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Hyperbaric oxygen treatment decreases inflammation and mechanical
hypersensitivity in an animal model of inflammatory painRSD
Wilson JR, Fuchs PN Brain Res
vol. 1098, 126 - 128, 2006
was initially developed to combat the adverse effects of deep sea diving. In
recent years, hyperbaric oxygen treatment has been used to treat a broad
spectrum of ailments, including delayed-onset muscle soreness, fibromyalgia,
and complex regional pain syndrome (CRPS). However, limited data are available
on the effect of hyperbaric oxygen treatment on inflammatory pain. The effect
of hyperbaric oxygen treatment on carrageenan-induced inflammation and pain in
rats was investigated. It was hypothesized that treatment with hyperbaric
oxygen would decrease paw edema and hyperalgesia in an acute inflammatory pain
model as compared with that of a sham-treated control group.
The experiment was
conducted on 44 male Sprague-Dawley rats each between 300 and 350 g. The
inflammatory pain condition was induced by subcutaneous injection of 1%
carrageenan suspended in saline in the left hind paw. Paw volume was assessed
via water displacement with a plethysmometer, and percentage differences were
calculated on the basis of posttreatment measures compared with pretreatment
measures. Hyperalgesia was assessed using the up/down method of mechanical paw
withdrawal thresholds. Hyperbaric oxygen treatment involved exposing animals to
100% oxygen at a pressure of 2.4 atmospheres absolute (ATA) for 90 minutes in a
hyperbaric chamber. A control group was placed in the hyperbaric chamber but
did not receive treatment.
A 1-way analysis of
variance revealed no significant preinjec-tion group differences. An overall
mixed-design analysis with 2 group levels (treatment, sham) and 7 levels of
time revealed a significant main effect for group, a main effect for time, and
a group by time interaction. In the hyperbaric oxygen treatment group, paw
edema remained at pretreatment levels immediately after treatment and continued
to decrease slightly until 2 hours posttreatment, at which time it began to
decrease. However, antinociceptive effects were apparent immediately after
treatment and continued to increase up to 5 hours after treatment, suggesting
that distinct mechanisms might be involved in the anti-inflammatory and
antinociceptive properties of Hyperbaric Oxygen Treatment.
treatment significantly reduced inflammation and pain after carrageenan
injection in this rat model of inflammatory pain. Hyperbaric oxygen may be used
in patients for whom nonsteroidal anti-inflammatory drugs are contraindicated
or for those with persistent inflammation.
H Sugiyama1, H Doi1, M Iida1, T Nagao2
and K Matsumoto3
Neurosurgery, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan
Neurology, Tokyo Metropolitan Ebara Hospital, Tokyo, Japan 3Department of
Neurosurgery, Showa University, School of Medicine, Tokyo, Japan
Correspondence to: S Asamoto, Department of Neurosurgery,
Tokyo Metropolitan Ebara Hospital, 4-5-10 Higashi-Yukigaya, Ohta-Ku, Tokyo
Study design: A retrospective study of spinal cord injury
(SCI) treated with and without hyperbaric oxygen (HBO) therapy. Objectives: To report on the use of HBO in spinal cord
injury. Setting: Neurosurgical Unit, Tokyo, Japan. Methods: Thirty-four cases of hyperextension spinal cord
injury without bone damage and previous history of surgical intervention
were divided into two groups, with (HBO) or without (non-HBO) therapy. The
neurological findings at admission and their outcomes were evaluated by
means of Neurological Cervical Spine Scale (NCSS) and the average
improvement rates in individual groups were compared. Results: The improvement rate ranged from 100% to 27.3%
with the mean value of 75.2% in the HBO group, while these values were
100%, 25.0% and 65.1% respectively in the non HBO group. Conclusion: In the HBO group, the improvement rate
indicated effectiveness in acute traumatic cervical spinal cord injury. Spinal Cord (2000) 38,
reduces the inflammation and restores circulation!
NEW YORK (Reuters Health) Nov 18 - Brains
obtained at autopsy from autism patients show widespread neuroglial activation
and inflammation, according to a report in the November 15th online edition of
Annals of Neurology.
Despite suggestions that immune dysfunction
plays a role in the pathogenesis of autism, the authors explain,
neuropathological studies have given little attention to immune and neuroglial
activity in autism.
Dr. Carlos A. Pardo from Johns Hopkins
University School of Medicine, Baltimore, and colleagues studied brain tissues
obtained at autopsy from 11 autistic patients and cerebrospinal fluid from 6
living autistic patients.Neuropathological
examination of autistic brains revealed extensive neuroglial responses, along
with patchy loss of neurons in the Purkinje cell layer and granular cell layer
of the cerebellum."The marked
neuroglial activity in the cerebellum is consistent with previous observations
that the cerebellum is one focus of pathological abnormalities in morphological
and neuroimaging studies of patients with autism," Dr. Pardo
commented.There was, however, no
evidence of adaptive immune reactions in autistic brains, the authors report.
Brain tissues from autistic patients showed
increased levels of proinflammatory cytokines, the results indicate,
particularly in the region of the anterior cingulate gyrus. Cytokines
originated principally from reactive astrocytes.
Cerebrospinal fluid from living autistic
patients showed significant increases in MCP-1, IL-6, IFN-gamma, IL-8,
MIP-1beta, and other proinflammatory cytokines and modulatory cytokines.
"These cytokines play important roles in
immune mediated processes, and their presence in the CSF in autistic patients
may reflect an ongoing stage of inflammatory reactions likely associated with
neuroglial activation and/or neuronal injury," Dr. Pardo explained."At present, there is no indication for
using anti-inflammatory medications in patients with autism," Dr. Pardo
cautioned. "There are ongoing experimental studies to examine the effect
of drugs that limit the activation of microglia and astrocytes, but their use
in humans must await further evidence of their efficacy and safety."
Hyperbaric Oxygen Therapy is known for its
ability to dramatically reduce inflammation!
purpose of this study was to determine if hyperbaric oxygen therapy affected
Lyme disease caused by the spirochete, Borrelia burgdorferi.
spirochete B. burgdorferi is a microaerophilic organism carried by the Deer
tick (Ixodid) and transferred to humans and other mammals by its bite. Symptoms
often begin by a bulls-eye rash and erythema migrans. Symptoms may include pain
in joints and muscles, sore throat, fever, swollen glands, and mental "
fogginess". If not diagnosed within the first one or two months, the
disease may become a chronic infection. At that time it apparently becomes
sequestered in fibroblasts and other cells which, in turn appear to protect it
against effective treatment by all known antibiotics so far tested. The disease
is difficult to diagnose without serological findings and requires the skill of
a highly qualified physician, experienced in treating this disease.
was shown by Austin that the spirochete could not survive if transferred in air
to another host, but would survive if transferred in a gas mixture of 4%
oxygen. This demonstrated that the spirochete could not survive in an oxygen
partial pressure of 160-mm Hg (the partial pressure of oxygen in air), but
could survive in a partial pressure of 30-mm Hg (which is the partial pressure
of 4% oxygen at 1 atmosphere, absolute (ground level pressure). Therefore, it
seems clear that a lethal level of oxygen for the spirochete falls somewhere
between 30 mm Hg, and 160 mm Hg.
also is known that while the inspired partial pressure of oxygen is
approximately 160 mm Hg, at the tissue level, the partial pressure of oxygen
normally is approximately 30-35 mm Hg. Thus, it would not be expected that
breathing air at ground level would cause any damage to the spirochete.
However, if the patient were placed in a hyperbaric chamber and the pressure
increased to 2. 36 atmospheres, absolute (ata), the total barometric pressure
would be 1794 mm Hg. If the patient were then to breathe pure oxygen the
inspired partial pressure of oxygen would be 1794 mm Hg. Inspired oxygen is
diluted by carbon dioxide and water vapor in the alveoli, so that the arterial
blood would be exposed to an oxygen partial pressure of approximately 1700-mm
Hg, and the tissue oxygen would be between 200 and 300 mm Hg. This clearly
would be above lethal oxygen levels for the spirochete since it is expected
that oxygen normally would diffuse throughout all cells of the body.
partial pressure of oxygen can be safely achieved in a hyperbaric chamber, and
the patients can tolerate this level for 90 minutes or longer quite
study was approved by the University Institutional Review Board.
were selected from those referred by clinical physicians who were experienced
in the treatment of Lyme disease. All subjects presented with a positive
diagnosis of this disease according to the CDC criteria, including a positive
Western blot serology of the proper bands. All had failed intravenous
antibiotics, and many were continuing to deteriorate even though still on
were given a briefing on the use of the hyperbaric chamber, including the
risks, and signed a waiver and release in accordance with the Belmont Report.
They were placed in the multiplace chamber and compressed to 2.36 ata,
whereupon a plastic helmet was placed over the head and pure oxygen was
administered. The oxygen flow pattern was such that the subject inspired 100%
oxygen with each breath. Subjects were able to communicate with the attendant
in the chamber as well as with each other.
duration was 60 minutes on oxygen, and in most instances the treatments were
administered bid for 5 days followed by a two-day rest. Several different
series were tried, ranging from 10 treatments to 30 treatments. One subject
received 145 treatments over the course of 3 months.
subjects completed a total of 1,995 hyperbaric oxygen treatments, although nine
were eliminated later due to the presence of another medical problem not
apparent during their treatments. These other medical problems were such things
as babesiosis, ehrlichosis, hepatitis C, and previously unidentified neurological
problems. Two subjects were eliminated due to the development of septicemia
from IV catheters, and one because of recent breast cancer, although all three
of them later showed an improvement of Lyme symptoms with hyperbaric oxygen
evaluation was carried out by an abbreviated questionnaire taken from a
standard questionnaire used by several Lyme specialists as part of their
evaluation. This questionnaire was designed so that zero reflected no symptoms,
while ten reflected severe symptoms.
additional statistical evaluation still is being carried out, it appears that
approximately 84.8% of those treated showed significant improvement by a
decrease or elimination of symptoms. Only 12 subjects (13.1%) claimed no
treatment, the subjects had an average score of 114.12 (of a possible 270), and
after treatment they averaged 49.27. This reduction of 64.85 points was
statistically significant in a paired t-test (p=0.000). The variability of the
scores from patient-to-patient declined as well after the treatment series. The
standard deviation of the scores was 56.00 before and 44.14 after treatment.
The p-value of this reduction is 0.057 in a Fisher's F-test. Further, 58% of
the respondents had score reduction of 41.86 points or more.
except one of the 91 subjects developed severe Jarisch-Herxheimer reaction,
usually appearing within the first 5 days of the beginning of hyperbaric oxygen
treatment. In most cases, the Jarisch-Herxheimer reaction continued throughout
the series of treatments, and in many instances continued for up to a month
after the treatments were finished. Most subjects then began to show major
improvement that in some instances has continued for 8 months.