Kopernik G, Avinoach E, Grossman Y, Levy R, Yulzari R, Rogachev B, Douvdevani A
Department of Obstetrics and Gynecology "B," Laboratory, and the Department of Nephrology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of Negev, Beer-Sheva, Israel.
Am J Obstet Gynecol. 1998 Dec;179(6 Pt 1):1503-10. doi: 10.1016/s0002-9378(98)70016-x.
Our purpose was to evaluate in vitro the effect of a high partial pressure of carbon dioxide environment used in laparoscopy on metabolic and immune response of various human peritoneal cells.
Polymorphonuclear leukocytes were obtained from 5 healthy volunteers, peritoneal macrophages were obtained from the effluent of 8 patients undergoing continuous ambulatory peritoneal dialysis, and human peritoneal mesothelial cell cultures were prepared from omentum derived from 5 patients undergoing elective surgery. The cells were exposed to a laparoscopy-like environment (1 atmosphere carbon dioxide and 0.2 atmosphere oxygen), to a control gas mixture (1 atmosphere helium and 0.2 atmosphere oxygen), or air for 3 hours. After exposure to gas mixtures, cell functions were tested at various recovery periods.
Three hours of exposure to a high partial pressure of carbon dioxide had no effect on viability of peritoneal macrophages and human peritoneal mesothelial cells, tested by trypan blue dye uptake and lactate dehydrogenase release. A high partial pressure of carbon dioxide decreased the mitochondrial dehydrogenases activity of peritoneal macrophages and human peritoneal macrophage cells by 60%, assayed by 3-(4, 5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide reduction. High partial pressure of carbon dioxide blocked the superoxide release from activated polymorphonuclear leukocytes and the secretion of interleukin 1beta from stimulated peritoneal macrophages, and human peritoneal macrophage cells were decreased by 15% and 30% and the secretion of tumor necrosis factor-alpha from peritoneal macrophages was suppressed by 85%. Mitochondrial activity, polymorphonuclear leukocyte function, and interleukin 1beta and tumor necrosis factor-alpha secretion returned to normal after a recovery period of 12 to 24 hours, 4.5 hours, and 24 hours, respectively. In the control experiments exposure of cells to helium had no suppressive effect.
Exposure of cells to a high partial pressure of carbon dioxide environment suppresses the inflammatory and metabolic responses of peritoneal cells. We suggest that this suppressive effect may contribute to the low postsurgery adhesion formation and the reduction in postoperative pain observed in laparoscopy. Nevertheless, the suppression of the immune response should also be taken into account for operations involving a high risk of bacterial dissemination.
我们的目的是在体外评估腹腔镜检查中使用的高二氧化碳分压环境对各种人腹膜细胞代谢和免疫反应的影响。
从5名健康志愿者中获取多形核白细胞，从8名接受持续性非卧床腹膜透析患者的流出液中获取腹膜巨噬细胞，并从5名接受择期手术患者的大网膜中制备人腹膜间皮细胞培养物。将细胞暴露于类似腹腔镜检查的环境（1个大气压二氧化碳和0.2个大气压氧气）、对照气体混合物（1个大气压氦气和0.2个大气压氧气）或空气中3小时。暴露于气体混合物后，在不同恢复期测试细胞功能。
通过台盼蓝染色摄取和乳酸脱氢酶释放测试，暴露于高二氧化碳分压3小时对腹膜巨噬细胞和人腹膜间皮细胞的活力没有影响。通过3-（4,5-二甲基噻唑-2-基）-2,5-二苯基四氮唑溴化物还原法测定，高二氧化碳分压使腹膜巨噬细胞和人腹膜巨噬细胞的线粒体脱氢酶活性降低60%。高二氧化碳分压阻断了活化多形核白细胞的超氧化物释放以及刺激的腹膜巨噬细胞白细胞介素1β的分泌，人腹膜巨噬细胞减少了15%和30%，腹膜巨噬细胞肿瘤坏死因子-α的分泌被抑制了85%。线粒体活性、多形核白细胞功能以及白细胞介素1β和肿瘤坏死因子-α的分泌分别在12至24小时、4.5小时和24小时的恢复期后恢复正常。在对照实验中，细胞暴露于氦气没有抑制作用。
细胞暴露于高二氧化碳分压环境会抑制腹膜细胞的炎症和代谢反应。我们认为这种抑制作用可能有助于腹腔镜检查中术后粘连形成减少和术后疼痛减轻。然而，对于有细菌播散高风险的手术，也应考虑免疫反应的抑制。
