This study was undertaken to examine the effect of uridine 5'-diphosphate, administered intravenously or intraperitoneally, on cold injury-induced brain edema in rabbits. Bolus injection or continuous intravenous infusion of uridine 5'-diphosphate 26 hours after a lesion was established had adverse effects, such as increased intracranial pressure and lowered systolic arterial blood pressure and cerebral perfusion pressure for approximately 10-29 minutes, but these parameters did not change appreciably from 29 minutes to 3 hours after administration. Intraperitoneally administered uridine 5'-diphosphate did not affect these parameters appreciably during 3 hours. Thus, the intravenous administration of uridine 5'-diphosphate is harmful under neurosurgical conditions. In contrast, 10 mg/kg/day i.p. uridine 5'-diphosphate pretreatment and posttreatment, beginning 24 hours before and continuing until 24 hours after the insult, significantly reduced neurologic abnormalities, Evans blue extravasation, water content in the injured gray matter, and intracranial pressure without affecting water content in the white matter. Intravenous dexamethasone pretreatment and posttreatment in this setting significantly reduced only neurologic abnormalities. However, there were no significant differences between intraperitoneal uridine 5-diphosphate and intravenous dexamethasone effects on cold-injured brain. {Stroke 1989;20:1694-1699) K atunuma, Kido, and colleagues 1 -5 showed that derivatives of uridine nucleotide sugar may amplify the many biologic functions of glucocorticoids, such as liver enzyme induction, cytotoxicity for lymphoblast cells in vivo and in vitro, anti-inflammatory mechanisms, and protection against the development of carrageenan edema in rabbit leg. We found that uridine 5'-diphosphate (UDP) may also be protective against the development of carrageenan edema in rabbit leg (S. Yoshida, unpublished data). These two observations suggest that exogenous UDP might also amplify the actions of endogenous glucocorticoids against brain edema. Therefore, this study was designed to examine the effects of 3 hours of UDP treatment on a wellestablished, 26-hour-old cold lesion to determine the appropriate route and method of UDP administration and then to compare the effects of intraperitoneal UDP and intravenous dexamethasone treat- Received May 12, 1988; accepted June 29, 1989. ment beginning 24 hours before and continuing to 24 hours after the insult on the evolution of pathologic changes in cold-injured brain.
Materials and MethodsIn the delayed treatment experiment, 50 New Zealand White rabbits weighing 2.5-3.3 kg were anesthetized with 25 mg/kg i.v. sodium thiopental (Abbott Laboratories, North Chicago, Illinois) and positioned in a head frame. These rabbits were not pretreated with UDP (Sigma Chemical Co., St. Louis, Missouri). A 12.5-mm-diameter circular trephine hole was made over the left parietooccipital cortex using a standardized technique 6 in all 50 rabbits. The cold injury was induced in 38 rabbits when a r...