We investigated effect of a neuroprotective agent, FK506 in monkey cerebral ischemia using positron emmision tomography (PET). The right middle cerebral artery (MCA) of cynomolgus monkeys was occluded for 3 hours or permanently by a transorbital device. Four consecutive PET studies were performed to assess cerebral blood flow (CBF), oxygen extraction fraction (OEF), and the cerebral metabolic rate of oxygen (CMRO
2). For investigating effect of FK506 in transient ischamic model, FK506 was injected just after the MCA occlusion. The extent of necrotic brain damage 8 hours after MCA occlusion was significantly greater in the transient model than in the permanent model. Cortical damage was greater in the transient model. The MCA occlusion decreased CBF and CMRO
2 in deep MCA territory, and increased OEF in the cortex. In the permanent MCA occlusion model, these changes continued throughout the experiment. In the transient model, the reperfusion induced post-ischemic hyperperfusion in the cortex, which showed necrotic damage at the end of the experiment. In this area, OEF and CMRO
2 were decreased by reperfusion. FK506 significantly reduced infarct volume, especially in the cortex. In PET studies, FK506 prevented the reduction of CMRO
2 during ischemia and after reperfusion, which was greater than that during ischemia. The present results suggest that reperfusion may strongly contribute to cortical brain damage. PET studies revealed a peculiar OEF and CMRO
2 decrease in the cortex immediately after reperfusion, which may be an indicator of reperfusion injury, and that reperfusion injury may be caused by excessive hyperperfusion. FK506 has a nueroprotective action, especially in reperfusion injury.
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