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Circulating Antibody against Tumor Necrosis Factor–Alpha Protects Rat Brain from Reperfusion Injury

The role of tumor necrosis factor-alpha (TNF-α) in brain injury is controversial. We studied the effect of anti–TNF-α antibody in a rat model of reversible middle cerebral artery occlusion. During focal ischemia and early reperfusion, TNF-α was rapidly and transiently released into circulation. Pretreatment with intravenous anti–TNF-α antibody reduced cortical (71%, P < 0.015) and subcortical (58%, P < 0.007) injury, enhanced the cerebral blood flow during reperfusion, and improved the neurologic outcome. This further supports the contention that TNF-α is a deleterious cytokine in stroke, whereas circulating antibody against TNF-α may protect brain from reperfusion injury.