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ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Diabetes: Molecular Mechanisms

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1620004

Ischemic postconditioning ameliorates diabetic cerebral ischemia via activating the brain-derived neurotrophic factor-tropomyosin receptor kinase B-hypoxia-inducible factor 1α-Bcl-2/adenovirus E1B 19-kDa-interacting protein 3 pathway to induce microglial mitophagy and suppress A1 astrocyte-mediated neuroinflammation

Provisionally accepted
Shiying  HuangShiying Huang1Yuanyuan  HanYuanyuan Han2Ying  WangYing Wang3Tingyu  KeTingyu Ke3Lin  ZhaoLin Zhao4*
  • 1The First Affiliated Hospital of Kunming Medical University, Kunming, China
  • 2Chinese Academy of Medical Science and Peking Union Medical College, Kunming, China
  • 3The Second Affiliated Hospital of Kunming medical university, Kunming, China
  • 4The Second Affiliated Hospital of Kunming Medical University, Kunming, China

The final, formatted version of the article will be published soon.

Aim: Diabetes mellitus exacerbates cerebral ischemic injury. However, effective interventions remain limited. Ischemic postconditioning (IPOC) is a potential neuroprotective strategy; however, its efficacy and mechanisms in diabetes remain poorly understood. This study aimed to explore the therapeutic effects and underlying mechanisms of IPOC in diabetes complicated by cerebral ischemia.Methods: Tree shrews with diabetes complicated by cerebral ischemia were used as the study subjects and were subjected to a standardized IPOC intervention protocol.The results showed that compared with the control group, the cerebral infarction volume of tree shrews in the cerebral ischemia (IS) group and the diabetes complicated with cerebral ischemia (DMIS) group was significantly higher, the neurons were severely damaged, A1 astrocytes were activated, the levels of inflammatory factors interleukin (IL)-1β and IL-6 increased, and mitochondrial autophagy was inhibited. In contrast, in the DMIS + IPOC group, cerebral infarction volume was significantly reduced, neuronal damage was improved, activation of A1 astrocytes and release of inflammatory factors were inhibited, and mitochondrial autophagy was increased. Mechanistically, IPOC activated the brain-derived neurotrophic factor (BDNF)/tropomyosin receptor kinase B (TrkB) pathway and upregulated hypoxia-inducible factor 1α (HIF-1α) expression, which further promoted the expression of Bcl-2/adenovirus E1B 19-kDa-interacting protein 3 (BNIP3).inflammatory regulation through the BDNF-TrkB-HIF-1α-BNIP3 signaling cascade, providing a new target for precise intervention in diabetes combined with cerebral ischemia.

Keywords: Ischemic Postconditioning, diabetes, cerebral ischemia, BDNF-TrkB-HIF-1α-BNIP3, neuroprotective

Received: 29 Apr 2025; Accepted: 25 Aug 2025.

Copyright: © 2025 Huang, Han, Wang, Ke and Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Lin Zhao, The Second Affiliated Hospital of Kunming Medical University, Kunming, China

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