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Hexokinase-2-glycolytic overload axis in brain disorders exacerbated by diabetes.

Hexokinase-2-glycolytic overload axis in brain disorders exacerbated by diabetes.

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Riyadh, SA · Author affiliation

Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia; Department of Academic Affairs, Saudi German Hospital-Riyadh, Middle East Healthcare Company, Jeddah, Saudi Arabia.
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Jeddah, SA · Author affiliation

Department of Biochemistry, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia; Department of Academic Affairs, Saudi German Hospital-Riyadh, Middle East Healthcare Company, Jeddah, Saudi Arabia.
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Kenilworth, GB · Author affiliation

Glocentrica (UK) Ltd, Kenilworth, Warwickshire, UK.
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Original abstract

Subjects with diabetes have an increased risk of dementia, Parkinson's disease, and stroke. In the central nervous system, there is increased inflammation, blood-brain barrier permeability, amyloid-β and α-synuclein deposition, and decreased neuronal synaptogenesis and survival. The role of hexokinases in controlling glucose metabolism therein is often overlooked. We propose that hexokinase-2 dysfunction-driven glycolytic overload is critically involved. This increases glycolytic intermediates in astrocytes, microglial cells, microvessel endothelial cells, and pericytes, stimulating mitochondrial dysfunction, protein O-linked β-N-acetylglucosaminylation, protein kinase C phosphorylation, and methylglyoxal-induced unfolded protein response and NOD-, LRR-, and pyrin domain-containing protein 3 inflammasome activation. Therapeutic prevention is achieved through activation of transcription factor nuclear factor erythroid 2-related factor 2, increasing the expression of glucose-6-phosphate (G6P) dehydrogenase, glyoxalase 1, and antioxidant enzymes. This diverts excess G6P to the pentose phosphate pathway, methylglyoxal to the glyoxalase pathway, and counters oxidative stress, respectively.

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