C erebral hypoxia is commonly caused by traumatic brain injury (TBI) and brain tumors. A prospective study reported that almost half of patients with a severe head injury had epidemiologically experienced a period of hypoxia. 6 This low-oxygen condition can subsequently lead to brain edema and neurodegeneration. 30 To neurologically critically ill patients, cerebral hypoxia is further recognized as a major potential cause of secondary injury. 22 Clinically, hypoxia is highly associated with a significant increase in morbidity and mortality from severe head injuries. 22,30 Because brain ischemia and hypoxia are vital causes of brain damage, preservation of sufficient tissue oxygenation is a primary objective in the field of neurocritical care. 26 Additionally, hypoxia has abbreviatioNs cIAP2 = cellular inhibitor of apoptosis protein 2; CREB = cAMP response element-binding; DMEM = Dulbecco's modified Eagle's medium; DMSO = dimethyl sulfoxide; ELISA = enzyme-linked immunosorbent assay; GBM = glioblastoma multiforme; mAb = monoclonal antibody; NOR-1 = neuron-derived orphan receptor 1; OGD = oxygen/glucose-deprivation; RT-PCR = reverse transcription polymerase chain reaction; pAb = polyclonal antibody; PAGE = polyacrylamide gel electrophoresis; PBS = phosphate-buffered saline; PCNA = proliferating cell nuclear antigen; PI = propidium iodide; PMSF = phenylmethylsulfonyl fluoride; RNAi = RNA interference; SDS = sodium dodecyl sulfate; siRNA = small interfering RNA; TBI = traumatic brain injury. obJective Hypoxia can induce cell death or trigger adaptive mechanisms to guarantee cell survival. Neuron-derived orphan receptor 1 (NOR-1) works as an early-response protein in response to a variety of environmental stresses. In this study, the authors evaluated the roles of NOR-1 in hypoxia-induced neuronal insults. methods Neuro-2a cells were exposed to oxygen/glucose deprivation (OGD). Cell viability, cell morphology, caspase-3 activity, DNA fragmentation, and cell apoptosis were assayed to determine the mechanisms of OGD-induced neuronal insults. RNA and protein analyses were carried out to evaluate the effects of OGD on expressions of NOR-1, cAMP response element-binding (CREB), and cellular inhibitor of apoptosis protein 2 (cIAP2) genes. Translations of these gene expressions were knocked down using RNA interference. Mice subjected to traumatic brain injury (TBI) and NOR-1 was immunodetected. results Exposure of neuro-2a cells to OGD decreased cell viability in a time-dependent manner. Additionally, OGD led to cell shrinkage, DNA fragmentation, and cell apoptosis. In parallel, treatment of neuro-2a cells with OGD time dependently increased cellular NOR-1 mRNA and protein expressions. Interestingly, administration of TBI also augmented NOR-1 levels in the impacted regions of mice. As to the mechanism, exposure to OGD increased nuclear levels of the transcription factor CREB protein. Downregulating CREB expression using RNA interference simultaneously inhibited OGD-induced NOR-1 mRNA expression. Also, levels of cIAP2 mRNA a...