Contribution of alveolar lymphocytes to acute lung injury.

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1.Effects of alveolar lymphocytes on mild hypercapneaTo evaluate the mild hypercapnea on alveolar cell functions, we studied anesthetic patients maintained mild hypercapnea or normocapnea.To harvest alveolar cells were performed immediately after induction, 2,4,and 6 hours after induction of anesthesia, and at the end of the surgery. Phagocytic and microbicidal activities were evaluated. Also, harvested cells were dissolved in guanidinium buffer. Total RNA was isolated and cDNA was synthesized with a reverse transcriptase. By specific primers of interleukin-1beta and 8,interferon-gamma, tumor necrosis factor-alpha, semi-quantitative analysis was performed by polymerase chain reaction.We analyzed neutrophil and macrophage derived adhesion molecules including CD10a,b,c,CD18,49d,and 54,and lymphocyte derived adhesion molecules(CD 4 and 8) by a flowcytometry.Inter-group differences were not detected in any parameters of phagocytic and microbicidal functions. However, Expression of pro-infl … More ammatory cytokines, activated lymphocytes and neutrophil and macrophage derived adhesion molecules were much greater in hypercapneic patients than in normocapneic patients.Our results suggest that mild hypercapnea may protect pulmonary inflammatory reactions during anesthesia and surgery.2.Operative magnitude seriously modulates alveolar cell functions.We evaluated the effects of operative magnitude on alveolar macrophages functions.We studied patients undergoing major, moderate and minor surgery. Study protocol was described previously. Expression of pro-inflammatory cytokines, activated lymphocytes, and adhesion molecules significantly increase as the operative magnitude increased. The decrease in phagocytic and microbicidal activities was much greater in patients undergoing major surgery.These results suggest that increase in operative magnitude seriously aggravate pulmonary functions.3.Perioperiative hypothermia decreases all alveolar cell functions.We evaluated the effects of operative magnitude on alveolar macrophages functions.We studied perioperative hypothermic and normothermic patients. All alveolar cell functions decreased by hypothermia.These results may imply increase in rate of postoperative pulmonary infections. Less