The effect of ethyl pyruvate and N-acetylcysteine on ischemia-reperfusion injury in an experimental model of ischemic stroke

Am J Emerg Med. 2016 Sep;34(9):1804-7. doi: 10.1016/j.ajem.2016.06.003. Epub 2016 Jun 4.


Introduction: Reperfusion therapies play an important role in early-period treatment for patients presenting to the emergency department due to stroke. However, the ischemia-reperfusion injury that may occur with reperfusion must then be considered. The purpose of this study was to determine the effectiveness of N-acetylcysteine (NAC) and ethyl pyruvate in preventing ischemia-reperfusion injury.

Method: This study is a randomized, controlled experimental study. In group 1, rats' left main carotid arteries were clamped. Reperfusion was established by releasing the clamp after 1.5 hours. In group 2, the left main carotid artery was clamped, and 20 mg/kg intraperitoneal NAC was administered after 1 hour. The clamp was released 0.5 hour after NAC administration. In group 3, rats' left carotid arteries were clamped, and 50 mg/kg ethyl pyruvate was administered intraperitoneally after 1 hour. The clamp was released 0.5 hour after ethyl pyruvate administration. All tissue samples were collected 2.5 hours after reperfusion. Brain tissues were compared histopathologically.

Results: A higher percentage of degenerative neurons was determined in group 1 compared with groups 2 and 3 (P values: P(a) = .003 and P(c) = .003, respectively). A significant difference was also observed between groups 2 and 3 (P(b) = .003), with the percentage of degenerative neurons being lower in the NAC group than in the ethyl pyruvate group.

Conclusion: The use of NAC and ethyl pyruvate reduces injury resulting from ischemia-reperfusion in an experimental animal model of acute ischemic stroke and subsequent reperfusion.

MeSH terms

  • Acetylcysteine / pharmacology*
  • Animals
  • Brain / drug effects*
  • Brain / pathology
  • Brain Ischemia*
  • Carotid Arteries
  • Cell Count
  • Female
  • Free Radical Scavengers / pharmacology*
  • Neurons / drug effects*
  • Neurons / pathology
  • Pyruvates / pharmacology*
  • Random Allocation
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury*
  • Stroke*


  • Free Radical Scavengers
  • Pyruvates
  • ethyl pyruvate
  • Acetylcysteine