This study was designed to investigate the cardioprotective effects of pharmacological interventions, modulating resident cardiac mast cells, on ischemia-reperfusion-induced injury. Isolated rat hearts were mounted on Langendorff apparatus and subjected to 30-min global ischemia followed by 120-min reperfusion. The extent of mast cell degranulation was assessed by release of mast cell peroxidase (MPO). The release of lactate dehydrogenase (LDH) and creatine kinase (CK) and estimation of infarct size were used to assess the extent of myocardial injury. Left ventricle developed pressure (LVDP) and its derivatives, that is, dp/dt(max) and dp/dt(min), were recorded to evaluate the postischemic recovery of the contractility of heart. Ketotifen (0.1 microM) and low-dose carvedilol (0.1 microM), without beta-blockade activity, attenuated ischemia-reperfusion-induced mast cell degranulation along with the reduction in myocardial injury, suggesting the protective effects of mast cell stabilization during ischemia and reperfusion. Administration of compound 48/80 (1 microg/ml), a specific mast cell degranulating agent, completely degranulated cardiac mast cells before global ischemia. Moreover, it also resulted in the attenuation of ischemia-reperfusion-induced myocardial injury. Decreased release of cytotoxic mediators from already degranulated (empty) mast cells during sustained global ischemia may be responsible for the cardioprotective effects of compound 48/80. Administration of carvedilol or ketotifen after compound 48/80 perfusion did not further enhance the cardioprotective effects, suggesting that the cardiac mast cells may be the common target site for ketotifen, compound 48/80 and low-dose carvedilol.