Abstract

Objectives

Necrotizing enterocolitis (NEC) is a severe neonatal surgical condition, associated with a prolonged pro inflammatory state, leading to high mortality and morbidity rates. Carbon dioxide (CO2) insufflation during laparoscopy may have an anti-inflammatory effect. We aimed to evaluate the effects of CO2-insufflation on experimental colitis.

Methods

Acute colitis was induced in 6-week-old Balb/c mice by the administration of 2%-dextran sulfate-sodium (DSS) during 7 days (n = 45). On Day 4, two groups received intraperitoneal insufflation (duration: 30 mn, pressure: 5 mmHg) of CO2 (“DSS+CO2”) or air (“DSS+air”). A group received no insufflation (“DSS”). Groups were compared for clinical severity using the disease activity index (DAI—body weight loss, stool consistency, and bleeding), histological severity (histopathological activity index, colon length, and ulcerations), colonic mucosecretion, and inflammation.

Results

DAI was significantly decreased in DSS+CO2 group, compared to DSS (p < 0.0001) or DSS+air (p < 0.0001) groups. Colon length was increased in DSS+CO2 treated mice compared to DSS (p = 0.0002). The histopathological activity index was lower in DSS+CO2 (vs. DSS, p = 0.0059/vs. DSS+air, p = 0.0389), with decreased ulcerations (3.77 vs. 10.7, p = 0.0306), and persistent mucosecretion with increased mucin-secreting cells.

Conclusions

CO2-insufflation attenuates DSS-induced colitis and improves both clinical and histological scores. Laparoscopy with CO2 insufflation represents a therapeutic anti-inflammatory strategy for NEC.

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