HBOT induced expression of genes associated with healthy ageing

Ann N Y Acad Sci. 2010 Jun;1197:178-83. Hyperbaric oxygen treatment induces antioxidant gene expression.

Godman CA, Joshi R, Giardina C, Perdrizet G, Hightower LE. Department of Molecular and Cell Biology, University of Connecticut, Storrs, Connecticut, USA.

Although the underlying molecular causes of aging are not entirely clear, hormetic agents like exercise, heat, and calorie restriction may generate a mild pro-oxidant stress that induces cell protective responses to promote healthy aging. As an individual ages, many cellular and physiological processes decline, including wound healing and reparative angiogenesis. This is particularly critical in patients with chronic non-healing wounds who tend to be older. We are interested in the potential beneficial effects of hyperbaric oxygen as a mild hormetic stress on human microvascular endothelial cells. We analyzed global gene expression changes in human endothelial cells following a hyperbaric exposure comparable to a clinical treatment. Our analysis revealed an upregulation of antioxidant, cytoprotective, and immediate early genes. This increase coincided with an increased resistance to a lethal oxidative stress. Our data indicate that hyperbaric oxygen can induce protection against oxidative insults in endothelial cells and may provide an easily administered hormetic treatment to help promote healthy aging.

HBOT induces apoptosis in cancer cells in vitro

Role of elevated pressure in TRAIL-induced apoptosis in human lung carcinoma cells.

Oh S, Kwon D, Lee HJ, Kim J, Lee E. Apoptosis. 2010 Dec;15(12):1517-28.

Cellular and Developmental Biology, Division of Biomedical Science, Seoul, Korea.

TNF-related apoptosis-inducing ligand (TRAIL, Apo2L) is a promising anticancer agent with high specificity for cancer cells. Many strategies have been proposed to enhance the sensitivity of cancer cells to TRAIL-mediated apoptosis, including the use of combination treatment with conventional cancer therapies. However, few reports have evaluated the effects of TRAIL in combination with mechanical stress, which can also cause apoptosis of cancer cells. In the present study, we describe a custom-designed culture system that delivers two atmospheres of elevated pressure (EP) by using compressed air, and which enhances the sensitivity of cancer cells to TRAIL-mediated apoptosis. The combination of TRAIL and EP significantly increased apoptosis of human H460 lung cancer cells more than hyperbaric normoxia or normobaric mild hyperoxia. EP-potentiating TRAIL-mediated apoptosis of H460 cells was accompanied by up-regulated death receptor 5 (DR5), activation of caspases, decreased mitochondrial membrane potential, and reactive oxygen species production. We also observed EP-induced sensitization of TRAIL-mediated apoptosis in other cancer cell types. In contrast, human normal cells showed no DNA damage or cell death when exposed to the combined treatment. In a chicken chorioallantoic membrane model, EP enhanced TRAIL-mediated apoptosis of tumors that developed from transplanted H460 cells. Collectively, EP enhanced TRAIL-induced apoptosis of human lung carcinoma cells in vitro and in vivo. These findings suggest that EP is a mechanical and physiological stimulus that might have utility as a sensitizing tool for cancertherapy.

HBOT may be beneficial in the management of radiation-induced cystitis

Management of radiation cystitis. Nat Rev Urol. 2010 Apr;7(4):206-14. Epub 2010 Mar 9.

Smit SG, Heyns CF. Department of Urology, University of Stellenbosch and Tygerberg Hospital, PO Box 19063, Tygerberg 7505, South Africa. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Acute radiation cystitis occurs during or soon after radiation treatment. It is usually self-limiting, and is generally managed conservatively. Late radiation cystitis, on the other hand, can develop from 6 months to 20 years after radiation therapy. The main presenting symptom is hematuria, which may vary from mild to severe, life-threatening hemorrhage. Initial management includes intravenous fluid replacement, blood transfusion if indicated and transurethral catheterization with bladder washout and irrigation. Oral or parenteral agents that can be used to control hematuria include conjugated estrogens, pentosan polysulfate or WF10. Cystoscopy with laser fulguration or electrocoagulation of bleeding points is sometimes effective. Injection of botulinum toxin A in the bladder wall may relieve irritative bladder symptoms. Intravesical instillation of aluminum, placental extract, prostaglandins or formalin can also be effective. More-aggressive treatment options include selective embolization or ligation of the internal iliac arteries. Surgical options include urinary diversion by percutaneous nephrostomy or intestinal conduit, with or without cystectomy. Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at higher than atmospheric pressure. The reported success rate of HBOT for radiation cystitis varies from 60% to 92%. An important multicenter, double-blind, randomized, sham-controlled trial to evaluate the effectiveness of HBOT for refractory radiation cystitis is currently being conducted.

HBOT may help stroke victims

Hyperbaric oxygen therapy in the treatment of post cardiac surgical strokes--a case series and review of the literature.

Gibson AJ, Davis FM. Anaesth Intensive Care. 2010 Jan;38(1):175-84

Hyperbaric Medicine Unit, Christchurch Hospital, Christchurch, New Zealand.

Strokes remain an uncommon but significant complication of cardiac surgery. Cerebral air embolism is the likely aetiology in the majority of cases. Hyperbaric oxygen therapy is the recognised treatment for cerebral air embolism associated with compressed air (SCUBA) diving accidents and is therefore also the standard of care for iatrogenic causes of air embolism. It follows that there is a logic in treating post-cardiac surgical stroke patients with hyperbaric oxygen. The aim of this retrospective review was to examine the outcomes of 12 such patients treated in the Christchurch Hospital hyperbaric unit and to appraise the evidence base for the use of hyperbaric oxygen therapy in this setting. Despite delays of up to 48 hours following surgery before the institution of hyperbaric oxygen therapy, 10 of the 12 patients made a full neurological recovery or were left with mild residual symptoms, with nine returning to their previous level of care. One patient remained hemiplegic and there was one early neurological death. There is a paucity of prospective data in this area, but based on sound pathophysiological principles and clinical experience, we believe that patients suffering a stroke following open cardiac surgery should be considered for hyperbaric oxygen therapy.

HBOT helps victims of bomb blash with mild traumatic brain injury

Case report: Treatment of mild traumatic brain injury with hyperbaric oxygen.

Wright JK, Zant E, Groom K, Schlegel RE, Gilliland K. Undersea Hyperb Med. 2009 Nov-Dec;36(6):391-9.

720th Special Tactics Group, Hurlburt Field, Florida, USA.

Two United States Air Force Airmen were injured in a roadside improvised explosive device (IED) blast in Iraq in January 2008. Both airmen suffered concussive injuries and developed irritability, sleep disturbances, headaches, memory difficulties and cognitive difficulties as symptoms of mild traumatic brain injury (mTBI). Six months after injury, repeat Automated Neuropsychological Assessment Metrics (ANAM) testing showed deterioration, when compared to pre-injury baseline ANAM assessment, in all measured areas (simple reaction time, procedural reaction time, code substitution learning, code substitution delayed, mathematical processing, and matching to sample). The airmen were treated with hyperbaric oxygen in treatments of 100% oxygen for one hour at 1.5 atmospheres absolute, resulting in rapid improvement of headaches and sleep disturbances, improvement in all symptoms and resolution of most symptoms. Repeat ANAM testing after completion of the hyperbaric treatments - nine months after initial injury - showed improvement in all areas, with most measures improving to pre-injury baseline levels. The airmen received no other treatment besides medical monitoring. Repeat neuropsychologic testing confirmed the improvement. We conclude that the improvement in symptoms and ANAM performance is most likely attributable to HBO treatment.

HBOT may improve chemotherapy

Systemic chemotherapy using paclitaxel and carboplatin plus regional hyperthermia and hyperbaric oxygen treatment for non-small cell lung cancer with multiple pulmonary metastases: preliminary results.

Ohguri T, Imada H, Narisada H, Yahara K, Morioka T, Nakano K, Miyaguni Y, Korogi Y. Int J Hyperthermia. 2009 Mar;25(2):160-7.

Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Japan. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

The purpose of this retrospective case series was to evaluate the toxicity and efficacy of systemic chemotherapy using paclitaxel and carboplatin plus regional hyperthermia (HT) and hyperbaric oxygen treatment (HBO) for non-small-cell lung cancer (NSCLC).

Twenty-two patients with NSCLC with multiple pulmonary metastases intravenously received paclitaxel (50 mg/m(2)), carboplatin (area under the curve of 1.0-1.5) and 10% glucose weekly for 3 out of 4 weeks. Hyperthermia (HT) of the whole thoracic region was also administered weekly during intravenous infusion of carboplatin in all patients. In addition, 16 (72%) of 22 patients received hyperbaric oxygen (HBO) treatment immediately after weekly chemotherapy. A total of 107 cycles were performed in 16 patients with HBO, and 27 cycles in 6 patients without HBO. The toxicity and efficacy of these patients were retrospectively analyzed.

Both the hematologic and non-hematologic toxicities were mild and leucopenia/neutropenia of > or = grade 3 was seen in one patient, while pneumonitis of > or = grade 3 occurred in one patient. Fourteen (64%) of 22 patients had an objective response. The median time to progression of disease in all patients was 8 months and in 16 patients with HBO was 9 months. Four (44%) of 9 patients with prior chemotherapy including paclitaxel and carboplatin obtained objective responses.

CONCLUSIONS:

The novel combined therapy of paclitaxel and carboplatin with HT and HBO may therefore be a feasible and promising modality for treating NSCLC with multiple pulmonary metastases, and the results justify further evaluation to clarify the benefits of this treatment regimen.

HBOT for interstitial cystitis

Hyperbaric oxygen therapy for interstitial cystitis resistant to conventional treatments.

Tanaka T, Kawashima H, Makino T, Kamikawa S, Kato N, Nakatani T. Int J Urol. 2007 Jun;14(6):563-5.

Department of Urology, Osaka City University Graduate School of Medicine, Osaka, Japan. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

We treated two cases of interstitial cystitis (IC) that were resistant to some conventional therapies with hyperbaric oxygen (HBO). Both patients underwent 20 sessions of 100% oxygeninhalation (2.0 atmosphere absolute for 60 min/day x 5 days/week for 4 weeks) in a hyperbaric chamber. The period of follow up was 12 months for case 1 and 9 months for case 2. After a course of HBO, the bladder mucosal ulcer (Hunner's ulcer) disappeared, and changes from baseline in pain and urinary frequency was constitutively inhibited. There were no adverse events during the 20 treatment sessions. One woman (case 1) had mild Eustachian tube dysfunction, resulting in a transient hearing impairment. HBO seems to be an option for treatment of IC resistant to conventional therapies.

Hyperbaric oxygen in the treatment of sudden hearing loss.

Racic G, Maslovara S, Roje Z, Dogas Z, Tafra R. ORL J Otorhinolaryngol Relat Spec. 2003 Nov-Dec;65(6):317-20.

ENT Department, University Hospital Split, Split, Croatia. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Treatment of idiopathic sudden hearing loss (SHL) is still a great problem for the physicians, due to the still unexplained etiopathogenesis of the disease. This retrospective study includes 115 patients with idiopathic SHL and compares two therapy regimens. Of the total number of patients, 51 had been primarily treated by hyperbaric oxygen (HBO) at 2.8 bar. The remaining 64 patients had been treated by pentoxifylline infusions in increasing and decreasing doses. Hearing thresholds were ascertained at the frequencies of 250, 500, 1,000, 2,000 and 4,000 Hz using pure-tone audiometry. The results after treatment showed a statistically significant improvement of hearing by 46.35 (SD +/-18.58) dB hearing level (HL) in the group of patients treated with HBO, compared with an improvement of hearing by 21.48 dB HL (SD +/-13.5) in the group of patients treated with pentoxifylline infusions (p < 0.001). Furthermore, hearing recovered to physiological values in 24 of 51 (47.1%) HBO-treated patients, compared to only 4 of 64 (6.2%) of the pentoxifylline-treated patients. Furthermore, after pentoxifylline treatment only 8/64 (12.5%) patients showed partial recovery, whereas after HBO therapy 21/51 (41.2%) patients improved up to a mild persistent hearing loss. This indicates strong evidence that HBO therapyis more effective in the treatment of idiopathic SHL than conventional rheological treatment. However, more prospective clinical trials should confirm the efficiency of HBO therapy and lead to its wider application.