To assess the role of brain antioxidant capacity in the pathogenesis of neonatal hypoxic-ischemic brain injury, we measured the activity of glutathione peroxidase (GPX) in both humansuperoxide dismutase-1 (hSOD1) and human-GPX1 overexpressing transgenic (Tg) mice after neonatal hypoxia-ischemia (HI). We have previously shown that mice that overexpress the hSOD1 gene are more injured than their wild-type (WT) littermates after HI, and that H 2 O 2 accumulates in HI hSOD1-Tg hippocampus. We hypothesized that lower GPX activity is responsible for the accumulation of H 2 O 2 . Therefore, increasing the activity of this enzyme through gene manipulation should be protective. We show that brains of hGPX1-Tg mice, in contrast to those of hSOD-Tg, have less injury after HI than WT littermates: hGPX1-Tg, median injury score ϭ 8 (range, 0 -24) versus WT, median injury score ϭ 17 (range, 2-24), p Ͻ 0.01. GPX activity in hSOD1-Tg mice, 2 h and 24 h after HI, showed a delayed and bilateral decline in the cortex 24 h after HI (36.0 Ϯ 1.2 U/mg in naive hSOD1-Tg versus 29.1 Ϯ 1.7 U/mg in HI cortex and 29.2 Ϯ 2.0 for hypoxic cortex, p Ͻ 0.006). On the other hand, GPX activity in hGPX1-Tg after HI showed a significant increase by 24 h in the cortex ipsilateral to the injury (48.5 Ϯ 5.2 U/mg, compared with 37.2 Ϯ 1.5 U/mg in naive hGPX1-Tg cortex, p Ͻ 0.008). These findings support the hypothesis that the immature brain has limited GPX activity and is more susceptible to oxidative damage and may explain the paradoxical effect seen in ischemic neonatal brain when SOD1 is overexpressed. (Pediatr Res 56: 656-662, 2004) Abbreviations CCA, common carotid artery GPX, glutathione peroxidase GSH, glutathione HI, hypoxia-ischemia P, postnatal day red-ox, oxidation-reduction reaction ROS, reactive oxygen species SOD1, copper-zinc superoxide dismutase Tg, transgenic WT, wild-typeThe developing brain faces unique challenges from oxidative stress, and has responses to injury and protective mechanisms that are different from the mature nervous system. The developmental profile of the activity of the endogenous antioxidant enzymes SOD1 and selenium-dependent GPX have been described for both rats (1-3) and mice (4). In the mouse brain, GPX activity is almost exclusively due to the classic, cellular glutathione peroxidase GPX1 (EC 1.11.1.9) (5). In the CD1 mouse, the outbred background strain used in this study, SOD1 activity decreases around the time of birth, and then remains unchanged to weaning. GPX activity, on the other hand, rises steeply around birth but declines sharply in the first few days of life and then remains low through weaning. Protein levels for both enzymes, however, show a steady increase during early development (4). We have shown that, in the CD1 mouse brain, adult levels of GPX activity are reached by weaning (6). Therefore, maturational differences may impact the response of the newborn brain to injury. It has been shown that the adult and juvenile brain attempts to compensate during oxidative stress in response to stroke (...