Abstract

Hyperbaric oxygen therapy (HBOT) consists of breathing 100% oxygen under increased ambient pressure. There are indications that HBOT induces oxidative stress and activates immune pathways. However, previous research on immunological effects of HBOT has mainly been established in in vitro experiments and selected patient populations, limiting generalizability and increasing the chances of confounding by comorbidities and specific patient-related factors. More insight into the immunological effects of HBOT would aid investigation and comprehension of potentially novel treatment applications. Therefore, in this study, we investigated the effects of three 110-min HBOT-sessions with 24-h intervals on immunological parameters in healthy, young, male volunteers. Blood samples were obtained before and after the first and third HBOT sessions. We assessed neutrophilic reactive oxygen species (ROS) production, systemic oxidative stress [plasma malondialdehyde (MDA) concentrations] as well as neutrophil phagocytic activity, plasma concentrations of tumor necrosis factor (TNF), interleukin (IL)-6, IL-8, and IL-10, and production of TNF, IL-6, and IL-10 by leukocytes ex vivo stimulated with the Toll-like receptor (TLR) ligands lipopolysaccharide (TLR4) and Pam3Cys (TLR2). We observed decreased neutrophilic ROS production and phagocytosis following the second HBOT session, which persisted after the third session, but no alterations in MDA concentrations. Furthermore, plasma concentrations of the investigated cytokines were unaltered at all-time points, and ex vivo cytokine production was largely unaltered over time as well. These results indicate no induction of systemic oxidative stress or a systemic inflammatory response after repeated HBOT in healthy volunteers but may suggest exhaustion of ROS generation capacity and phagocytosis.

Highlights

  • Hyperbaric oxygen therapy (HBOT) consists of breathing 100% oxygen under increased ambient pressure (Moon, 2019)

  • Plasma concentrations of the investigated cytokines were unaltered at all-time points, and ex vivo cytokine production was largely unaltered over time as well. These results indicate no induction of systemic oxidative stress or a systemic inflammatory response after repeated HBOT in healthy volunteers but may suggest exhaustion of reactive oxygen species (ROS) generation capacity and phagocytosis

  • In patients with unilateral femoral head necrosis, an increase in plasma ROS production was found following a large number of HBOT sessions and a gradual decrease in plasma levels of tumor necrosis factor (TNF) and interleukin (IL)-6 was observed (Bosco et al, 2018)

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Summary

Introduction

Hyperbaric oxygen therapy (HBOT) consists of breathing 100% oxygen under increased ambient pressure (Moon, 2019). Many of the currently used and potential new indications for HBOT rely on its putative effects on the immune system, including the generation of reactive oxygen species (ROS), which constitutes an important antimicrobial defense mechanism (Camporesi and Bosco, 2014; Shinomiya, 2019; Ürütük, 2020). This effect on the immune system may be especially relevant for the possible use of HBOT in preconditioning before surgery. Little research has been performed concerning the immunological effects of HBOT in healthy volunteers, this may yield more clear-cut insights due to the lack of comorbidities or specific patient-related factors

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