The contribution of lung protective ventilation and anti-cytokine therapy in ventilator induced lung injury

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Prior to the assessment of anti-cytokine therapy, we tried to elucidate the effect of pCO2 on the production of proinflammatory cytokine in order to determine the effect of pCO2 in HFO upon experimental results in animal study.Wistar rats were ventilated and administered HCl intratracheally. After HC1 injection, rats were randomized to two groups: hypercapnia group and normocapnia group. The animals were ventilated with HFO for 4hrs. Lung volume was titrated to achieve PaCO2 40-50 mmHg (normocapnia group) or 80mmHg (hypercapnia group). After 4hrs of mechanical ventilation, the level of TNF-a,IL-6,and CINC-1 in BAL fluid was determined. No significant difference was observed between these two groups. However, W/D ratio and histological study showed that hypercapnia attenuated lung injury.Furthermore, we tried to establish quantitative RT-PCR system of chemokine receptors(CCR4,5,6,7,9,CXCR3,4) by the use of colitis model. Chemokine receptors except CCR6 were upregulated in diseased mice. Interestingly, mRNA of CCR7 and CXCR4 were upregulated in diseased colon compared with non-diseased small intestine.