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Review
. 2022 Dec 6;10(12):3145.
doi: 10.3390/biomedicines10123145.

Hyperbaric Oxygen Therapy and Tissue Regeneration: A Literature Survey

Affiliations
Review

Hyperbaric Oxygen Therapy and Tissue Regeneration: A Literature Survey

J Lindenmann et al. Biomedicines. .

Abstract

By addressing the mechanisms involved in transcription, signaling, stress reaction, apoptosis and cell-death, cellular structure and cell-to-cell contacts, adhesion, migration as well as inflammation; HBO upregulates processes involved in repair while mechanisms perpetuating tissue damage are downregulated. Many experimental and clinical studies, respectively, cover wound healing, regeneration of neural tissue, of bone and cartilage, muscle, and cardiac tissue as well as intestinal barrier function. Following acute injury or in chronic healing problems HBO modulates proteins or molecules involved in inflammation, apoptosis, cell growth, neuro- and angiogenesis, scaffolding, perfusion, vascularization, and stem-cell mobilization, initiating repair by a variety of mechanisms, some of them based on the modulation of micro-RNAs. HBO affects the oxidative stress response via nuclear factor erythroid 2-related factor 2 (Nrf2) or c-Jun N-terminal peptide and downregulates inflammation by the modulation of high-mobility group protein B1 (HMGB-1), toll-like receptor 4 and 2 (TLR-4, TLR-2), nuclear factor kappa-B (NFκB), hypoxia-inducible factor (HIF-1α) and nitric oxide (NO•). HBO enhances stem-cell homeostasis via Wnt glycoproteins and mammalian target of rapamycin (mTOR) and improves cell repair, growth, and differentiation via the two latter but also by modulation of extracellular-signal regulated kinases (ERK) and the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT) pathway. The HBO-induced downregulation of matrix metalloproteinases-2 and 9 (MMP-2/-9), rho-associated protein kinase (ROCK) and integrins improve healing by tissue remodeling. Interestingly, the action of HBO on single effector proteins or molecules may involve both up- or downregulation, respectively, depending on their initial level. This probably mirrors a generally stabilizing potential of HBO that tends to restore the physiological balance rather than enhancing or counteracting single mechanisms.

Keywords: hyperbaric oxygen; mechanism; tissue regeneration.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main points of action of HBO in tissue regeneration.

References

    1. Lindenmann J., Smolle C., Kamolz L.P., Smolle-Juettner F.M., Graier W.F. Survey of Molecular Mechanisms of Hyperbaric Oxygen in Tissue Repair. Int. J. Mol. Sci. 2021;22:11754. doi: 10.3390/ijms222111754. - DOI - PMC - PubMed
    1. Mathieu D., Marroni A., Kot J. Tenth European Consensus Conference on Hyperbaric Medicine: Recommendations for accepted and non-accepted clinical indications and practic of hyperbaric oxygten treatment. Diving Hyperb. Med. 2017;47:24–32. doi: 10.28920/dhm47.2.131-132. - DOI - PMC - PubMed
    1. Lee J., Cho Y. Comparative gene expression profiling reveals the mechanisms of axon regeneration. FEBS J. 2021;288:4786–4797. doi: 10.1111/febs.15646. - DOI - PubMed
    1. Das D., Fletcher R.B., Ngai J. Cellular mechanisms of epithelial stem cell self-renewal and differentiation during homeostasis and repair. Wiley Interdiscip. Rev. Dev. Biol. 2020;9:e361. doi: 10.1002/wdev.361. - DOI - PubMed
    1. Julier Z., Park A.J., Briquez P.S., Martino M.M. Promoting tissue regeneration by modulating the immune system. Acta Biomater. 2017;53:13–28. doi: 10.1016/j.actbio.2017.01.056. - DOI - PubMed

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