Early peritoneal macrophage function after laparoscopic surgery compared with laparotomy in a mouse mode.
BACKGROUND
The authors previously demonstrated postoperative preservation of the immune function measured by delayed-type skin reaction and tumor growth after laparoscopic surgery, as compared with laparotomy. For further elucidation of the origin of the demonstrated immune preservation, peritoneal macrophage (PMo) function was investigated 1 h after different surgical procedures.


METHODS
Female NMRI mice were divided into five groups: anesthesia only, abdominal skin incision, laparotomy, peritoneal carbon dioxide (CO2) insufflation, and peritoneal air insufflation. Escherichia Coli phagocytosis, tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta1 (TGF-beta1), and interleukin-10 (IL-10) release of isolated PMo were investigated.


RESULTS
All invasive interventions reduced the PMo phagocytosis by factors of approximately 2 to 4.7, as compared with the sham control group. Spontaneous ex vivo TNF-alpha release was significantly increased whenever the abdominal cavity was exposed to ambient air. The macrophage's ability to release TNF-alpha after E. coli exposure was diminished in the abdominal air exposure groups, as compared with the CO2 insufflation group.


CONCLUSIONS
Reduced phagocytosis 1 h after surgical interventions suggests a contribution of PMo to the altered immune function. When exposed to CO2, PMo show a decreased basal TNF-alpha release. However, PMo also show an increased TNF-alpha release after a second immune stimulation (E. coli), suggesting a greater competency of interaction in an immune defense reaction after CO2 exposure.
Moehrlen
U
U
Department of Pediatric Surgery, University Children's Hospital, Steinwiesstrasse 75, Zurich, CH-8032, Switzerland.
Schwoebel
F
F
Schwöbel
F
F
Reichmann
E
E
Stauffer
U
U
Gitzelmann
C A
CA
Hamacher
J
J
D000818:Animals; D002245:Carbon Dioxide; D016207:Cytokines / Q000032:analysis; D004926:Escherichia coli / Q000502:physiology; D005260:Female; D007327:Insufflation / Q000379:methods; D010535:Laparoscopy; D007813:Laparotomy; D017737:Macrophages, Peritoneal / Q000276:immunology / Q000502:physiology*; D051379:Mice; D008815:Mice, Inbred Strains; D023421:Models, Animal; D010587:Phagocytosis; D011028:Pneumoperitoneum, Artificial; D011897:Random Allocation; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D002245:Carbon Dioxide