Background & objectives: Stroke is third leading cause of death and disability in the most of human communities. Several experimental studies have shown that combination therapy with drugs that act via different mechanisms can produce amplified protective effects. We examined the effects of combination therapy with candesartan and alpha tocopherol against cerebral ischemia.

Methods: Male Sprague-Dawley rats were divided into five groups (n=24): sham, control ischemic, candesartan treated (0.3 mg/kg), alpha tocopherol treated (30 mg/kg) and combined treated ischemic groups. Transient focal cerebral ischemia was induced by 90-min-long occlusion of the left middle cerebral artery followed by 24-h-long reperfusion. Neurological deficit score was evaluated at the end of the reperfusion period. Thereafter, the animals were randomly used for measurement of the infarct volumes and investigation of ischemic brain edema formation using a wet/dry method.

Results: Induction of cerebral ischemia produced considerable brain infarction in conjunction with severely impaired motor functions and edema formation. Combined treatment with candesartan and alpha tocopherol significantly reduced the infarct volume and lowered the water content in the ischemic lesioned hemisphere. These effects on brain edema and oxidative stress biomarkers were significantly more than the monotherapy with candesartan.

Conclusion: The combination therapy with candesartan and alpha tocopherol can noticeably decrease ischemic brain injury and attenuate edema formation likely via increasing the antioxidant activity.

Background & objectives: Ischemic stroke has complex pathophysiology and its treatment with single neuroprotective drugs has so far failed. Combination therapy could produce amplified protective effects via different mechanisms. We examined the neuroprotective effects of enalapril and/or alpha tocopherol against sensorimotor dysfunctions of ischemic stroke.

Methods: Forty male Sprague-Dawley rats were randomly divided into five groups (n=8): sham, control ischemic, enalapril (0.03 mg/kg), alpha tocopherol (30mg/kg) and enalapril plus alpha tocopherol treated groups. Transient focal cerebral ischemia (90 min) was induced by occlusion of the left middle cerebral artery that followed by 24 h reperfusion periods. Infarct volumes were detected by TTC coloring technique and sensorimotor dysfunctions investigated by rotarod, grip strength and hotplate tests.

Results: Induction of cerebral ischemia in the control group produced severe neurological sensorimotor deficits in conjunction with considerable cerebral infarctions. Compared with the enalapril or alpha tocopherol groups, the combined treatment significantly improved neurological motor and sensory functions (p=0.038 and p=0.034, respectively) and also reduced the infarct volume (p=0.032).

Conclusion: Administration of alpha tocopherol increased protective effects of enalapril. Enalapril combined with alpha tocopherol can produce an augmented protection against ischemic brain injury, and improvement in sensorimotor dysfunctions.