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

Published: October 23rd, 2018



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....

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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.......

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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.......

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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.

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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.


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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

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