Figure 6.

Possible association of PDK2, PDH, DCA, and neuronal death under hypoglycemic conditions. This schematic illustration shows the effects of DCA on the process of hypoglycemia-induced hippocampal neuronal death. (A) Experimental timeline. (B) Neuronal cell death mechanism caused by hypoglycemia: (1) After hypoglycemia, mitochondria disruption occurs and then PDK2 increase abnormally (2) An abnormally increased PDK2 inhibits the activity of PDH by phosphating PDH (3) The conversion from pyruvate to acetyl-CoA is unsuccessful due to the inhibition of PDH (4) The rate of synthesis of ATP through the TCA cycle significantly reduces. When these conditions dominate, neuronal death is more likely to occur. (C) Effects of DCA on hypoglycemia-induced neuronal cell death: administration of DCA can inhibit PDK2 and thus prevent hippocampal neuronal death after hypoglycemia.