The possible neuroprotective effect of D-glucose against glutamate-mediated neurotoxicity was studied in rat cortical neurons in primary culture. Brief (5-min) exposure of neurons to glutamate (100 microM) increased delayed (24-h) necrosis and apoptosis by 3- and 1.8-fold, respectively. Glutamate-mediated neurotoxicity was accompanied by a D-(-)-2-amino-5-phosphonopentanoate (100 microM) and N(omega)-nitro-L-arginine methyl ester (1 mM)-inhibitable, time-dependent ATP depletion (55% at 24 h), confirming the involvement of NMDA receptor stimulation followed by nitric oxide synthesis in this process. Furthermore, the presence of D-glucose (20 mM), but not its inactive enantiomer, L-glucose, fully prevented glutamate-mediated delayed ATP depletion, necrosis, and apoptosis. Succinate- cytochrome c reductase activity, but not the activities of NADH-coenzyme Q(1) reductase or cytochrome c oxidase, was inhibited by 32% by glutamate treatment, an effect that was abolished by incubation with D-glucose. Lactate accumulation in the culture medium was unmodified by any of these treatments, ruling out the possible involvement of the glycolysis pathway in either glutamate neurotoxicity or D-glucose neuroprotection. In contrast, D-glucose, but not L-glucose, abolished glutamate-mediated glutathione oxidation and NADPH depletion. Our results suggest that NADPH production from D-glucose accounts for glutathione regeneration and protection from mitochondrial dysfunction. This supports the notion that the activity of the pentose phosphate pathway may be an important factor in protecting neurons against glutamate neurotoxicity.