1 3
DOI 10.1007/s00726-017-2417-2
Amino Acids
REVIEW ARTICLE
Glucose transportation in the brain and its impairment
in Huntington disease: one more shade of the energetic
metabolism failure?
Veronica Morea
1
· Eris Bidollari
2,3
· Gianni Colotti
1
· Annarita Fiorillo
1
·
Jessica Rosati
3
· Lidia De Filippis
3
· Ferdinando Squitieri
4
· Andrea Ilari
1
Received: 9 March 2017 / Accepted: 1 April 2017
© Springer-Verlag Wien 2017
processes are impaired in HD, and discuss the potential
ability of strategies aimed at increasing intracellular energy
levels to counteract neurological and motor degeneration in
HD patients.
Keywords Huntington disease · Energetic metabolism ·
Glucose transport · GLUT1 · GLUT3
Brain glucose metabolism
The brain relies predominantly on glucose as a substrate
for its metabolism, at variance with other body tissues that
can utilize other energy sources, mostly fatty acids. Brain
requirements for glucose are quite high: the adult brain
weighs ~2% of the whole body, but consumes ~20% of
total body glucose in the resting state (Mergenthaler et al.
2013). Glucose is used by the brain to both provide the
energy for cellular functions (e.g., generation of synaptic
and action potentials, maintenance of ion gradients, etc.)
and as a carbon source for the biosynthesis of a variety of
molecules (e.g., neurotransmitters) (Siegel et al. 1999).
In brain cells glucose is phosphorylated by hexokinase
(HK) to glucose-6-phosphate (G6P) (Patel et al. 2014) and
metabolized, as in other cells, through one of the following
pathways.
1. Glycolysis. It takes place in the cytoplasm under
anaerobic conditions, and leads to formation, for each
glucose molecule, of two molecules of pyruvate, two
molecules of adenosine triphosphate (ATP) and two
molecules of NADPH. NADPH is a reducing agent,
important for the management of oxidative stress,
which in animals is mostly produced by the pentose
phosphate pathway (see below). ATP stores chemical
Abstract Huntington’s disease (HD) or Huntington’s cho-
rea is the most common inherited, dominantly transmitted,
neurodegenerative disorder. It is caused by increased CAG
repeats number in the gene coding for huntingtin (Htt) and
characterized by motor, behaviour and psychiatric symp-
toms, ultimately leading to death. HD patients also exhibit
alterations in glucose and energetic metabolism, which
result in pronounced weight loss despite sustained calorie
intake. Glucose metabolism decreases in the striatum of all
the subjects with mutated Htt, but affects symptom presen-
tation only when it drops below a specific threshold. Recent
evidence points at defects in glucose uptake by the brain,
and especially by neurons, as a relevant component of
central glucose hypometabolism in HD patients. Here we
review the main features of glucose metabolism and trans-
port in the brain in physiological conditions and how these
Veronica Morea and Eris Bidollari contributed equally to the
work.
* Ferdinando Squitieri
f.squitieri@css-mendel.it
* Andrea Ilari
andrea.ilari@uniroma1.it
1
National Research Council of Italy (CNR), Institute
of Molecular Biology and Pathology c/o Department
of Biochemical Sciences, Sapienza University of Rome,
P.le A. Moro 5, 00185 Rome, Italy
2
Department of Biochemical Sciences, Sapienza University
of Rome, P.le A. Moro 5, 00185 Rome, Italy
3
IRCCS Casa Sollievo della Sofferenza Hospital, San
Giovanni Rotondo, Italy
4
Huntington and Rare Diseases Unit, IRCCS Casa Sollievo
della Sofferenza Hospital c/o Mendel Institute of Human
Genetics, Viale Regina Margherita, 00198 Rome, Italy