CO₂ Modulates the Inflammatory Cytokine Release of Primary Human Pleural Macrophages

Abstract

Background: It is well known that CO₂ used during laparoscopy affects the peritoneal surface and local inflammatory response, including the inflammatory reactivity of peritoneal macrophages. However, little is known about the local effects of CO₂ during thoracoscopy. In a previous study we have shown that in healthy adolescents, macrophages are the dominant cell population on the pleural surface. Therefore, we examined the effects of CO₂ on the inflammatory response of primary human pleural macrophages.

Methods: Human primary macrophages were harvested lavage from healthy adolescents undergoing elective surgery for pectus bar correction (n=8). After purification and 24 h resting, cells were incubated for 2 h in 100% CO₂, 5% CO₂ or 95% inert helium with 5% CO₂ as hypoxic control. After incubation cells were stimulated with LPS for 4 h and 24 h. The release of TNF-α, IL-8, IL-6, IL-10 and IL-1β were determined by ELISA.

Results: CO₂, but not hypoxia, induced a significant reduction in the release of TNF-α and IL-8 as well as a significant increase in the release of IL-10 and IL-1β within the first 4 h after incubation. The levels of IL-6 and the release of cytokines at 24 h after incubation were not significantly affected.

Conclusions: CO₂ directly modulates the immediate inflammatory response of pleural macrophages. Therefore, CO₂ insufflation during thoracoscopy could lower the local stress response, but does not appear to have a lasting effect.

Key words

thoracoscopy - endoscopy - TNF-alpha - interleukin

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