Carbon dioxide pneumoperitoneum reduces levels of TNF-a mRNA in the brain, liver, and peritoneum in mice.
BACKGROUND
Cytokines are important regulators of the biological response to surgical stress. The aim of this study was to determine whether the CO(2) pneumoperitoneum would change the expression of TNF-a mRNA in the visceral organs, including the brain, in mice.


METHODS
Mice were randomly assigned to one of six groups: control, anesthesia alone, insufflation with carbon dioxide, insufflation with air, laparotomy by short incision, or laparotomy by long incision. The brain, liver, jejunum, and peritoneum were harvested either 3 or 24 h after surgery. Levels of TNF-a mRNA in each tissue was measured by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR).


RESULTS
The air insufflation group showed higher TNF-a mRNA levels in the brain and liver than the short-incision group. Levels of TNF-a mRNA in the brain, liver, and peritoneum were lower in the CO(2) pneumoperitoneum group than in the air insufflation group. Plasma IL-6 and catecholamine in the urine were lower in the CO(2) pneumoperitoneum group than the air insufflation group.


CONCLUSIONS
Reduced synthesis of TNF-a in the visceral organs, including the brain, is correlated with a less marked biologic response to laparoscopic surgery.
Kamei
H
H
Department of Surgery, School of Medicine, Kurume University, Kurume, Fukuoka 830-0011, Japan.
Yoshida
S
S
Yamasaki
K
K
Tajiri
T
T
Shirouzu
K
K
D000818:Animals; D001921:Brain / Q000378:metabolism*; D002245:Carbon Dioxide / Q000008:administration & dosage*; D002395:Catecholamines / Q000652:urine; D007327:Insufflation / Q000009:adverse effects; D015850:Interleukin-6 / Q000097:blood; D007413:Intestinal Mucosa / Q000378:metabolism; D007583:Jejunum / Q000378:metabolism; D008099:Liver / Q000378:metabolism*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D010537:Peritoneum / Q000378:metabolism*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D012333:RNA, Messenger / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D002395:Catecholamines; D015850:Interleukin-6; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D002245:Carbon Dioxide