Prefrontal-medullary circuitry is necessary for sex-specific responses to metabolic stress in rats

Chronic stress increases risk for metabolic disorders, including diabetes mellitus. Additionally, projections from the infralimbic cortex (IL) to the rostral ventrolateral medulla (RVLM) regulate endocrine stress responses. However, the neurobiological basis for chronic stress effects on glucose homeostasis has not been identified. The current study tests the hypothesis that the IL-RVLM circuit is necessary to prevent glucose intolerance. Accordingly, male and female rats with Cre-dependent expression of tetanus toxin light chain (TeLC) to inhibit neurotransmitter release from RVLM-projecting IL neurons were subject to chronic variable stress (CVS) or remained as No CVS controls. Animals were then acutely challenged with a fasted intraperitoneal glucose tolerance test (GTT). Endocrine metabolic function was evaluated during GTT via time courses of glucose, insulin, glucagon, and corticosterone. In No CVS females expressing TeLC, inhibition of IL-RVLM circuit signaling impaired glucose tolerance characterized by elevated glucose and decreased insulin sensitivity. Following chronic stress, females had impaired glucoregulation characterized by decreased glucose clearance and elevated corticosterone. When combined with TeLC, chronically-stressed females showed shifts in the ratio of insulin to glucagon compared to CVS GFP females, suggesting circuit function impacts the pancreatic mechanisms mediating glucose homeostasis during chronic stress. In No CVS males, TeLC increased glucagon only. However, CVS TeLC males had impaired glucose tolerance, reduced insulin sensitivity, and decreased corticosterone. These data indicate that the IL-RVLM circuit mediates glucoregulation in a manner dependent on both sex and stress history. Collectively, the IL-RVLM circuit is necessary for the sex-specific maintenance of glucose homeostasis following chronic stress.