JoVE Logo
Faculty Resource Center

Sign In

Summary

Abstract

Introduction

Protocol

Representative Results

Discussion

Acknowledgements

Materials

References

Medicine

In Vitro Method to Control Concentrations of Halogenated Gases in Cultured Alveolar Epithelial Cells

Published: October 23rd, 2018

DOI:

10.3791/58554

1Department of Perioperative Medicine, CHU Clermont-Ferrand, 2Centre National de la Recherche Scientifique Unité Mixte de Recherche (CNRS UMR) 6293, Institut National de la Santé et de la Recherche Médicale (INSERM) U1103, Laboratoire de Génétique, Reproduction et Développement (GReD), Université Clermont Auvergne, 3Department of Pharmacology, CHU Clermont-Ferrand, 4Nurse Anesthetist School, CHU Clermont-Ferrand

We describe an easy protocol specifically designed to reach precise and controlled concentrations of sevoflurane or isoflurane in vitro in order to improve our understanding of mechanisms involved in the epithelial lung injury and to test novel therapies for acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a syndrome of diffuse alveolar injury with impaired alveolar fluid clearance and severe inflammation. The use of halogenated agents, such as sevoflurane or isoflurane, for the sedation of intensive care unit (ICU) patients can improve gas exchange, reduce alveolar edema, and attenuate inflammation during ARDS. However, data on the use of inhaled agents for continuous sedation in the ICU to treat or prevent lung damage is lacking. To study the effects of halogenated agents on alveolar epithelial cells under "physiologic" conditions, we describe an easy system to culture cells at the air-liquid interface and expose them to halogenated agents to provide precise controlled "air" fractions and "medium" concentrations for these agents. We developed a sealed air-tight chamber in which plates with human alveolar epithelial immortalized cells could be exposed to a precise, controlled fraction of sevoflurane or isoflurane using a continuous gas flow provided by an anesthetic machine circuit. Cells were exposed to 4% of sevoflurane and 1% of isoflurane for 24 hours. Gas mass spectrometry was performed to determine the concentration of halogenated agents dissolved in the medium. After the first hour, the concentrations of sevoflurane and isoflurane in the medium were 251 mg/L and 25 mg/L, respectively. The curves representing the concentrations of both sevoflurane and isoflurane dissolved in the medium showed similar courses over time, with a plateau reached at one hour after exposure.

This protocol was specifically designed to reach precise and controlled concentrations of sevoflurane or isoflurane in vitro to improve our understanding of mechanisms involved in epithelial lung injury during ARDS and to test novel therapies for the syndrome.

Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by diffuse alveolar injury, lung edema, and hypoxemic respiratory failure. Although ARDS represents more than 10% of intensive care unit (ICU) admissions and nearly 25% of ICU patients requiring mechanical ventilation, it is still an under-recognized challenge for clinicians, with a hospital mortality rate of 35-45%1. Despite intense research, the identification of an effective ARDS pharmacologic therapy or prevention has failed to date. Two major features contribute to mortality in ARDS: impaired alveolar fluid clearance (AFC) (i.e., the altered resorption....

Log in or to access full content. Learn more about your institution’s access to JoVE content here

1. Culture of Alveolar Epithelial Cells (hAELVi)

  1. Thawing
    1. Pipette 4 mL of cultivation ready-to-use human alveolar epithelial (huAEC) medium in a 15 mL plastic tube and quickly thaw the vial in a preheated water bath (37 °C).
    2. Transfer the thawed cell suspension to a 15 mL plastic tube containing 4 mL of the medium before centrifuging the tube at 200 x g for 5 min.
    3. Aspirate the supernatant and resuspend the cell pellet with 5 mL of the cultivation medium. Then, transfer the.......

Log in or to access full content. Learn more about your institution’s access to JoVE content here

The concentrations of the sevoflurane and isoflurane, which dissolved in the medium over time, are reported in Table 1 and Table 2, respectively.

The courses of the sevoflurane and isoflurane concentrations in the medium were similar over time. Immediately after the required concentration of halogenated agent was set, concentrations rose over the first hour. A plateau was then reached, which per.......

Log in or to access full content. Learn more about your institution’s access to JoVE content here

Our protocol describes an easy method to expose cells to a precise fraction of a halogenated anesthetic agent, such as sevoflurane or isoflurane. Furthermore, we report here—for the first time—a rigorous correlation between both the gas fraction and the concentration of sevoflurane and isoflurane inside the culture medium itself. This fundamental step now allows us to safely use our air-tight chamber to study the effects of these halogenated agents in a cultured monolayer of human alveolar epithelial cells.

Log in or to access full content. Learn more about your institution’s access to JoVE content here

The authors acknowledge the Auvergne Regional Council ("Programme Nouveau Chercheur de la Région Auvergne" 2013) and the French Agence Nationale de la Recherche and the Direction Générale de L'Offre de Soins ("Programme de Recherche Translationnelle en Santé" ANR-13-PRTS-0010) for the grants. The funders had no influence in the study design, conduct, and analysis or in the preparation of this article.

....

Log in or to access full content. Learn more about your institution’s access to JoVE content here

Name Company Catalog Number Comments
Sevoflurane Baxter Performing experiments using sevoflurane or isoflurane while being pregnant should be strongly discouraged
Isoflurane Virbac Performing experiments using sevoflurane or isoflurane while being pregnant should be strongly discouraged
Human Alveolar Epithelial cells InScreenex INS-CI-1015
huAEC Medium (ready-to-use) InScreenex INS-ME-1013-500ml
Anesthetic machine circuit Drager Fabius
Gas analyzer Drageer Vamos Plus
Anesthetic gas filter SedanaMedical FlurAbsord
Heated Humifier Fisher&Paykel MR850
Chamber Curver 00012-416-00
Gas chromatography coupled with mass detection Thermo Fisher Scientific, San Jose, CA, USA Trace 1310 with TSQ 8000evo
Fused-silica column (30 m x 1.4 µm, 0.25 mm ID) Restek, Lisses, France Rxi-624Sil MS

  1. Bellani, G., Laffey, J. G., et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA:T Journal of the American Medical Association. 315 (8), 788-800 (2016).
  2. Thompson, B. T., Chambers, R. C., Liu, K. D. Acute Respiratory Distress Syndrome. The New England Journal of Medicine. 377 (6), 562-572 (2017).
  3. Weiser, T. G., Regenbogen, S. E., et al. An estimation of the global volume of surgery: a modelling strategy based on available data. The Lancet. (9633), 139-144 (2008).
  4. Khuri, S. F., Henderson, W. G., et al. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Annals of Surgery. 242 (3), 341-343 (2005).
  5. De Conno, E., Steurer, M. P., et al. Anesthetic-induced improvement of the inflammatory response to one-lung ventilation. Anesthesiology. 110 (6), 1316-1326 (2009).
  6. Fu, H., Sun, M., Miao, C. Effects of different concentrations of isoflurane pretreatment on respiratory mechanics, oxygenation and hemodynamics in LPS-induced acute respiratory distress syndrome model of juvenile piglets. Experimental Lung Research. 41 (8), 415-421 (2015).
  7. Reutershan, J., Chang, D., Hayes, J. K., Ley, K. Protective effects of isoflurane pretreatment in endotoxin-induced lung injury. Anesthesiology. (3), 511-517 (2006).
  8. Uhlig, C., Bluth, T., et al. Effects of Volatile Anesthetics on Mortality and Postoperative Pulmonary and Other Complications in Patients Undergoing Surgery: A Systematic Review and Meta-analysis. Anesthesiology: The Journal of the American Society of Anesthesiologists. 124 (6), 1230-1245 (2016).
  9. Li, Q. F., Zhu, Y. S., Jiang, H., Xu, H., Sun, Y. Isoflurane preconditioning ameliorates endotoxin-induced acute lung injury and mortality in rats. Anesthesia and Analgesia. (5), 1591-1597 (2009).
  10. Voigtsberger, S., Lachmann, R. A., et al. Sevoflurane ameliorates gas exchange and attenuates lung damage in experimental lipopolysaccharide-induced lung injury. Anesthesiology. (6), 1238-1248 (2009).
  11. Englert, J. A., Macias, A. A., et al. Isoflurane Ameliorates Acute Lung Injury by Preserving Epithelial Tight Junction Integrity. Anesthesiology. (2), 377-388 (2015).
  12. Jabaudon, M., Boucher, P., et al. Sevoflurane for Sedation in ARDS: A Randomized Controlled Pilot Study. American Journal of Respiratory and Critical. , (2016).
  13. Blondonnet, R., Audard, J., et al. RAGE inhibition reduces acute lung injury in mice. Scientific Reports. 7 (1), (2017).
  14. Jabaudon, M., Blondonnet, R., et al. Soluble Receptor for Advanced Glycation End-Products Predicts Impaired Alveolar Fluid Clearance in Acute Respiratory Distress Syndrome. American Journal of Respiratory and Critical Care Medicine. 192 (2), 191-199 (2015).
  15. Jabaudon, M., Blondonnet, R., et al. Soluble Forms and Ligands of the Receptor for Advanced Glycation End-Products in Patients with Acute Respiratory Distress Syndrome: An Observational Prospective Study. PloS One. 10 (8), e0135857 (2015).
  16. Kuehn, A., Kletting, S., et al. Human alveolar epithelial cells expressing tight junctions to model the air-blood barrier. ALTEX. 33 (3), 251-260 (2016).
  17. Yue, T., Roth Z'graggen, B., et al. Postconditioning with a volatile anaesthetic in alveolar epithelial cells in vitro. The European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology. 31 (1), 118-125 (2008).
  18. Suter, D., Spahn, D. R., et al. The immunomodulatory effect of sevoflurane in endotoxin-injured alveolar epithelial cells. Anesthesia and Analgesia. (3), 638-645 (2007).
  19. Schläpfer, M., Leutert, A. C., Voigtsberger, S., Lachmann, R. A., Booy, C., Beck-Schimmer, B. Sevoflurane reduces severity of acute lung injury possibly by impairing formation of alveolar oedema. Clinical and Experimental Immunology. (1), 125-134 (2012).
  20. Nickalls, R. W. D., Mapleson, W. W. Age-related iso-MAC charts for isoflurane, sevoflurane and desflurane in man. British Journal of Anaesthesia. 91 (2), 170-174 (2003).
  21. Bourdeaux, D., Sautou-Miranda, V., et al. Simple assay of plasma sevoflurane and its metabolite hexafluoroisopropanol by headspace GC-MS. Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences. 878 (1), 45-50 (2010).
  22. Eger, E. I., Saidman, L. J., Brandstater, B. Minimum alveolar anesthetic concentration. Anesthesiology. 26 (6), 756-763 (1965).
  23. Perbet, S., Fernandez-Canal, C., Pereira, B., Cardot, J. M., Bazin, J. E., Constantin, J. M. Evaluation of Richmond Agitation Sedation Scale According To Alveolar Concentration of Sevoflurane During a Sedation With Sevoflurane in Icu Patients. Intensive Care Medicine Experimental. 3 (Suppl 1), (2015).
  24. Goolaerts, A., Pellan-Randrianarison, N., et al. Conditioned media from mesenchymal stromal cells restore sodium transport and preserve epithelial permeability in an in vitro model of acute alveolar injury. American Journal of Physiology. Lung Cellular and Molecular Physiology. 306 (11), L975-L985 (2014).

This article has been published

Video Coming Soon

JoVE Logo

Privacy

Terms of Use

Policies

Research

Education

ABOUT JoVE

Copyright © 2024 MyJoVE Corporation. All rights reserved