The protective effect of mannitol, vitamin E and glucocorticoid on ischaemic brain injury: evaluation by chemiluminescence, energy metabolism and water content.

We currently have used three drugs in combination [mannitol, vitamin E and glucocorticoid (beta-methasone)] for the treatment of cerebral infarction in the acute stage. For the purpose of evaluating the efficacy of this therapy, we have conducted experiments evaluated by chemiluminescence (CL), energy metabolism and water content of the cortex using a global highly ischaemic rat brain. During the ischaemic period, CL levels increased with time and further increases were seen after recirculation of the blood flow. However, in the group which was administered the three drugs in combination, there was marked inhibition of CL value. Determination of adenine nucleotide and carbohydrate levels revealed that these drugs in combination promoted their recovery at the time of recirculation following ischaemia. In particular, the increase in lactate was inhibited during the ischaemia, thus preventing the progression of lactic acidosis. Moreover, in the group given all three drugs and in the group given 20% or isotonic mannitol, the increase in cortical water content following recirculation was inhibited. From these results it is deduced that these three drugs inhibit the cellular destruction by attenuation of free radical mediated peroxidation.