Abstract
Endothelial dysfunction has been considered as pivotal in the pathogenesis of decompression sickness (DCS) and contributes substantively to subsequent inflammatory responses. Escin is well known for its endothelial protection and anti-inflammatory properties, and its protection against DCS has been proved in a rat model. This study aimed to further investigate the protection of escin against DCS in swine. Sixteen swine were subjected to a two-stage experiment with an interval of 7 days. In each stage, 7 days before a simulated air dive, the swine were treated with escin or saline. The first group received a successive administration of escin for 7 days prior to the first dive and saline for 7 days prior to the second; the second group was treated with saline and then escin. After decompression, signs of DCS and circulating bubbles were monitored, and blood was sampled for platelet count and determination of inflammatory and endothelial related indices. The death rate of DCS was markedly decreased in swine treated with escin compared with that in animals treated with saline, though not statistically significant due to the limited number of animals. Escin had no effect on bubble load but significantly ameliorated platelet reduction and endothelial dysfunction, as well as oxidative and inflammatory responses. The results further suggest the beneficial effects of escin on DCS by its endothelia-protective properties, and escin has the potential to be a candidate drug for DCS prevention and treatment.
Highlights
In sudden and unexpected events during diving, aviation, and other barometric pressure exposures, an excessively rapid drop of ambient pressure can induce the formation of inert gas bubbles, which will entail a serious risk of decompression sickness (DCS) (Vann et al, 2011)
Bubbles are at the core of the pathogenesis of DCS by mechanical injury and their secondary reaction with vascular endothelia leading to inflammation and vascular dysfunction (Brubakk and Møllerløkken, 2009)
Mean body mass had increased by approximately 8% by the day of the second simulated dive compared with that of the first dive, from 21.3 ± 1.1 to 23.1 ± 1.2 kg
Summary
In sudden and unexpected events during diving, aviation, and other barometric pressure exposures, an excessively rapid drop of ambient pressure can induce the formation of inert gas bubbles, which will entail a serious risk of decompression sickness (DCS) (Vann et al, 2011). Bubbles are at the core of the pathogenesis of DCS by mechanical injury and their secondary reaction with vascular endothelia leading to inflammation and vascular dysfunction (Brubakk and Møllerløkken, 2009). We have confirmed that endothelial dysfunction induced by decompression was well correlated with bubble formation in a rat model (Zhang et al, 2016). It has been proven in our previous studies that drugs with potential endothelial protection, such as simvastatin, were beneficial to DCS (Zhang et al, 2015). Escin is an endothelium-protective drug that is extracted from Aesculus hippocastanum seeds. Escin can reduce vascular permeability, increase venous reflux, alleviate venous congestion
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