insults including oxygen deprivation, mitochondrial toxins and activation of glutamate receptors. Glucose deprivation (GD) is associated with ischemia and hypoglycemia, and to date there is no effective therapeutic agent able to prevent neuronal damage induced by these conditions. In this study, we have investigated the effects of 17β-E2 and the selective agonists of the alpha (ERα) and beta (ERβ) estrogen receptors, propyl pyrazole triol (PPT) and diarylpropionitrile (DPN), respectively, on neuronal death induced by GD in cultured rat hippocampal neurons. We have also analyzed the expression of both ER isoforms after GD. Results show that GD for 2 and 4 h reduces cell survival by 42 and 55%, respectively. Treatment with 17β-E2 (10 nM to 10 µM) induces a dose-dependent protective effect that is blocked by ICI 182,780, an ER antagonist, and by 1,3-bis(4-hydroxyphenyl)-4-methyl-5-[4-(-piperidinylethoxy)phenol]-1H′pyrazole dihydrochloride (MPP) and 4-[2-phenyl-5,7-bis(trifluoromethyl)pyrazolo[1,5-a]pyrimidin-3-yl]phenol (PHTPP), selective ERα and ERβ antagonists, respectively. The ERα and ERβ agonists PPT and DPN show a similar neuroprotective effect to that of 17β-E2, but DPN is more efficient. In addition, hippocampal neurons under normal conditions show a higher expression of the ERβ isoform. When exposed to GD during 4 h, the expression of both ER isoforms is increased, while only that of the ERβ isoform significantly increases after 2 h of GD. Results demonstrate that E2 prevents neuronal death induced by GD through its interaction with ER, although the ERβ isoform might have a predominant role. Results also suggest that GD differentially alters the expression of ERα and ERβ in hippocampal neurons.

1.
Auer RN, Olsson Y, Siesjo BK: Hypoglycemic brain injury in the rat. Correlation of density of brain damage with the EEG isoelectric time: a quantitative study. Diabetes 1984;33:1090–1098.
2.
Ryan C, Vega A, Drash A: Cognitive deficits in adolescents who developed diabetes early in life. Pediatrics 1985;75:921–927.
3.
Rovet JF, Ehrlich RM, Hoppe M: Intellectual deficits associated with early onset of insulin-dependent diabetes mellitus in children. Diabetes Care 1987;10:510–515.
4.
Jones TW, Davis EA: Hypoglycemia in children with type 1 diabetes: current issues and controversies. Pediatr Diabetes 2003;4:143–150.
5.
Naguib JM, Kulinskaya E, Lomax CL, Garralda ME: Neuro-cognitive performance in children with type 1 diabetes – a meta-analysis. J Pediatr Psychol 2009;34:271–282.
6.
Kalimo H, Olsson Y: Effects of severe hypoglycemia on the human brain. Neuropathological case reports. Acta Neurol Scand 1980;62:345–356.
7.
Cryer PE: Hypoglycemia, functional brain failure, and brain death. J Clin Invest 2007;117:868–870.
8.
Suh SW, Shin BS, Ma H, Van Hoecke M, Brennan AM, Yenari MA, Swanson RA: Glucose and NADPH oxidase drive neuronal superoxide formation in stroke. Ann Neurol 2008;64:654–663.
9.
Auer RN, Kalimo H, Olsson Y, Siesjo BK: The temporal evolution of hypoglycemic brain damage. II. Light- and electron-microscopic findings in the hippocampal gyrus and subiculum of the rat. Acta Neuropathol 1985;67:25–36.
10.
Auer RN, Jensen ML, Whishaw IQ: Neurobehavioral deficit due to ischemic brain damage limited to half of the CA1 sector of the hippocampus. J Neurosci 1989;9:1641–1647.
11.
Auer RN, Siesjo BK: Hypoglycaemia: brain neurochemistry and neuropathology. Baillieres Clin Endocrinol Metab 1993;7:611–625.
12.
Suh SW, Gum ET, Hamby AM, Chan PH, Swanson RA: Hypoglycemic neuronal death is triggered by glucose reperfusion and activation of neuronal NADPH oxidase. J Clin Invest 2007;117:910–918.
13.
Suh SW, Aoyama K, Chen Y, Garnier P, Matsumori Y, Gum E, Liu J, Swanson RA: Hypoglycemic neuronal death and cognitive impairment are prevented by poly (ADP-ribose) polymerase inhibitors administered after hypoglycemia. J Neurosci 2003;23:10681–10690.
14.
Behl C: Oestrogen as a neuroprotective hormone. Nat Rev Neurosci 2002;3:433–442.
15.
Toran-Allerand CD: Minireview: a plethora of estrogen receptors in the brain: where will it end? Endocrinology 2004;145:1069–1074.
16.
Blaustein JD: Minireview: neuronal steroid hormone receptors: they’re not just for hormones anymore. Endocrinology 2004;145:1075–1081.
17.
Zhao C, Dahlman-Wright K, Gustafsson JA: Estrogen signaling via estrogen receptor β. J Biol Chem 2010;285:39575–39579.
18.
Morissette M, Le Saux M, D’Astous M, Jourdain S, Al Sweidi S, Morin N, Estrada-Camarena E, Mendez P, Garcia-Segura LM, Di Paolo T: Contribution of estrogen receptors alpha and beta to the effects of estradiol in the brain. J Steroid Biochem Mol Biol 2008;108:327–338.
19.
Kuiper GG, Enmark E, Pelto-Huikko M, Nilsson S, Gustafsson JA: Cloning of a novel receptor expressed in rat prostate and ovary. Proc Natl Acad Sci USA 1996;93:5925–5930.
20.
Mosselman S, Polman J, Dijkema R: ER beta: identification and characterization of a novel human estrogen receptor. FEBS Lett 1996;392:49–53.
21.
Tremblay GB, Tremblay A, Copeland NG, Gilbert DJ, Jenkins NA, Labrie F, Giguere V: Cloning, chromosomal localization, and functional analysis of the murine estrogen receptor beta. Mol Endocrinol 1997;11:353–365.
22.
Shughrue PJ, Lane MV, Merchenthaler I: Comparative distribution of estrogen receptor-alpha and -beta mRNA in the rat central nervous system. J Comp Neurol 1997;388:507–525.
23.
Merchenthaler I, Lane MV, Numan S, Dellovade TL: Distribution of estrogen receptor alpha and beta in the mouse central nervous system: in vivo autoradiographic and immunocytochemical analyses. J Comp Neurol 2004;473:270–291.
24.
Simpkins JW, Green PS, Gridley KE, Singh M, de Fiebre NC, Rajakumar G: Role of estrogen replacement therapy in memory enhancement and the prevention of neuronal loss associated with Alzheimer’s disease. Am J Med 1997;103:19S–25S.
25.
Yaffe K, Sawaya G, Lieberburg I, Grady D: Estrogen therapy in postmenopausal women: effects on cognitive function and dementia. JAMA 1998;279:688–695.
26.
Bagger YZ, Tanko LB, Alexandersen P, Qin G, Christiansen C: Early postmenopausal hormone therapy may prevent cognitive impairment later in life. Menopause 2005;12:12–17.
27.
Hruska Z, Dohanich GP: The effects of chronic estradiol treatment on working memory deficits induced by combined infusion of beta-amyloid (1–42) and ibotenic acid. Horm Behav 2007;52:297–306.
28.
Miller NR, Jover T, Cohen HW, Zukin RS, Etgen AM: Estrogen can act via estrogen receptor alpha and beta to protect hippocampal neurons against global ischemia-induced cell death. Endocrinology 2005;146:3070–3079.
29.
Cimarosti H, Zamin LL, Frozza R, Nassif M, Horn AP, Tavares A, Netto CA, Salbego C: Estradiol protects against oxygen and glucose deprivation in rat hippocampal organotypic cultures and activates Akt and inactivates GSK-3beta. Neurochem Res 2005;30:191–199.
30.
Raval AP, Bramlett H, Perez-Pinzon MA: Estrogen preconditioning protects the hippocampal CA1 against ischemia. Neuroscience 2006;141:1721–1730.
31.
Goodman Y, Bruce AJ, Cheng B, Mattson MP: Estrogens attenuate and corticosterone exacerbates excitotoxicity, oxidative injury, and amyloid beta-peptide toxicity in hippocampal neurons. J Neurochem 1996;66:1836–1844.
32.
Singer CA, Rogers KL, Strickland TM, Dorsa DM: Estrogen protects primary cortical neurons from glutamate toxicity. Neurosci Lett 1996;212:13–16.
33.
Hilton GD, Nunez JL, Bambrick L, Thompson SM, McCarthy MM: Glutamate-mediated excitotoxicity in neonatal hippocampal neurons is mediated by mGluR-induced release of Ca++ from intracellular stores and is prevented by estradiol. Eur J Neurosci 2006;24:3008–3016.
34.
De Girolamo LA, Hargreaves AJ, Billett EE: Protection from MPTP-induced neurotoxicity in differentiating mouse N2a neuroblastoma cells. J Neurochem 2001;76:650–660.
35.
Jover T, Tanaka H, Calderone A, Oguro K, Bennett MV, Etgen AM, Zukin RS: Estrogen protects against global ischemia-induced neuronal death and prevents activation of apoptotic signaling cascades in the hippocampal CA1. J Neurosci 2002;22:2115–2124.
36.
Wilson ME, Dubal DB, Wise PM: Estradiol protects against injury-induced cell death in cortical explant cultures: a role for estrogen receptors. Brain Res 2000;873:235–242.
37.
Wise PM: Estrogens and neuroprotection. Trends Endocrinol Metab 2002;13:229–230.
38.
Brewer GJ, Torricelli JR, Evege EK, Price PJ: Optimized survival of hippocampal neurons in B27-supplemented Neurobasal, a new serum-free medium combination. J Neurosci Res 1993;35:567–576.
39.
Massieu L, Haces ML, Montiel T, Hernandez-Fonseca K: Acetoacetate protects hippocampal neurons against glutamate-mediated neuronal damage during glycolysis inhibition. Neuroscience 2003;120:365–378.
40.
Berridge MV, Tan AS: Characterization of the cellular reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT): subcellular localization, substrate dependence, and involvement of mitochondrial electron transport in MTT reduction. Arch Biochem Biophys 1993;303:474–482.
41.
Paramo B, Hernandez-Fonseca K, Estrada-Sanchez AM, Jimenez N, Hernandez-Cruz A, Massieu L: Pathways involved in the generation of reactive oxygen and nitrogen species during glucose deprivation and its role on the death of cultured hippocampal neurons. Neuroscience 2010;167:1057–1069.
42.
Mosmann T: Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods 1983;65:55–63.
43.
Ankarcrona M, Dypbukt JM, Bonfoco E, Zhivotovsky B, Orrenius S, Lipton SA, Nicotera P: Glutamate-induced neuronal death: a succession of necrosis or apoptosis depending on mitochondrial function. Neuron 1995;15:961–973.
44.
Liu Y, Schubert D: Cytotoxic amyloid peptides inhibit cellular 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction by enhancing MTT formazan exocytosis. J Neurochem 1997;69:2285–2293.
45.
Hernandez-Fonseca K, Cardenas-Rodriguez N, Pedraza-Chaverri J, Massieu L: Calcium-dependent production of reactive oxygen species is involved in neuronal damage induced during glycolysis inhibition in cultured hippocampal neurons. J Neurosci Res 2008;86:1768–1780.
46.
Camacho-Arroyo I, Pasapera AM, Cerbon MA: Regulation of progesterone receptor gene expression by sex steroid hormones in the hypothalamus and the cerebral cortex of the rabbit. Neurosci Lett 1996;214:25–28.
47.
Sandberg M, Butcher SP, Hagberg H: Extracellular overflow of neuroactive amino acids during severe insulin-induced hypoglycemia: in vivo dialysis of the rat hippocampus. J Neurochem 1986;47:178–184.
48.
Swanson RA, Choi DW: Glial glycogen stores affect neuronal survival during glucose deprivation in vitro. J Cereb Blood Flow Metab 1993;13:162–169.
49.
Wieloch T: Hypoglycemia-induced neuronal damage prevented by an N-methyl-D-aspartate antagonist. Science 1985;230:681–683.
50.
Suh SW, Hamby AM, Gum ET, Shin BS, Won SJ, Sheline CT, Chan PH, Swanson RA: Sequential release of nitric oxide, zinc, and superoxide in hypoglycemic neuronal death. J Cereb Blood Flow Metab 2008;28:1697–1706.
51.
Haces ML, Montiel T, Massieu L: Selective vulnerability of brain regions to oxidative stress in a non-coma model of insulin-induced hypoglycemia. Neuroscience 2010;165:28–38.
52.
Klinge CM, Brolly CL, Bambara RA, Hilf R: hsp70 is not required for high affinity binding of purified calf uterine estrogen receptor to estrogen response element DNA in vitro. J Steroid Biochem Mol Biol 1997;63:283–301.
53.
Caruso D, Scurati S, Maschi O, De Angelis L, Roglio I, Giatti S, Garcia-Segura LM, Melcangi RC: Evaluation of neuroactive steroid levels by liquid chromatography-tandem mass spectrometry in central and peripheral nervous system: effect of diabetes. Neurochem Int 2008;52:560–568.
54.
Green PS, Bishop J, Simpkins JW: 17 alpha-estradiol exerts neuroprotective effects on SK-N-SH cells. J Neurosci 1997;17:511–515.
55.
Bae YH, Hwang JY, Kim YH, Koh JY: Anti-oxidative neuroprotection by estrogens in mouse cortical cultures. J Korean Med Sci 2000;15:327–336.
56.
Behl C, Widmann M, Trapp T, Holsboer F: 17-beta estradiol protects neurons from oxidative stress-induced cell death in vitro. Biochem Biophys Res Commun 1995;216:473–482.
57.
Chen S, Nilsen J, Brinton RD: Dose and temporal pattern of estrogen exposure determines neuroprotective outcome in hippocampal neurons: therapeutic implications. Endocrinology 2006;147:5303–5313.
58.
Nilsen J, Chen S, Irwin RW, Iwamoto S, Brinton RD: Estrogen protects neuronal cells from amyloid beta-induced apoptosis via regulation of mitochondrial proteins and function. BMC Neurosci 2006;7:74.
59.
Harrington WR, Sheng S, Barnett DH, Petz LN, Katzenellenbogen JA, Katzenellenbogen BS: Activities of estrogen receptor alpha- and beta-selective ligands at diverse estrogen responsive gene sites mediating transactivation or transrepression. Mol Cell Endocrinol 2003;206:13–22.
60.
Meyers MJ, Sun J, Carlson KE, Marriner GA, Katzenellenbogen BS, Katzenellenbogen JA: Estrogen receptor-beta potency-selective ligands: structure-activity relationship studies of diarylpropionitriles and their acetylene and polar analogues. J Med Chem 2001;44:4230–4251.
61.
Carswell HV, Macrae IM, Gallagher L, Harrop E, Horsburgh KJ: Neuroprotection by a selective estrogen receptor beta agonist in a mouse model of global ischemia. Am J Physiol Heart Circ Physiol 2004;287:H1501–H1504.
62.
Zhao L, Wu TW, Brinton RD: Estrogen receptor subtypes alpha and beta contribute to neuroprotection and increased Bcl-2 expression in primary hippocampal neurons. Brain Res 2004;1010:22–34.
63.
Aguirre C, Jayaraman A, Pike C, Baudry M: Progesterone inhibits estrogen-mediated neuroprotection against excitotoxicity by down-regulating estrogen receptor-beta. J Neurochem 2010;115:1277–1287.
64.
Kim H, Bang OY, Jung MW, Ha SD, Hong HS, Huh K, Kim SU, Mook-Jung I: Neuroprotective effects of estrogen against beta-amyloid toxicity are mediated by estrogen receptors in cultured neuronal cells. Neurosci Lett 2001;302:58–62.
65.
Dubal DB, Zhu H, Yu J, Rau SW, Shughrue PJ, Merchenthaler I, Kindy MS, Wise PM: Estrogen receptor alpha, not beta, is a critical link in estradiol-mediated protection against brain injury. Proc Natl Acad Sci USA 2001;98:1952–1957.
66.
Cordey M, Pike CJ: Neuroprotective properties of selective estrogen receptor agonists in cultured neurons. Brain Res 2005;1045:217–223.
67.
Nilsen J, Mor G, Naftolin F: Estrogen-regulated developmental neuronal apoptosis is determined by estrogen receptor subtype and the Fas/Fas ligand system. J Neurobiol 2000;43:64–78.
68.
Dubal DB, Shughrue PJ, Wilson ME, Merchenthaler I, Wise PM: Estradiol modulates bcl-2 in cerebral ischemia: a potential role for estrogen receptors. J Neurosci 1999;19:6385–6393.
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