Abstract
IntroductionIschemia/reperfusion (I/R) injury, such as myocardial infarction, stroke, and peripheral vascular disease, has been recognized as the most frequent causes of devastating disorders and death currently. Protective effect of various preconditioning stimuli, including hyperbaric oxygen (HBO), has been proposed in the management of I/R.MethodsIn this study, we searched and reviewed up‐to‐date published papers to explore the pathophysiology of I/R injury and to understand the mechanisms underlying the protective effect of HBO as conditioning strategy.ResultsAnimal study and clinic observation support the notion that HBO therapy and conditioning provide beneficial effect against the deleterious effects of postischemic reperfusion. Several explanations have been proposed. The first likely mechanism may be that HBO counteracts hypoxia and reduces I/R injury by improving oxygen delivery to an area with diminished blood flow. Secondly, by reducing hypoxia–ischemia, HBO reduces all the pathological events as a consequence of hypoxia, including tissue edema, increased affective area permeability, postischemia derangement of tissue metabolism, and inflammation. Thirdly, HBO may directly affect cell apoptosis, signal transduction, and gene expression in those that are sensitive to oxygen or hypoxia. HBO provides a reservoir of oxygen at cellular level not only carried by blood, but also by diffusion from the interstitial tissue where it reaches high concentration that may last for several hours, improves endothelial function and rheology, and decreases local inflammation and edema.ConclusionEvidence suggests the benefits of HBO when used as a preconditioning stimulus in the setting of I/R injury. Translating the beneficial effects of HBO into current practice requires, as for the “conditioning strategies”, a thorough consideration of risk factors, comorbidities, and comedications that could interfere with HBO‐related protection.
Highlights
Ischemia/reperfusion (I/R) injury, such as myocardial infarction, stroke, and peripheral vascular disease, has been recognized as the most frequent causes of devastating disorders and death currently
Because it had been recently discovered that increased reactive oxygen species (ROS) levels may upregulate HIF-1 expression (Kietzmann & Gorlach, 2005; Peng et al, 2006), and there had been evidence that EPO may exert potent neuroprotective effects (Morishita, Masuda, Nagao, Yasuda, & Sasaki, 1997; Sakanaka et al, 1998), the researchers studied in parallel the clinical, histological, and molecular effects of hyperbaric oxygen (HBO) preconditioning in a rat focal cerebral ischemic model (Gu, Kehl et al 2008; Gu, Li et al 2008)
Another study in rats showed that HBO preconditioning protected grafted skin flaps against subsequent I/R injury and improved skin flap survival rates, which was associated with the attenuation of inflammatory responses (Kang, Hai, Liang, Gao, & Liu, 2014)
Summary
Ischemia/reperfusion (I/R) injury, such as myocardial infarction, stroke, and peripheral vascular disease, has been recognized as the most frequent causes of devastating disorders and death currently. It was concluded that HBO increases ROS formation that triggers signaling pathways to upregulate antioxidant enzymes which protect from I/R injury.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
