Metabolic sensors: viewing glucosensing neurons from a broader perspective.

Glucose is a critical substrate for brain and organ function. Specialized glucosensing neurons, which are involved in the control of energy homeostasis and neuroendocrine function, are located in specific anatomic locations in the brain. Glucose-excited neurons increase their firing rate when ambient glucose levels rise. This glucosensing capacity appears to be regulated by a combination of glucokinase and an ATP-sensitive K(+) (K(ATP)) channel whose activity is regulated by ATP derived from glucose metabolism. Glucose inhibited neurons decrease their firing rate when glucose levels rise, although it is unclear what mechanism is used to control this function. Neuropeptide Y and proopiomelanocortin neurons in the hypothalamic arcuate nucleus are examples of neurons that are capable of sensing both glucose and a host of other peripheral metabolic signals, possibly by their actions on the K(ATP) channel. These metabolic sensing neurons are intimately involved in energy homeostasis, and it is postulated that glucose is only one of several peripheral metabolic signals involved in this process under physiologic conditions. However, when glucose supply is severely limited, glucose appears to assume primacy as a stimulant of glucosensing in order to activate the counterregulatory and ingestive processes necessary to restore the vital supply of glucose. Thus, the role of glucosensing is postulated to be a relative one that is dependent upon the supply of peripheral glucose.