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Fig. 1. Anoxia or severe hypoxia typically lead to energy deficit (1), subsequent
disruption of ion homeostasis and neuronal depolarization (2, 3). Release of
neurotransmitters, including the excitotoxin glutamate, and activation of NMDA
and AMPA receptors contribute to the flood of Ca2+ from extra- and
intracellular stores, which leads to calcium overload (4). Activated microglia
release inflammatory cytokines and nitric oxide and contribute to oxidative
stress and neuronal cell death (5). Increased reactive oxygen species (ROS)
production leads to oxidative modification of cellular components, which
contributes to cell death (6). During hibernation, multiple adaptations, in
addition to hypothermia, are hypothesized to act in concert to produce
pronounced neuroprotection. Decreased demand for oxygen, as well as
downregulation of Ca2+ channels, maintains energy balance, ion
homeostasis and minimizes Ca2+ overload. Evidence suggests that
immune modulation attenuates inflammatory response, and upregulation of
antioxidant defense systems maintains redox balance, thus minimizing the
neurodegenerative cascade (Sidky et al.,
1972; Spurrier and Dawe,
1973; Drew et al.,
1999; Zhou et al.,
2001b; Toien et al.,
2001). IL-1ß, interleukin-1ß; NO, nitric oxide; ROS,
reactive oxygen species; ER, endoplasmic reticulum; NMDA,
N-methyl-D-aspartate; Glu, glutamate; OGD, oxygen glucose
deprivation.