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This defect is characterised by reduced secretion of glucagon and other counterregulatory hormones. Evidence indicates that glucose-responsive neurons located in the hypothalamus orchestrate the CRR. Here, we aimed to identify the changes in hypothalamic gene and protein expression that underlie impaired CRR in a mouse model of defective CRR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>High-fat-diet fed and low-dose streptozocin-treated C57BL\/6N mice were exposed to one (acute hypoglycaemia [AH]) or multiple (recurrent hypoglycaemia [RH]) insulin-induced hypoglycaemic episodes and plasma glucagon levels were measured. Single-nuclei RNA-seq (snRNA-seq) data were obtained from the hypothalamus and cortex of mice exposed to AH and RH. Proteomic data were obtained from hypothalamic synaptosomal fractions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The final insulin injection resulted in similar plasma glucose levels in the RH group and AH groups, but glucagon secretion was significantly lower in the RH group (AH: 94.5\u00b19.2 ng\/l [<jats:italic>n<\/jats:italic>=33]; RH: 59.0\u00b14.8 ng\/l [<jats:italic>n<\/jats:italic>=37]; <jats:italic>p<\/jats:italic>&lt;0.001). Analysis of snRNA-seq data revealed similar proportions of hypothalamic cell subpopulations in the AH- and RH-exposed mice. Changes in transcriptional profiles were found in all cell types\u00a0analysed. In neurons from RH-exposed mice, we observed a significant decrease in expression of <jats:italic>Avp<\/jats:italic>, <jats:italic>Pmch<\/jats:italic> and <jats:italic>Pcsk1n<\/jats:italic>, and the most overexpressed gene was <jats:italic>Kcnq1ot1<\/jats:italic>, as compared with AH-exposed mice. Gene ontology analysis of differentially expressed genes (DEGs) indicated a coordinated decrease in many oxidative phosphorylation genes and reduced expression of vacuolar H<jats:sup>+<\/jats:sup>- and Na<jats:sup>+<\/jats:sup>\/K<jats:sup>+<\/jats:sup>-ATPases; these observations were in large part confirmed in the proteomic analysis of synaptosomal fractions. Compared with AH-exposed mice, oligodendrocytes from RH-exposed mice had major changes in gene expression that suggested reduced myelin formation. In astrocytes from RH-exposed mice, DEGs indicated reduced capacity for neurotransmitters scavenging in tripartite synapses as compared with astrocytes from AH-exposed mice. In addition, in neurons and astrocytes, multiple changes in gene expression suggested increased amyloid beta (A\u03b2) production and stability. The snRNA-seq analysis of the cortex showed that the adaptation to RH involved different biological processes from those seen in the hypothalamus.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>The present study provides a model of defective counterregulation in a mouse model of type 2 diabetes. It shows that repeated hypoglycaemic episodes induce multiple defects affecting all hypothalamic cell types and their interactions, indicative of impaired neuronal network signalling and dysegulated hypoglycaemia sensing, and displaying features of neurodegenerative diseases. It also shows that repeated hypoglycaemia leads to specific molecular adaptation in the hypothalamus when compared with the cortex.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Data availability<\/jats:title>\n                <jats:p>The transcriptomic dataset is available via the GEO (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.ncbi.nlm.nih.gov\/geo\/\">http:\/\/www.ncbi.nlm.nih.gov\/geo\/<\/jats:ext-link>), using the accession no. GSE226277. The proteomic dataset is available via the ProteomeXchange data repository (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.proteomexchange.org\">http:\/\/www.proteomexchange.org<\/jats:ext-link>), using the accession no. PXD040183.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-023-06043-x","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T20:01:36Z","timestamp":1701201696000},"page":"371-391","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Disrupted hypothalamic transcriptomics and proteomics in a mouse model of type 2 diabetes exposed to recurrent hypoglycaemia"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7833-0569","authenticated-orcid":false,"given":"Judit","family":"Castillo-Armengol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6684-6880","authenticated-orcid":false,"given":"Flavia","family":"Marzetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6002-2779","authenticated-orcid":false,"given":"Ana","family":"Rodriguez Sanchez-Archidona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Fledelius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8122-8987","authenticated-orcid":false,"given":"Mark","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4869-178X","authenticated-orcid":false,"given":"Alison","family":"McNeilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3957-1981","authenticated-orcid":false,"given":"Rory J.","family":"McCrimmon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3152-5670","authenticated-orcid":false,"given":"Mark","family":"Ibberson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3738-0129","authenticated-orcid":false,"given":"Bernard","family":"Thorens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"issue":"7","key":"6043_CR1","doi-asserted-by":"publisher","first-page":"2322","DOI":"10.2337\/db15-0331","volume":"64","author":"PE Cryer","year":"2015","unstructured":"Cryer PE (2015) Hypoglycemia-associated autonomic failure in diabetes: maladaptive, adaptive, or both? 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Dolci, X. P. Berney, S. Gaspari, A. Strembitska (University of Lausanne, Lausanne, Switzerland) and V. D. T. Tran (Swiss Insititute of Bioinformatics, Lausanne, Switzerland) is gratefully acknowledged. We thank the Genomic Technologies Facility of the University of Lausanne (Lausanne, Switzerland) for generating the snRNA-seq data and the Protein Analysis Facility from the University of Lausanne for the synaptosomal proteomic analysis. Some of the data were presented as an abstract at the 58th Annual Meeting of the EASD in 2022.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"All transcriptomic data are available via the GEO (), using the accession no. GSE226277. Proteomic data are available via the ProteomeXchange data repository (), using the accession no. PXD040183.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Open access funding provided by University of Lausanne This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking (JU), under grant agreement number 777460 (HypoRESOLVE). The JU receives support from the European Union\u2019s Horizon 2020 research and innovation programme and the EFPIA and T1D Exchange, JDRF, International Diabetes Federation (IDF) and The Leona M and Harry B Helmsley Charitable Trust. The project was also supported by grants to BT from the Swiss National Science Foundation (310030\u2013182496) from the European Research Council Advanced Grant (INTEGRATE, No. 694798).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"JC-A was, and CF is employed by Novo Nordisk. The authors report no industry links or other personal connections. All other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"JC-A participated in the study design, performed all the animal experimentations, prepared the nuclei for RNA-seq analysis and the synaptosomal fractions for proteomic analysis, analysed and interpreted the data, and wrote the paper. ARS-A participated in the study design, analysed the RNA-seq data and critically reviewed the paper. CF helped develop the mouse model, interpret the physiology data and corrected the manuscript. FM analysed the RNA-seq data, prepared the illustrations and wrote the paper. ME, AM and RJM contributed to the design of the experimental protocol and to the interpretation of the data, and critically reviewed the manuscript. MI contributed to the study design, data interpretation and writing the paper. BT conceived the study and supervised its execution, interpreted the data and wrote the paper. All authors commented on the paper and approved its final content. BT is the guarantor of this work.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}