REDUCED INFLAMMATORY RESPONSE DURING LAPAROSCOPY

腹腔镜检查期间炎症反应减少

• 批准号: 6926949
• 负责人: MARK A TALAMINI
• 金额: $ 6.69万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2005-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6926949
• 关键词: acid base balance; acute phase protein; bacterial disease; blood toxicology; carbon dioxide; cytokine receptors; gene expression; helium; hydrochloric acid; immunoregulation; inflammation; interleukin 1; interleukin 10; interleukin 6; laboratory rat; laparoscopy; leukocytes; leukocytosis; liver cells; macroglobulins; northern blottings; nuclear runoff assay; peritoneal cavity; posttranscriptional RNA processing; surgery; tumor necrosis factor alpha; western blottings

DESCRIPTION (provided by applicant): Laparoscopic surgery represents a new paradigm, with less pain, quicker recovery times, and reduced disability. In time, most general surgical procedures will be performed in this manner. Laparoscopic surgery is not simply a reduced surgical insult, it is a different surgical insult. Preliminary data in the rat shows that a pneumoperitoneum with CO2 gas alters the inflammatory response associated with laparoscopic surgery in the setting of sepsis. The objective of this application is to establish whether CO2 pneumoperitoneum has a modifying role, and to determine the possible mechanism(s). AIM 1: To test whether CO2 modifies the inflammatory response during laparoscopic surgery. The effect of pneumoperitoneum with CO2, helium, or air on the inflammatory response after sepsis (cecal ligation and puncture) will be compared. The parameters of the inflammatory response to be evaluated are: leukocytosis, leukocyte infiltration, hepatic acute phase gene expression, and circulating levels of cytokines. AIM 2: To determine where in the pathway of the inflammatory response CO2 pneumoperitoneum exerts its effect. Expression of the acute phase proteins will be used as an experimental paradigm. Pre-transcriptional, transcriptional, and post transcriptional regulation of the acute phase genes will be evaluated. AIM 3: To determine how the C02 pneumoperitoneum alters the inflammatory response. The hypothesis of this aim is that alteration of pH with abdominal distension alters the inflammatory response. A) Arterial pH will be measured to correlate pH changes with immune modulation. B) The pH will be artificially decreased by a comparable amount via systemic intravenous infusion of hydrochloric acid in the setting of sepsis plus C02 pneumoperitoneum, helium pneumoperitoneum, air pneumoperitoneum, and open surgery. The information provided by this investigation will be essential in patient care as increasing numbers of patients undergo operations using the CO2 pneumoperitoneum.

描述（由申请人提供）：腹腔镜手术代表了一种新的范式，疼痛，更快的恢复时间和减少的残疾。随着时间的流逝，大多数一般的手术程序将以这种方式进行。腹腔镜手术不仅是减少手术损伤，而且是一种不同的手术侮辱。大鼠中的初步数据表明，具有二氧化碳气体的气tone骨会改变败血症的炎症反应与腹腔镜手术相关的炎症反应。该应用的目的是确定二氧化碳气压核的作用是否具有修饰作用，并确定可能的机制。目标1：测试二氧化碳在腹腔镜手术过程中是否修饰炎症反应。将比较败血症（Cecal结扎和穿刺）后使用CO2，氦气或空气的气tone酮对炎症反应的影响。要评估的炎症反应的参数是：白细胞增多，白细胞浸润，肝急性相基因表达和细胞因子的循环水平。 AIM 2：确定在炎症反应途径中的位置，二氧化碳的效果会发挥作用。急性相蛋白的表达将用作实验范式。将评估急性期基因的转录前，转录和转录后调节。 AIM 3：确定C02肺炎的如何改变炎症反应。该目标的假设是，腹部扩张的pH改变改变了炎症反应。 A）将测量动脉pH，以将pH变化与免疫调节相关。 b）在败血症加上C02肺炎肺炎，氦气肺苯甲酸氦气，气动性气Pneumoperitoneum和开放手术的情况下，通过全身静脉注射盐酸的全身性静脉注射盐酸，将通过可相当的量通过可相当的量降低pH值。这项研究提供的信息对于患者护理至关重要，因为使用CO2 pneumoperitoneum进行了越来越多的患者进行手术。