ABSTRACT. Cytotoxic free radicals are generated during cerebral hypoxia-ischemia and reperfusion. We studied the efficacy of allopurinol, a xanthine oxidase inhibitor and free radical scavenger, in reducing posthypoxic-ischemic damage in the developing brain of 7-d-old rat pups. Hypoxic-ischemic injury to the right cerebral hemisphere was produced by ligation of the right common carotid artery followed by 3 h of hypoxia with 8% oxygen. Thirty to 45 min before the hypoxia, the rats received either allopurinol Free radicals contribute to the pathogenesis of hypoxicischemic brain damage (1-5), and successful management of traumatic or ischemic brain injury includes prevention of free radical damage (6-10).During cerebral hypoxia-ischemia, tissue stores of ATP are degraded sequentially to ADP, AMP, adenosine, inosine, and hypoxanthine (1 I, 12). Hypoxanthine levels accumulate as further metabolism is impeded by tissue hypoxia (13, 14). During reperfusion and reoxygenation, there is a transient rise in xanthine with a concomitant fall in hypoxanthine, reflecting the conversion of hypoxanthine to xanthine by the enzyme xanthine oxidase (1 5). This reaction generates superoxide and secondarily derived cytotoxic species including hydroxyl radicals (2). Free radicals are highly reactive molecules capable of damaging cells by peroxidation of membrane phospholipids (16) and by oxidation of cellular proteins and nucleic acids (17).Allopurinol is both an inhibitor of xanthine oxidase (1 8) and a scavenger of free radicals (19, 20). It has been used successfully to reduce ischemic injury of the heart (21), kidney (22), small intestine (23), and adult rat brain (24, 25). Accordingly, we aimed to establish if allopurinol could reduce hypoxic-ischemic injury to the developing brain of the 7-d-old rat pup.
MATERIALS AND METHODSTo evaluate the potential neuroprotective effect of allopurinol, we studied 7-d postnatal rat pups in which we induced a hypoxicischemic insult to the right cerebral hemisphere (see below). Animals were killed after either a short (42 h) or long (30 d) period of recovery to evaluate the extent of the lesion.Animals in the short recovery study were evaluated for brain water content, whereas those in the long recovery study were killed after 30 d of age to evaluate long-term neuropathologic alterations. The rat pups were treated alternately with either saline or allopurinol (see below).Animal model. Seven-d-old Wistar (Charles River, Wilmington, MA) rat pups of either sex, weighing between 12-18 g were anesthetized with a mixture of halothane (4% halothane, 1-1.5% for maintenance), 30% oxygen, and balance nitrous oxide. The right common carotid artery of each pup was ligated with 4-0 surgical silk. The wound was then sutured and the animal allowed to recover. The duration of anesthesia was about 5 min. After surgery, the rat pups were returned to their dams for 2' /2 h. Pups from mixed litters were then randomly divided into two equal treatment groups. One group received an injection of normal saline (0.2 mL)...