Antioxidant Response of Chronic Wounds to Hyperbaric Oxygen Therapy.

Antoni Sureda,Silvia Tejada,Miquel Martorell,Josep A Tur,Juan M Batle,Antoni Pons,Xavier Capó,Nukhet Aykin-Burns

doi:10.1371/journal.pone.0163371

Abstract

We analyzed the effects of the clinical hyperbaric oxygen therapy (HBOT) on the plasma antioxidant response and levels of endothelin-1, Interleukine-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with chronic wounds (20.2±10.0 months without healing). They received 20 HBOT sessions (five sessions/week), and blood samples were obtained at sessions 1, 5 and 20 before and 2 hours after the HBOT. An additional blood sample was collected 1 month after wound recovery. Serum creatine kinase activity decreased progressively in accordance with the wound healing. Plasma catalase activity significantly increased after the first and fifth sessions of HBOT. Plasma myeloperoxidase activity reported significantly lower values after sessions. Plasma VEGF and IL-6 increased after sessions. Endothelin-1 levels were progressively decreasing during the HBOT, being significant at the session 20. Plasma malondialdehyde concentration was significantly reduced at the last session. Both creatine kinase activity and malondialdehyde levels were maintained lower 1 month after wound recovery respect to initial values. In conclusion, HBOT enhanced the plasma antioxidant defenses and may contribute to activate the healing resolution, angiogenesis and vascular tone regulation by increasing the VEGF and IL-6 release and the endothelin-1 decrease, which may be significant factors in stimulating wound healing.

Highlights

Hyperbaric oxygen therapy (HBOT) is the clinical utilization of the oxygen at pressures higher than atmospheric pressure, habitually at 2–3 atmosphere absolute (ATA) pressure with 100% oxygen exposure
The results at the session 5 were significantly lower than the ones from the first session and the results from the session 20 were lower than the ones found in the sessions 1 and 5; at the session 20, serum Creatine kinase (CK) activity attained a 54% reduction with respect to the session 1
The decrease observed in the oxidative damage markers during HBOT is in accordance with the recovery process reported in the patients

Summary

Introduction

Hyperbaric oxygen therapy (HBOT) is the clinical utilization of the oxygen at pressures higher than atmospheric pressure, habitually at 2–3 atmosphere absolute (ATA) pressure with 100% oxygen exposure. Breathing oxygen at elevated pressure increases the oxygen availability for the body tissues. HBOT increases the capacity of blood plasma to transport oxygen with respect to normobaric conditions. HBOT has been successfully employed to manage diverse clinical diseases [1], such as non-healing diabetic and selected problem wounds, and PLOS ONE | DOI:10.1371/journal.pone.0163371. HBOT has been successfully employed to manage diverse clinical diseases [1], such as non-healing diabetic and selected problem wounds, and PLOS ONE | DOI:10.1371/journal.pone.0163371 September 21, 2016

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