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Hypercapnic Acidosis Attenuates Endotoxin-Induced Nuclear Factor-B Activation

Department of Medicine, School of Medicine, Keio University, Tokyo; and Departments of Medicine and Biomedical Research, Kitasato Institute Hospital, Tokyo, Japan

Address correspondence to: Kazuhiro Yamaguchi, M.D., Department of Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: yamaguc{at}cpnet.med.keio.ac.jp

Although permissive hypercapnia improves the prognosis of patients with acute respiratory distress syndrome, it has not been conclusively determined whether hypercapnic acidosis (HA) is harmful or beneficial to sustained inflammation of the lung. The present study was designed to explore the molecular mechanism of HA in modifying lipopolysaccharide (LPS)-associated signals in pulmonary endothelial cells. LPS elicited degradation of inhibitory protein B (IB)-, but not IB-ß, resulting in activation of nuclear factor (NF)-B in human pulmonary artery endothelial cells. Exposure to HA significantly attenuated LPS-induced NF-B activation through suppressing IB- degradation. Isocapnic acidosis and buffered hypercapnia showed qualitatively similar but quantitatively smaller effects. HA did not attenuate the LPS-enhanced activation of activator protein-1. Following the reduced NF-B activation, HA suppressed the mRNA and protein levels of intercellular adhesion molecule-1 and interleukin-8, resulting in a decrease in both lactate dehydrogenase release into the medium and neutrophil adherence to LPS-activated human pulmonary artery endothelial cells. In contrast, HA did not inhibit LPS-enhanced neutrophil expression of integrin, Mac-1. Based on these findings, we concluded that hypercapnic acidosis would have anti-inflammatory effects essentially through a mechanism inhibiting NF-B activation, leading to downregulation of intercellular adhesion molecule-1 and interleukin-8, which in turn inhibits neutrophil adherence to pulmonary endothelial cells.

Abbreviations: activator protein-1, AP-1 • acute respiratory distress syndrome, ARDS • buffered hypercapnia, BH • Dulbecco's phosphate-buffered saline, DPBS • endothelial cell growth medium, EGM • glyceraldehyde-3-phosphate dehydrogenase, G3PDH • hypercapnic acidosis, HA • human pulmonary artery endothelial cells, HPAEC • isocapnic acidosis, IA • intercellular adhesion molecule-1, ICAM-1 • inhibitory protein B, IB • IB kinase, IKK • interleukin-8, IL-8 • lactate dehydrogenase, LDH • normocapnia, NC • nuclear factor-B, NF-B • carbon dioxide tension, PCO₂ • phycoerythrin, PE • tumor necrosis factor-, TNF- • TNF receptor–associated factor 6, TRAF6

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