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Hyperbaric Oxygen Therapy

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Ulcerative Colitis & Crohn's Disease

Ulcerative colitis is a condition in which the lining of the large intestine (colon) and rectum become inflamed. It is a form of inflammatory bowel disease (IBD).

Crohn's Disease causes swelling of the tissues (inflammation) in your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. It is also a form of inflammatory bowel disease (IBD).

Because hyperbaric oxygen therapy (HBOT) reduces inflammation, experts believe that HBOT can reduce inflammation from Ulcerative Colitis and Crohn's Disease when it flares.

Studies on Ulcerative Colitis, Crohn's Disease and HBOT

The Host-Microbiome Response to Hyperbaric Oxygen Therapy in Ulcerative Colitis Patients

Gonzalez CG, Mills RH, Kordahi MC, Carrillo-Terrazas M, Secaira-Morocho H, Widjaja CE, Tsai MS, Mittal Y, Yee BA, Vargas F, Weldon K, Gauglitz JM, Delaroque C, Sauceda C, Rossitto LA, Ackermann G, Humphrey G, Swafford AD, Siegel CA, Buckey JC Jr, Raffals LE, Sadler C, Lindholm P, Fisch KM, Valaseck M, Suriawinata A, Yeo GW, Ghosh P, Chang JT, Chu H, Dorrestein P, Zhu Q, Chassaing B, Knight R, Gonzalez DJ, Dulai PS. The Host-Microbiome Response to Hyperbaric Oxygen Therapy in Ulcerative Colitis Patients. Cell Mol Gastroenterol Hepatol. 2022;14(1):35-53. doi: 10.1016/j.jcmgh.2022.03.008. Epub 2022 Apr 1. PMID: 35378331; PMCID: PMC9117812.

Background & aims: 

Hyperbaric oxygen therapy (HBOT) is a promising treatment for moderate-to-severe ulcerative colitis. However, our current understanding of the host and microbial response to HBOT remains unclear. This study examined the molecular mechanisms underpinning HBOT using a multi-omic strategy.

Results: 

Proteomics identified negative associations between HBOT response and neutrophil azurophilic granule abundance. DSP identified an HBOT-specific reduction of neutrophil STAT3, which was confirmed by immunohistochemistry. HBOT decreased microbial diversity with a proportional increase in Firmicutes and a secondary bile acid lithocholic acid. A major source of the reduction in diversity was the loss of mucus-adherent taxa, resulting in increased MUC2 levels post-HBOT. Targeted database searching revealed strain-level associations between Akkermansia muciniphila and HBOT response status. Colonization of IL10-/- with stool obtained from HBOT responders resulted in lower colitis activity compared with non-responders, with no differences in STAT3 expression, suggesting complementary but independent host and microbial responses.

Conclusions: 

HBOT reduces host neutrophil STAT3 and azurophilic granule activity in UC patients and changes in microbial composition and metabolism in ways that improve colitis activity. Intestinal microbiota, especially strain level variations in A muciniphila, may contribute to HBOT non-response.

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A Review of Hyperbaric Oxygen Therapy for Inflammatory Bowel Disease

Alenazi N, Alsaeed H, Alsulami A, Alanzi T. A Review of Hyperbaric Oxygen Therapy for Inflammatory Bowel Disease. Int J Gen Med. 2021 Oct 24;14:7099-7105. doi: 10.2147/IJGM.S336678. PMID: 34729019; PMCID: PMC8554584.

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Abstract

IBD (inflammatory bowel disease) characterized by chronic inflammation of the gastrointestinal (GI) tract is one of the chronic diseases the prevalence of which has been increasing globally. In the past few decades, significant improvements were made in the treatments relating to IBD which have reduced the hospitalization and mortality rates; however, there is still room for improvement with other alternative therapies. HBOT (hyperbaric oxygen treatment) is one of the effective therapies used in treating various conditions including wounds, decompression sickness, stroke, etc. Several studies have reported the role of HBOT as an adjunctive treatment to IBD, while adopting conventional treatment procedures. There is an increasing trend of research in this particular area. Studies have shown that HBOT reflects its therapeutic effect by controlling inflammation, reducing oxidation stress, improving the process of cleaning damaged cells and recruiting the cells involved in repair; thereby improving the immunity response system. In this context, the purpose of this review is to summarize past clinical and experimental studies and to understand the role of hyperbaric treatment for IBD. The findings from the review have suggested that hyperbaric therapy can be an effective adjunctive approach for IBD, based on which some ideas for future clinical and research work are provided.

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