A novel system for transcutaneous application of carbon dioxide causing an "artificial Bohr effect" in the human body
Yoshitada Sakai, Masahiko Miwa, Keisuke Oe, Takeshi Ueha, Akihiro Koh, Takahiro Niikura, Takashi Iwakura, Sang Yang Lee, Masaya Tanaka, Masahiro Kurosaka, Yoshitada Sakai, Masahiko Miwa, Keisuke Oe, Takeshi Ueha, Akihiro Koh, Takahiro Niikura, Takashi Iwakura, Sang Yang Lee, Masaya Tanaka, Masahiro Kurosaka
Abstract
Background: Carbon dioxide (CO(2)) therapy refers to the transcutaneous administration of CO(2) for therapeutic purposes. This effect has been explained by an increase in the pressure of O(2) in tissues known as the Bohr effect. However, there have been no reports investigating the oxygen dissociation of haemoglobin (Hb) during transcutaneous application of CO(2)in vivo. In this study, we investigate whether the Bohr effect is caused by transcutaneous application of CO2 in human living body.
Methods: We used a novel system for transcutaneous application of CO(2) using pure CO(2) gas, hydrogel, and a plastic adaptor. The validity of the CO(2) hydrogel was confirmed in vitro using a measuring device for transcutaneous CO(2) absorption using rat skin. Next, we measured the pH change in the human triceps surae muscle during transcutaneous application of CO(2) using phosphorus-31 magnetic resonance spectroscopy ((31)P-MRS) in vivo. In addition, oxy- and deoxy-Hb concentrations were measured with near-infrared spectroscopy in the human arm with occulted blood flow to investigate O2 dissociation from Hb caused by transcutaneous application of CO(2).
Results: The rat skin experiment showed that CO(2) hydrogel enhanced CO(2) gas permeation through the rat skin. The intracellular pH of the triceps surae muscle decreased significantly 10 min. after transcutaneous application of CO(2). The NIRS data show the oxy-Hb concentration decreased significantly 4 min. after CO(2) application, and deoxy-Hb concentration increased significantly 2 min. after CO(2) application in the CO(2)-applied group compared to the control group. Oxy-Hb concentration significantly decreased while deoxy-Hb concentration significantly increased after transcutaneous CO(2) application.
Conclusions: Our novel transcutaneous CO(2) application facilitated an O(2) dissociation from Hb in the human body, thus providing evidence of the Bohr effect in vivo.
Conflict of interest statement
Competing Interests: The hydro-gel was received as a gift from NeoChemir Inc. Takeshi Uhea is a full-time employee of NeoChemir Inc. Masaya Tanaka is Chief Executive Officer of NeoChemir Inc. and has patent licensing arrangements with the hydro-gel and CO2 application. The international patent publication number is WO2004/002393; the publication date is January 8, 2004. This does not alter the authors' adherence to all the PLoS ONE policies on sharing data and materials.
Figures
References
- Blair DA, Glover WE, McArrdle L. The mechanism of the peripheral vasodilation following carbon dioxide inhalation in man. Clin Sci. 1960;19:407–423.
- Matz H, Orion E, Wolf R. Balneotherapy in dermatology. Dermatol Ther. 2003;16:132–140.
- Hartmann BR, Bassenge E, Pittler M. Effect of carbon dioxide-enriched water and fresh water on the cutaneous microcirculation and oxygen tension in the skin of the foot. Angiology. 1997;48:337–343.
- Hartmann BR, Bassenge E, Hartmann M. Effects of serial percutaneous application of carbon dioxide in intermittent claudication: results of a controlled trial. Angiology. 1997;48:957–963.
- Toriyama T, Kumada Y, Matsubara T, Murata A, Ogino A, et al. Effect of artificial carbon dioxide foot bathing on critical limb ischemia (Fontaine IV) in peripheral arterial disease patients. Int Angiol. 2002;21:367–73.
- Brandi C, D'Aniello C, Grimaldi L, Bosi B, Dei I, et al. Carbon dioxide therapy in the treatment of localized adiposities: clinical study and histopathological correlations. Aesthetic Plast Surg. 2001;25:170–4.
- Brandi C, D'Aniello C, Grimaldi L, Caiazzo E, Stanghellini E. Carbon dioxide therapy: effects on skin irregularity and its use as a complement to liposuction. Aesthetic Plast Surg. 2004;28:222–5.
- Savin E, Bailliart O, Bonnin P, Bedu M, Cheynel J, et al. Vasomotor effects of transcutaneous CO2 in stage II peripheral occlusive arterial disease. Angiology. 1995;46:785–91.
- Fabry R, Monnet P, Schmidt J, Lusson JR, Carpentier PH, et al. Clinical and microcirculatory effects of transcutaneous CO2 therapy in intermittent claudication. Randomized double-blind clinical trial with a parallel design. Vasa. 2009;38:213–24.
- Schmidt J, Monnet P, Normand B, Fabry R. Microcirculatory and clinical effects of serial percutaneous application of carbon dioxide in primary and secondary Raynaud's phenomenon. Vasa. 2005;34:93–100.
- Duling BR. Changes in microvascular diameter and oxygen tension induced by carbon dioxide. Circ Res. 1973;32:370–6.
- Bohr C, Hasselbach K, Krogh A. Ueber emen in biologischen Bezuehung wichtigen Einfluss, den die Kohlen saurespannung des Blutes anf dessen Samerstoffbinding ubt. Arch. Physiol. 1904;16:402–412.
- Riggs A. The nature and significance of the Bohr effect in mammalian hemoglobins. J. Gen. Physiol. 1960;43:737–752.
- Tyuma I. The Bohr effect and the Haldane effect in human hemoglobin. Jpn J Physiol. Jpn. J. Physiol. 1984;34:205–216.
- Jensen FB. Red blood cell pH, the Bohr effect, and other oxygenation-linked phenomena in blood O2 and CO2 transport. Acta. Physiol. Scand. 2004;182:215–227.
- Hashimoto M, Yamamoto N. Decrease in heart rates by artificial CO2 hot spring bathing is inhibited by beta1-adrenoceptor blockade in anesthetized rats. J. Appl. Physiol. 2004;96:226–232.
- Yamamoto N, Hashimoto M. Spinal cord transection inhibits HR reduction in anesthetized rats immersed in an artificial CO2-hot spring bath. Int. J. Biometeorol. 2007;51:201–208.
- Yamamoto N, Hashimoto M. Immersion in CO2-rich water containing NaCl diminishes blood pressure fluctuation in anesthetized rats. Int. J. Biometeorol. 2007;52:109–116.
- Irie H, Tatsumi T, Takamiya M, Zen K, Takahashi T, et al. Carbon dioxide-rich water bathing enhances collateral blood flow in ischemic hindlimb via mobilization of endothelial progenitor cells and activation of NO-cGMP system. Circulation. 2005;111:1523–9.
- Raymer GH, Green HJ, Ranney DA, Marsh GD, Thompson RT. Muscle metabolism and acid-base status during exercise in forearm work-related myalgia measured with 31P-MRS. J. Appl. Physiol. 2009;106:1198–1206.
- Jöbsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science. 1977;198:1264–1267.
- Boushel R, Piantadosi CA. Near-infrared spectroscopy for monitoring muscle oxygenation. Acta. Physiol. Scand. 2000;168:615–622.
- Koga S, Poole DC, Ferreira LF, Whipp BJ, Kondo N, et al. Spatial heterogeneity of quadriceps muscle deoxygenation kinetics during cycle exercise. J. Appl. Physiol. 2007;103:2049–2056.
- Karalezli N, Ogun CO, Ogun TC, Yildirim S, Tuncay I. Wrist tourniquet: the most patient-friendly way of bloodless hand surgery. J. Trauma. 2007;62:750–754.
- Miller SH, Lung RJ, Graham WP, Davis TS, Rusenas I. The acute effects of tourniquet ischemia on tissue and blood gas tensions in the primate limb. J. Hand. Surg. Am. 1978;3:11–20.
- Mancini DM, Bolinger L, Li H, Kendrick K, Chance B, Wilson JR. Validation of near-infrared spectroscopy in humans. J. Appl. Physiol. 1994;77:2740–2747.
- Chance B, Dait MT, Zhang C, Hamaoka T, Hagerman F. Hagerman, Recovery from exercise-induced desaturation in the quadriceps muscles of elite competitive rowers. Am. J. Physiol. 1992;262:C766–775.
- Ganong WF. New York: Lange medical Books; 2005. Review of medical physiology. pp. 666–670.
- Schenkman KA, Marble DR, Burns DH, Feigl EO. Myoglobin oxygen dissociation by multiwavelength spectroscopy. J. Appl. Physiol. 1997;82:86–92.
- Hilpert P, Fleischmann RG, Kempe D, Bartels H. The Bohr effect related to blood and erythrocyte pH. Am. J. Physiol. 1963;205:337–340.
Source: PubMed