Abstract

Various animal studies have shown beneficial effects of hypercapnia in lung injury. However, in patients with acute respiratory distress syndrome (ARDS), there is controversial information regarding the effect of hypercapnia on outcomes. The duration of carbon dioxide inhalation may be the key to the protective effect of hypercapnia. We investigated the effect of pre-treatment with inhaled carbon dioxide on lipopolysaccharide (LPS)-induced lung injury in mice. C57BL/6 mice were randomly divided into a control group or an LPS group. Each LPS group received intratracheal LPS (2 mg/kg); the LPS groups were exposed to hypercapnia (5% carbon dioxide) for 10 min or 60 min before LPS. Bronchoalveolar lavage fluid (BALF) and lung tissues were collected to evaluate the degree of lung injury. LPS significantly increased the ratio of lung weight to body weight; concentrations of BALF protein, tumor necrosis factor-α, and CXCL2; protein carbonyls; neutrophil infiltration; and lung injury score. LPS induced the degradation of the inhibitor of nuclear factor-κB-α (IκB-α) and nuclear translocation of NF-κB. LPS increased the surface protein expression of toll-like receptor 4 (TLR4). Pre-treatment with inhaled carbon dioxide for 10 min, but not for 60 min, inhibited LPS-induced pulmonary edema, inflammation, oxidative stress, lung injury, and TLR4 surface expression, and, accordingly, reduced NF-κB signaling. In summary, our data demonstrated that pre-treatment with 10-min carbon dioxide inhalation can ameliorate LPS-induced lung injury. The protective effect may be associated with down-regulation of the surface expression of TLR4 in the lungs.

Highlights

  • Acute respiratory distress syndrome (ARDS) develops most commonly in the context of severe sepsis, when caused by infection with Gram-negative bacilli such as Escherichia coli [1,2,3]

  • Laboratory studies have documented protective effects of hypercapnic acidosis (HCA) induced by adding inspired carbon dioxide in animal models of lung injury induced by free radicals [12], sepsis [13,14,15,16,17], ischemia-reperfusion [18,19,20,21], or excessive lung stretch [22,23,24]

  • To determine whether inhaled carbon dioxide had an anti-inflammatory effect in the lungs, mice were exposed to 5% carbon dioxide for 10 min or 60 min before LPS treatment (Figure 1)

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Summary

Introduction

Acute respiratory distress syndrome (ARDS) develops most commonly in the context of severe sepsis, when caused by infection with Gram-negative bacilli such as Escherichia coli [1,2,3]. Hypercapnia and hypercapnic acidosis (HCA) exerts multiple important effects in lung injury and acute respiratory failure, which may be beneficial or deleterious to multiple biological pathways [6,7]. Laboratory studies have documented protective effects of HCA induced by adding inspired carbon dioxide in animal models of lung injury induced by free radicals [12], sepsis [13,14,15,16,17], ischemia-reperfusion [18,19,20,21], or excessive lung stretch [22,23,24]

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