Serum erythropoietin levels in healthy humans after a short period of normobaric and hyperbaric oxygen breathing: the "normobaric oxygen paradox".

Renal (peritubular) tissue hypoxia is a well-known physiological trigger for erythropoietin (EPO) production. We investigated the effect of rebound relative hypoxia after hyperoxia obtained under normo- and hyperbaric oxygen breathing conditions. A group of 16 healthy volunteers were investigated before and after a period of breathing 100% normobaric oxygen for 2 h and a period of breathing 100% oxygen at 2.5 ATA for 90 min (hyperbaric oxygen). Serum EPO concentration was measured using a radioimmunoassay at various time points during 24-36 h. A 60% increase (P < 0.001) in serum EPO was observed 36 h after normobaric oxygen. In contrast, a 53% decrease in serum EPO was observed at 24 h after hyperbaric oxygen. Those changes were not related to the circadian rhythm of serum EPO of the subjects. These results indicate that a sudden and sustained decrease in tissue oxygen tension, even above hypoxia thresholds (e.g., after a period of normobaric oxygen breathing), may act as a trigger for EPO serum level. This EPO trigger, the "normobaric oxygen paradox," does not appear to be present after hyperbaric oxygen breathing.     

Study on mammal (rat) of the neuro-muscular synapse function under hyperbaric conditions (11 ata): effects of the curarization

Under hyperbaric conditions (11 ata) obtained with normoxic O2-N2 mixtures spontaneous EMG activity disappears, as do reactions to noise, but this phenomenon is reversible after the substitution of Helium for Nitrogen in the mixture. Analysis of EMG responses to sciatic nerve excitation has revealed no difference between the EMG tracings recorded under normobaric pressure and those obtained under hyperbaric conditions (O2-N2 or O2-He, 11 ata), and hyperbaric conditions do not seem to interfere with neuro-muscular synaptic transmission. Furthermore, the effect of Pavulon (an antidepolarising, acetyl-cholino-competitive curare-mimetic drug) is similar under normal and hyperbaric conditions: hyperbaria change neither the onset of neuro-muscular blockage nor its intensity or duration. The absence of a specific effect on synapse function of a change in the diluting gas from nitrogen to helium suggests that there was no change in post-synaptic receptor function. This result is not in accordance with the hypothesis that inert gas pressures of less than 10 ata modify molecular structures particularly at the neuro-muscular synapse level.     

Immunomodulatory effect of oxygen and pressure

The immunomodulatory effect of hyperbaric oxygen, involving altered cytokine release by macrophages, is well described. Importantly, however, it is not known what the relative contribution is of the hyperbaric environment of the cells vs. increased oxygen tension on these hyperbaric oxygen-dependent effects. We compared, therefore, cytokine release by murine macrophages under hyperbaric oxygen, hyperpressure of normal air and normobaric conditions. We observed that hyperbaric oxygen enhanced cytokine release of both unstimulated as well as lipopolysaccharide (LPS)-challenged macrophages. Hyperpressure of normal air, however, enhanced LPS-induced cytokine production but did not elicit cytokine release in unstimulated macrophages. To further investigate the molecular details underlying the effects of hyperbaric oxygen, we investigated the effect of the p42/p44 mitogen-activated protein (MAP) kinase inhibitor PD98059 and the p38 MAP kinase inhibitor SB203580. Neither inhibitor, however, had a significant effect on the modulatory effects of hyperbaric oxygen on cytokine release. We concluded that the immunomodulatory effect of hyperbaric oxygen contains a component for which hyperpressure is sufficient and a component that apart from hyperpressure also requires hyperoxygenation.     

The influence of hyperbaric oxygen on hemorheological parameters in diabetic rats

The effect of hyperbaric oxygen (HBO2) treatment on hemorheological parameters of diabetic rats was investigated. This study is a placebo-controlled, in vivo animal study. 30 streptozocin-induced diabetic rats were divided into two groups; one group received hyperbaric oxygen treatment while the other did not. Hematological and hemorheological parameters were tested with blood samples collected directly from the heart using surgical procedures. Student t-tests with a type I (alpha) error at 0.05 was used to test any significant difference between means of the hematologic and hemorheological parameters of the control (CON) and the HBO2 groups. Compared with the placebo group, hyperbaric oxygen resulted in significant higher lipid peroxidation stress of the erythrocytes and resistance of erythrocytes to deformation in rats of the HBO2 group. Whole blood viscosities measured at shear rates of 5, 150 and 400 s(-1) were all higher for the rats in the HBO2 group than those for rats in the control group. In addition, the oxygen delivery index was found to be significantly lower in rats of the HBO2 group. Thus, our work demonstrates that hyperbaric oxygen treatment significantly changes the hemorheological parameters in diabetic rats.     

高压氧预处理对减压病大鼠肺组织的影响

目的:研究高压氧预处理对减压病大鼠肺组织的影响及其意义。方法:SD大鼠30只,随机分为正常对照(CN)组,高压氧预处理(HBO)组,减压(DCS)组,减压组采用20min匀速升压至7.0ATA,停留20min使大鼠充分换气,2min内快速减压常压方案。减压24h后观察肺组织中谷胱甘肽过氧化物酶(GPx)、丙二醛(MDA)、超氧化物歧化酶(SOD)的变化;并通过HE染色观察肺组织病理学变化。结果:减压组肺泡腔不够完整,肺泡破裂融合,肺泡壁增厚,有中度炎性细胞浸润,高压氧组与减压组相比,病理改变明显减轻;与对照组相比,单纯减压使大鼠肺组织GPx、MDA升高,SOD降低,高压氧预处理组GPx、MDA降低,SOD降低升高;高压氧组与减压组相比GPx、MDA下降,SOD升高(P<0.05)。结论:高压氧预处理对减压病大鼠肺组织具有一定的保护作用。     

Metabolic effects of hyperbaric oxygen in postischemic muscle

In traumatic injuries to the extremities, with a circulatory insufficiency, the resultant ischemia leads to decreasing levels of the energy-rich compounds adenosine triphosphate (ATP) and phosphocreatine (PCr) and increasing levels of lactate in muscle. A tourniquet model for temporary ischemia was used to determine if hyperbaric oxygen treatment could enhance the cellular metabolic restitution when the circulation was restored. The circulation of the rat hindlimb was interrupted for 1.5 and 3 hours. After 1.5 hours of ischemia, the levels of adenosine triphosphate, phosphocreatine, and lactate were restored to normal in muscle biopsies taken 5 hours after the ischemia. After 3 hours of ischemia, there were marked reductions of adenosine triphosphate and phosphocreatine and elevated lactate values in the postischemic muscle, indicating severe ischemic damage. Hyperbaric oxygen treatment at 2.5 atm for 45 minutes reduced these changes significantly. A certain number of hyperbaric oxygen treatments were necessary to maintain this effect. It is concluded that repeated hyperbaric oxygen treatments in the postischemic phase stimulate aerobic metabolism.     

Effects of a hyperbaric environment on subcutaneous adipose tissue topography (SAT-top)

The physiological reactions of the body in scuba diving situation can be simulated in a pressure chamber by increasing the ambient pressure. In this study the influence of a hyperbaric environment of 6 bar on the changes of the subcutaneous adipose tissue (SAT) thicknesses on different body sites in 68 voluntary men with undersea diving experience was investigated. Measurements of SAT-topography (SAT-Top) were performed with the optical device Lipometer before and after hyperbaric exposure. We observed a significant increase of the SAT-layers of the upper body zones, upper abdomen (+24.5%), lower abdomen (+21%) and front chest (+19%) after hyperbaric exposure. This increase of volume can be assumed to the nitrogen accumulation in fat cells at increased ambient pressures. In conclusion we describe for the first time in detail the influence of a hyperbaric environment on quantitative and topographic changes of SAT.     

Dependence of Escherichia coli hyperbaric oxygen toxicity on the lipid acyl chain composition.

This study examines certain membrane-related aspects of oxygen poisoning in Escherichia coli K1060 (fabB fadE lacI) and its parent strain, K-12 Ymel. Cells were grown to exponential or stationary phase in a minimal medium and exposed to air plus 300 lb/in2 of O2 as a suspension in minimal salts. After an initial lag, both strains lost viability with apparent first-order kinetics. Hypebaric oxygen was more toxic to cells harvested during the exponential phase of growth than to cells harvested from the stationary phase of growth for both strains K-12 Ymel and K1060. Control suspensions exposed to air plus 300 lb/in2 of N2 did not lose viability during a 96-h exposure. The sensitivity of the unsaturated fatty acid auxotroph, strain K1060, to hyperbaric oxygen increased as the degree of unsaturation of the fatty acid supplement increased. Cells grown with a cyclopropane fatty acid (9,10=methylenoctadecanoate) were the most resistant; cells grown with a monounsaturated fatty acid (oleate) were intermediate; and those grown with polyunsaturated fatty acids (linoleate and linolenate) were most sensitive to hyperbaric oxygen. The parent strain, K-12 Ymel, lost viability in hyperbaric oxygen most similarly to strain K1060 supplemented with oleate. To determine the relative effect of hyperbaric oxygen on the survival of E. coli with saturated membranes, substrains of K1060 were selected for growth on 12-methyltetrade-canoate or on 9 or 10-monobromostearate. Substrains grown with a saturated fatty acid supplement were equally or more sensitive to hyperbaric oxygen than when the same substrains were grown with a cyclopropane fatty acid supplement. The lipid acyl chain composition was determined in E. coli K1060 before and after exposure to hyperbaric oxygen or hyperbaric nitrogen. The proportion of nonsaturated acyl chain lipid of either the oleate- or the 9,10-methyleneoctade-canoate-supplemented K1060 remained unchanged after hyperbaric gas exposure. In strain K1060 supplemented with linoleate and grown to stationary phase, however, the relative unsaturated acyl chain content after hyperbaric exposure decreased in both gases. This finding prompted an investigation of the role of lipid oxidation in hyperbaric oxygen toxicity. Assays of potential lipid oxidation products were performed with linoleate-grown cells. The lipid hydroperoxide and peroxide content of the lipid extract increased by 6.9 times after 48 h of air plus 300 lb/in2 of O2; malondialdehyde and fluorescent complex lipid oxidation products showed much smaller or no changes. Lipid extracts from hyperbaric oxygen-exposed cells were not toxic to viable E. coli K1060, nor did they increase the rate of loss of viability in cells simultaneously exposed to hyperbaric oxygen. Linoleic acid hydroperoxide at 1.0 mM had no effect on the viability of E. coli K-12 Ymel and only marginally decreased the viability of E. coli K1060 supplemented with linoleate. We conclude that the kinetics of oxygen toxicity in E...     

Changes in cardiac rhythm in humans during breathing compressed air under pressure up to 1.1 MPa (results of the rhythmo-cardiographic study)]

Dynamics of cardiac rhythm has been considered according to rhythmocardiographic characteristics of heart rate under orthostatic test and one-stage step-test in four altitude chamber experiments where air under pressure of 0.4-1.1 MPa is used as a breathing mixture. It is shown that these characteristics linearly depend on the partial nitrogen and oxygen pressure and hyperbaric bradycardia essentially decreases in the final period of isopression due to toxic oxygen effect. Cytochrome C decreases hyperbaric bradycardia. Under hyperbaric conditions the regulation of cardiac rhythm proceeds with altered central vegetative effects provided a direct effect of higher nitrogen and oxygen pressure on the sinusal node cells.     

Vitamin C prevents hyperbaric oxygen-induced growth retardation and lipid peroxidation and attenuates the oxidation-induced up-regulation of glutathione in guinea pigs

Hyperbaric oxygen therapy is used to treat various clinical conditions, but it also causes oxidative damage. The objectives of this study are to determine if increased vitamin C intake can prevent hyperbaric oxygen-induced damage and to determine interactions among vitamin C, glutathione and vitamin E in response to oxidative stress. The growth rates of unexposed guinea pigs fed 1.25 mg vitamin C/day were indistinguishable from that of guinea pigs fed 50 mg vitamin C/day. In contrast, hyperbaric oxygen exposure resulted in growth retardation in guinea pigs fed 1.25 mg vitamin C/day, but it had little effect on the growth rates of guinea pigs fed 50 mg vitamin C/day. Increased vitamin C intake also prevented hyperbaric oxygen-induced lipid peroxidation in the liver. In guinea pigs not exposed to hyperbaric oxygen, levels of vitamin C in tissues were closely related to vitamin C intake, but tissue levels of glutathione and vitamin E were not related to vitamin C intake. However, interactions between vitamin C and glutathione were observed upon chronic hyperbaric oxygen exposure. Chronic hyperbaric oxygen exposure resulted in >2-fold increases in the levels of glutathione in liver and lung of guinea pigs fed 1.25 mg vitamin C/day. In comparison, the oxidation-induced increases in glutathione were significantly attenuated in guinea pigs fed 50 mg vitamin C/day. These data show that increased intake of vitamin C can prevent or alleviate the hyperbaric oxygen-induced damage. The interactions between vitamin C and glutathione upon hyperbaric oxygen exposure indicate that there is a homeostatic regulation of antioxidant capacity in guinea pig tissues.     

Effects of Hyperbaric Oxygen at 1.25 Atmospheres Absolute with Normal Air on Macrophage Number and Infiltration during Rat Skeletal Muscle Regeneration

Use of mild hyperbaric oxygen less than 2 atmospheres absolute (2026.54 hPa) with normal air is emerging as a common complementary treatment for severe muscle injury. Although hyperbaric oxygen at over 2 atmospheres absolute with 100% O₂ promotes healing of skeletal muscle injury, it is not clear whether mild hyperbaric oxygen is equally effective. The purpose of the present study was to investigate the impact of hyperbaric oxygen at 1.25 atmospheres absolute (1266.59 hPa) with normal air on muscle regeneration. The tibialis anterior muscle of male Wistar rats was injured by injection of bupivacaine hydrochloride, and rats were randomly assigned to a hyperbaric oxygen experimental group or to a non-hyperbaric oxygen control group. Immediately after the injection, rats were exposed to hyperbaric oxygen, and the treatment was continued for 28 days. The cross-sectional area of centrally nucleated muscle fibers was significantly larger in rats exposed to hyperbaric oxygen than in controls 5 and 7 days after injury. The number of CD68- or CD68- and CD206-positive cells was significantly higher in rats exposed to hyperbaric oxygen than in controls 24 h after injury. Additionally, tumor necrosis factor-α and interleukin-10 mRNA expression levels were significantly higher in rats exposed to hyperbaric oxygen than in controls 24 h after injury. The number of Pax7- and MyoD- or MyoD- and myogenin-positive nuclei per mm² and the expression levels of these proteins were significantly higher in rats exposed to hyperbaric oxygen than in controls 5 days after injury. These results suggest that mild hyperbaric oxygen promotes skeletal muscle regeneration in the early phase after injury, possibly due to reduced hypoxic conditions leading to accelerated macrophage infiltration and phenotype transition. In conclusion, mild hyperbaric oxygen less than 2 atmospheres absolute with normal air is an appropriate support therapy for severe muscle injuries.     

Structural changes in the lungs induced by different levels of hyperbaric oxygenation

Morphological and ultrastructural changes in the lungs of 30 rabbits placed into the altitude chamber with 100% O2 and the pressure of 2, 2.5, 3 and 4 ata for 60 min daily during 1, 2 and 3 weeks have been studied. Morphological changes in the lungs were shown to depend on the degree and duration of oxygen pressure. 2 ata for 60 min daily during two weeks or 2.5 ata for 60 min daily during one week were considered to be safe regimens of hyperbaric oxygenation. Microcirculatory disorders and dystrophic changes of the aero-hematogenic barrier (AHB), its increased permeability, the development of intraalveolar and interstitial edema are observed in the lungs at a higher pressure of 3 or 4 ata. The endothelium and type I alveolocytes are more sensible to high doses of hyperbaric oxygenation. Hydropic degeneration and exfoliation of cells from the basilar membrane are gradually increasing. Type II alveolocytes are more stable to the destructive action of hyperbaric oxygenation. Greater dystrophic changes in other AHB elements are associated with the hypertrophy of mitochondria and lamellar bodies. The described AHB changes are more expressed in atelectasis areas.     

The effect of hyperbaric oxygenation on the antioxidant status of Xenopus laevis after its preliminary adaptation to oxygen]

We studied the level of lipid peroxidation and the activity of antioxidant enzymes (superoxide dismutase and catalase) in various tissues of adult Xenopus laevis after an initial exposure to hyperbaric oxygenation at the developmental stage 38. We have found that irrespective to the mode of treatment, the level of lipid peroxidation and activity of antioxidant enzymes in the brain, lungs, and blood of these animals were higher as compared to control animals. We demonstrate that, after the exposure of adult animals to hyperoxia, if they were earlier subjected to hyperbaric oxygenation (0.2 MPa) at stage 38, there was no intensification of lipid peroxidation or changes in the activity of superoxide dismutase and catalase. In adult animals initially subjected to hyperbaric oxygenation at the same stage of development but at the pressure--0.7 MPa, the second exposure to hyperoxia led to a drastic intensification of lipid peroxidation in the brain; in some animals, an increased level of lipid peroxidation products in the lungs was observed.     

自噬在高压氧预处理预防脊髓缺血再灌注损伤中 的作用机制研究*

目的:研究自噬在高压氧预处理预防脊髓缺血再灌注损伤中的机制。方法:新生大鼠脊髓神经元原代培养,分为对照组(氧糖剥夺)和高压氧(HBO)预处理组。通过应用免疫组织化学、Western blot分析两组LC3-Ⅱ与凋亡相关分子Beclin-1,Bcl-2,Casp-ase-3的表达变化。结果:发现重复高压氧预处理对氧糖剥夺诱导原代培养的脊髓神经元损伤具有明显的保护作用。免疫组化和Western blot显示与对照组相比高压氧预处理显著增加脊髓神经元细胞Bcl-2的表达,降低Beclin-1,Caspase-3以及自噬的特异性标记蛋白LC3-Ⅱ的表达。氧糖剥夺后对照组与高压氧组相比,LDH释放量明显增多(P<0.05)。结论:HBO预处理通过调节自噬减轻缺血再灌注损伤,为HBO预处理神经保护提供一条新的作用机制。     

Suppression of humoral antibody synthesis on exposure to hyperbaric oxygenation

The influence of hyperbaric oxygenation (HBO) on the immune response in mice, immunized intraperitoneally with sheep red blood cells, was studied. HBO was shown to reduce hemagglutinin and hemolysin titres in peripheral blood as well as to decrease the amount of antibody-forming cells in the spleen. The most pronounced immunodepressant HBO effect is seen when hyperbaric oxygenation is carried out under toxic conditions before immunization of the animals with low antigen doses. Relationship is shown between the immunodepressant HBO effect and reduced leucocyte and lymphocyte counts in peripheral blood of the animals.     

Hyperbaric oxygen treatment attenuates cytokine induction after massive hemorrhage

We investigated the effect of hyperbaric oxygen treatment (HBO) on cytokine induction after hemorrhage, because hypoxia induces cytokines in vitro. Chronically cannulated conscious rats were subjected to 40 ml/kg of hemorrhage and resuscitated with the shed blood and twice the volume of saline either under room air (room air group) or under 100% oxygen at 3 atmospheres absolute (hyperbaric group). Rats exposed to HBO with no hemorrhage served as controls. Time course changes in plasma endotoxin level, arterial ketone body ratio (AKBR), serum tumor necrosis factor (TNF), interleukin-6 (IL-6), and their hepatic mRNA were detected in the three groups. Plasma endotoxin levels increased significantly after hemorrhage, and there were no significant differences between the room air group and the hyperbaric group. In the room air group, AKBR dropped rapidly after hemorrhage and became minimal at hour 1, which was associated with significant increases in TNF-alpha and IL-6 at both mRNA and circulating levels. HBO significantly attenuated decreases in AKBR after hemorrhage with a significant reduction of mortality and cytokine induction. These results indicate that HBO attenuated the cytokine induction after hemorrhage by improving liver ischemia, and they suggest that tissue hypoxia may be responsible, at least in part, for cytokine induction after massive hemorrhage.     

高压氧暴露大鼠肺组织内PPAR通路分子变化规律

目的:研究高压氧暴露大鼠肺组织内过氧化物酶体增殖因子活化受体(PPAR)通路分子表达变化规律。方法:27只雄性SD大鼠随机分为高压常氧对照组(0.23 MPa空气)、高压氧时间序列处理组(0.23 MPa纯氧,分别暴露2 h、4 h、6 h和8 h),持续小流量通风,维持舱内O2浓度>99%。应用HE染色观察各组大鼠肺组织形态学变化;应用oligo芯片检测各个时间表达谱;应用RT-PCR验证发生改变的部分PPAR通路基因。结果:与高压常氧对照组相比,高压氧时间序列处理组造成的肺损伤逐渐加重;表达谱芯片的基因本体论(Go)富集分析结果中有一类PPAR通路类,包含有多个PPAR通路分子;RT-PCR结果提示PPARδ-和PPARγ-均在较长时间高压氧暴露的肺组织中上调。结论:高压氧长时间暴露造成的肺型氧中毒可引起PPAR通路的激活。     

Effects of Hypoxia,Hyperbaria and Hyposmosis on Ecto- ATPase Activity in Scorpionfish (<Emphasis Type="Italic">Scorpaena porcus</Emphasis> L.) Erythrocytes

Effects of hypoxic, hyperbaric and hyposmotic exposures on activity of erythrocyte membrane-bound ecto-ATPase were studied in the scorpionfish Scorpaena porcus L. One-hour autogenic hypoxia evoked a drop while longer hypoxia (12, 24 h)–a rise in the enzyme activity. Hyperbaric exposure, irrespective of its duration, evoked the same stimulation of ecto-ATPase activity in vivo. In vitro, instead, hydrostatic pressure caused a significant drop in the enzyme activity. Hyposmosis stimulated ecto-ATPase activity when the medium was diluted to 50% of its basal level, however, a stronger dilution (70%) led to its inhibition. Under hypoxia, changes in ecto-ATPase activity of scorpionfish erythrocytes are, most likely, due to a shift in the hormonal background and the plasma acid–base equilibrium. The reasons behind the activation of erythrocyte ecto-ATPase in response to hyperbaric pressure are obscure. Under in vitro conditions, the direct effect of hyperbaria and hyposmosis on scorpionfish erythrocytes may be due to alterations in characteristics of plasma membrane microviscosity and in the ecto-ATPase conformational state as manifested in fluctuations of enzyme activity during experiments.