Chintamaneni K, Bruder ED, Raff H. Effects of age on ACTH, corticosterone, glucose, insulin, and mRNA levels during intermittent hypoxia in the neonatal rat. Am J Physiol Regul Integr Comp Physiol 304: R782-R789, 2013. First published March 13, 2013 doi:10.1152/ajpregu.00073.2013.-Apnea, the temporary cessation of respiratory airflow, is a common cause of intermittent hypoxia (IH) in premature infants. We hypothesized that IH elicits a stress response and alters glucose homeostasis in the neonatal rat. Rat pups were studied on postnatal day (PD) 2, 8, 10, 12, and 14. Pups were exposed to normoxia (control) or six cycles consisting of 30-s exposures to hypoxia (FIO 2 ϭ 3%) over a 60-min period. Blood samples were obtained at baseline, after the third cycle (ϳ30 min), and after the sixth cycle (ϳ60 min). Tissue samples were collected following the sixth cycle. Plasma ACTH, corticosterone, glucose, and insulin were analyzed at all ages. Hypothalamic, pituitary, and adrenal mRNA expression was evaluated by quantitative PCR in PD2, PD8, and PD12 pups. Exposure to IH elicited significant increases in plasma ACTH and corticosterone at all ages studied. The largest increase in corticosterone occurred in PD2 pups, despite only a very small increase in plasma ACTH. This ACTH-independent increase in corticosterone in PD2 pups was associated with increases in adrenal Ldlr and Star mRNA expression. Additionally, IH caused hyperglycemia and hyperinsulinemia at all ages. We conclude that IH elicits a significant pituitary-adrenal response and significantly alters glucose homeostasis. Furthermore, the quantitative and qualitative characteristics of these responses depend on developmental age.hypothalamic-pituitary-adrenal axis; newborn; anoxia; apnea; adrenal cortex APNEA, the cessation of respiratory airflow, causes hypoxemia and bradycardia in the neonate (27). Apnea is the most common cause of hypoxia in neonates, particularly with prematurity, and is usually due to immature respiratory control systems (20). Incomplete respiratory maturation may involve deficits in neural respiratory control, central and peripheral chemoreceptors, or coordination of the upper airway muscles (20). It has previously been shown that about half of babies born prematurely (30 -31 wk of gestational age) may experience bouts of apnea (27).We have shown that acute, continuous hypoxia in the neonatal rat, a model of cardiopulmonary disease of prematurity, is a metabolic challenge that elicits a stress response from the hypothalamic-pituitary-adrenal (HPA) axis (3). This experimental model also results in bradycardia, alterations in glucose homeostasis, and a dramatic decrease in body temperature (3, 4, 11).The current study used intermittent hypoxia (IH) as an established model of apnea-induced hypoxia (21). IH mimics spontaneous, short duration episodes of hypoxia that occur during apnea in the neonate. A widely used definition of apnea specifies a 15-to 20-s cessation of breathing, a decrease in oxygen saturation to Ͻ80%, and a refractory period ...