CO2 pneumoperitoneum impact on early liver and lung cytokine expression in a rat model of abdominal sepsis.
BACKGROUND
Experimental evidence suggests that laparoscopy could have reduced inflammatory sequelae compared with laparotomy following abdominal surgery for peritonitis. The aim of the present study is to investigate the possible beneficial effects of CO(2) insufflation on liver and lung expression of proinflammatory cytokines during sepsis.


METHODS
Cecal ligation and puncture (CLP) was induced in Sprague-Dawley rats, and 6 h later rats were randomly subjected to CO(2) pneumoperitoneum (5-7 mmHg) or to laparotomy for 1 h. At the end of the CO(2) pneumoperitoneum or laparotomy procedures, animals were sacrificed, and liver and lung were removed and stored for molecular and histological analysis.


RESULTS
Liver and lung expression of proinflammatory cytokines was significantly reduced in animals subjected to CO(2) pneumoperitoneum compared with laparotomy. In particular, tumor necrosis factor-alpha (TNF-α) protein expression was significantly reduced (p < 0.05) following CO(2) pneumoperitoneum compared with laparotomy procedures. Interleukin (IL)-6 protein expression was accordingly, markedly reduced (p < 0.05) following CO(2) pneumoperitoneum. Histological analysis showed a reduced inflammatory infiltrate in liver and lung from animals subjected to CO(2) pneumoperitoneum compared with laparotomy.


CONCLUSIONS
Our results support the hypothesis that laparoscopic procedures reduce the inflammatory cascade, following peritoneal sepsis, via reduced expression of proinflammatory cytokines.
Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery, University of Messina, A.O.U., G. Martino Via C. Valeria, 98125, Messina, Italy.
Angela Simona
AS
Montalto
Alessandra
A
Bitto
Natasha
N
Irrera
Francesca
F
Polito
Mariagrazia
M
Rinaldi
Pietro
P
Antonuccio
Pietro
P
Impellizzeri
Domenica
D
Altavilla
Francesco
F
Squadrito
Carmelo
C
Romeo
D055371:Acute Lung Injury / Q000517:prevention & control; D000818:Animals; D015153:Blotting, Western; D002245:Carbon Dioxide / Q000008:administration & dosage; D015850:Interleukin-6 / Q000378:metabolism*; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D008026:Ligation / Q000379:methods; D008099:Liver / Q000378:metabolism*; D008168:Lung / Q000378:metabolism*; D010538:Peritonitis / Q000209:etiology / Q000378:metabolism*; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley; D018805:Sepsis / Q000209:etiology / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002245:Carbon Dioxide