Rossignol DA
Medical gas research. Date of publication 2012 Mar 15;volume 2(1):6.
1. Med Gas Res. 2012 Mar 15;2(1):6. doi: 10.1186/2045-9912-2-6.
Hyperbaric oxygen treatment for inflammatory bowel disease: a systematic review
and analysis.
Rossignol DA(1).
Author information:
(1)Rossignol Medical Center, 3800 West Eau Gallie Blvd,, Melbourne, FL 32934,
USA. rossignolmd@gmail.com.
BACKGROUND: Traditionally, hyperbaric oxygen treatment (HBOT) has been used to
treat a limited repertoire of disease, including decompression sickness and
healing of problem wounds. However, some investigators have used HBOT to treat
inflammatory bowel disease (IBD), including Crohn's disease and ulcerative
colitis.
METHODS: Comprehensive searches were conducted in 8 scientific databases through
2011 to identify publications using HBOT in IBD. Human studies and animal models
were collated separately.
RESULTS: Thirteen studies of HBOT in Crohn's disease and 6 studies in ulcerative
colitis were identified. In all studies, participants had severe disease
refractory to standard medical treatments, including corticosteroids,
immunomodulators and anti-inflammatory medications. In patients with Crohn's
disease, 31/40 (78%) had clinical improvements with HBOT, while all 39 patients
with ulcerative colitis improved. One study in Crohn's disease reported a
significant decrease in proinflammatory cytokines (IL-1, IL-6 and TNF-alpha) and
one study in ulcerative colitis reported a decrease in IL-6 with HBOT. Adverse
events were minimal. Twelve publications reported using HBOT in animal models of
experimentally-induced IBD, including several studies reporting decreased markers
of inflammation or immune dysregulation, including TNF-alpha (3 studies),
IL-1beta (2 studies), neopterin (1 study) and myeloperoxidase activity (5
studies). HBOT also decreased oxidative stress markers including malondialdehyde
(3 studies) and plasma carbonyl content (2 studies), except for one study that
reported increased plasma carbonyl content. Several studies reported HBOT lowered
nitric oxide (3 studies) and nitric oxide synthase (3 studies) and one study
reported a decrease in prostaglandin E2 levels. Four animal studies reported
decreased edema or colonic tissue weight with HBOT, and 8 studies reported
microscopic improvements on histopathological examination. Although most
publications reported improvements with HBOT, some studies suffered from
limitations, including possible publication and referral biases, the lack of a
control group, the retrospective nature and a small number of participants.
CONCLUSIONS: HBOT lowered markers of inflammation and oxidative stress and
ameliorated IBD in both human and animal studies. Most treated patients were
refractory to standard medical treatments. Additional studies are warranted to
investigate the effects of HBOT on biomarkers of oxidative stress and
inflammation as well as clinical outcomes in individuals with IBD.
DOI: 10.1186/2045-9912-2-6
PMCID: PMC3328239
PMID: 22417628
