Hypoglycemia sensing neurons of the ventromedial hypothalamus require AMPK-induced Txn2 expression but are dispensable for physiological counterregulation

The ventromedial nucleus of the hypothalamus (VMN) is involved in the counterregulatory response to hypoglycemia. VMN neurons activated by hypoglycemia (glucose inhibited, GI neurons) have been assumed to play a critical, although untested role in this response. Here, we show that expression of a dominant negative form of AMP-activated protein kinase (AMPK) or inactivation of AMPK α1 and α2 subunit genes in Sf1 neurons of the VMN selectively suppressed GI neuron activity. We found that Txn2, encoding a mitochondrial redox enzyme, was strongly down-regulated in the absence of AMPK activity and that reexpression of Txn2 in Sf1 neurons restored GI neuron activity. In cell lines, Txn2 was required to limit glucopenia-induced ROS production. In physiological studies, absence of GI neuron activity following AMPK suppression in the VMN had no impact on the counterregulatory hormone response to hypoglycemia nor on feeding. Thus, AMPK is required for GI neuron activity by controlling the expression of the anti-oxidant enzyme Txn2. However, the glucose sensing capacity of VMN GI neurons is not required for the normal counterregulatory response to hypoglycemia. Instead, it may represent a fail-safe system in case of impaired hypoglycemia sensing by peripherally located gluco-detection systems that are connected to the VMN.