Role of nitric oxide in blood-brain barrier permeability, brain edema and cell damage following hyperthermic brain injury. An experimental study using EGB-761 and Gingkolide B pretreatment in the rat.

The role of oxidative stress in hyperthermia induced upregulation of constitutive and inducible isoforms of nitric oxide synthase (NOS) in the central nervous system (CNS) was investigated using immunohistochemistry in a rat model. Exposure of rats to heat stress at 38 degrees C for 4 h resulted in marked upregulation of constitutive NOS (cNOS) and a mild but significant expression of inducible NOS (iNOS) in several brain regions exhibiting leakage of the blood-brain barrier (BBB), brain edema formation and cell injury. Pretreatment with the potent antioxidative compound EGB-761 or its constituent, Ginkgolide B significantly attenuated upregulation of cNOS and iNOS in the brain and also reduced the BBB permeability disturbances, brain edema and cell injury. These neuroprotective effects were most marked in the EGB-761 pretreated rats. Our observations strongly suggest that (i) EGB-761 and Ginkgolide B pretreatment offer significant neuroprotection in hyperthermic brain injury, (ii) upregulation of cNOS and iNOS are injurious to the cell and, (iii) oxidative stress plays an important role in NOS expression and cell injury.