title: The effects of CO2 on cytokine concentrations in endotoxin-stimulated human whole blood.
abstract: OBJECTIVE
  Hypercapnia is known to modulate inflammation in lungs. However, the effect of hypocapnia and hypercapnia on blood cytokine production during sepsis is not well understood. We hypothesized that CO2 modulates ex vivo inflammatory cytokine production during endotoxin stimulation. To test this hypothesis, we measured the production of pro- and anti-inflammatory cytokines in endotoxin-stimulated human whole blood cultures under hypercapnic, normocapnic, and hypocapnic conditions.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Basic research laboratory.
  
  
  METHODS
  Ten male and 10 female volunteers.
  
  
  METHODS
  Venous blood samples, taken from volunteers were cultured at 37 degrees C, under hypocapnic (2% CO2), normocapnic (5% CO2), and hypercapnic (7% CO2) conditions, with and without endotoxin stimulation. After 24 hrs of incubation, each culture's supernatant was analyzed for tumor necrosis factor-alpha, interleukin-1beta, interleukin-6, interleukin-10, and interferon-gamma concentrations by enzyme-linked immunosorbent assay. Data were analyzed using nonparametric repeated measures of analysis of variance followed by Dunn's multiple comparisons test. Analysis of variance with Bonferroni correction was used to compare gender differences in cytokine concentrations. The Pearson test was used to estimate correlation between hydrogen ion and individual cytokine concentrations.
  
  
  RESULTS
  Concentrations of the proinflammatory cytokines tumor necrosis factor-alpha, interleukin-1beta and of the anti-inflammatory cytokine interleukin-10 under hypercapnic condition were significantly decreased (p < 0.05, 0.01, and 0.001, respectively) for both genders when compared with either normocapnic or hypocapnic conditions. Concentrations of tumor necrosis factor-alpha and interleukin-1beta were significantly higher in men. In women, concentrations of interleukin-6 were significantly decreased under hypercapnic condition when compared with hypocapnic condition. An inverse relationship was found between hydrogen ion concentration and concentrations of tumor necrosis factor-alpha and interleukin-10.
  
  
  CONCLUSIONS
  Our results are consistent with the hypothesis that CO2 can affect the production of pro- and anti-inflammatory cytokines after ex vivo stimulation with endotoxin.
authors.affiliation: Division of Critical Care Medicine, Miami Children's Hospital, Miami, FL, USA.
authors.forename: Dai
authors.initials: D
authors.lastname: Kimura
authors.forename: Balagangadhar R
authors.initials: BR
authors.lastname: Totapally
authors.forename: Andre
authors.initials: A
authors.lastname: Raszynski
authors.forename: Cheppail
authors.initials: C
authors.lastname: Ramachandran
authors.forename: Dan
authors.initials: D
authors.lastname: Torbati