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Antigen and collagen-induced arthritis (ACIA) is animal model of rheumatoid arthritis. The aim of this study was to identify the effect of different doses of hyperbaric oxygen (HBO) exposure in reducing inflammation on ACIA through analysis hypoxia inducible factor-1α (HIF-1α), anticyclic citrullinated peptide antibody (ACPA) and interleukine 17a (IL-17a). 24 male Balb/C mice were divided into 3 groups, 8 mice did not receive HBO exposure as a control group (G1) and 16 mice received HBO exposure as treatment group (G2 and G3). G2 was ACIA which was exposed to HBO 2.4 ATA O2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days. G3 was ACIA which was exposed to HBO 2.4 ATA O2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 5 consecutive days, break 5 days, 5 consecutive days. ACPA and IL-17a were measured by enzyme-linked immunosorbent assay (ELISA) technique. The expression of HIF-1α was measured by immunohistochemistry technique. There was significant decrease of ACPA levels, IL-17a levels and HIF-1α expression (P< 0.05) in G2 and G3 compared to G1. There was not significant decrease of ACPA levels (P> 0.05), there was significant decrease of IL-17a levels and HIF-1α expression (P<0.05) in G2 compared to G3. G2 was a group with a higher oxygen partial pressure than G3. HBO 2.4 ATAO2 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days more effective in reducing inflammation than exposure 5 consecutive days, break 5 days, 5 consecutive days in ACIA. HBO has therapeutic potential for the treatment of RA.

Anti-cyclic citrullinated peptide antibody (ACPA) is a specific autoantibody that binds with citrullineamino acid in rheumatoid arthritis (RA). Interleukin-17a (IL-17a) is one of the cytokines that play an important role in chronic inflammation during the process of autoimmune diseases. Bacterial toxin antigen and collagen induced arthritis (ACIA) is the gold standard of RA animal model. The aim of this study was to see the effect of hyperbaric oxygen (HBO) exposure on ACIA animal models. ACIA model was made by combined antigens (bacterial toxin and collagen). A total of 24 male Balb/Cmice modelled on ACIA were divided into three groups. Eight mice did not receive HBO exposure (control group, indicated as G1), eight mice (indicated as G2) received HBO exposure for 10 days while remaining eight mice (indicated as G3) for five days. G2 mice were exposed to HBO 2.4 ATA oxygen 100% for 90 minutes (30 minutes each with two intervals of five minutes breathing with normal air) for 10 consecutive days while G3 mice were exposed only for five days. The indicators of arthritis i.e. ACPA and IL-17a were measured by enzyme-linked immunosorbent assay (ELISA) technique. A significant decrease in ACPA and IL-17a levels was seen in both HBO exposed groups (G2 and G3) compared to G1 (p<0.05). There was no significant difference in levels of ACPA and IL-17a in G3 mice and G2 mice (p > 0.05). HBO reduced inflammation in ACIA by decreasing ACPA andIL-17a levels through improvement of hypoxic conditions and showed therapeutic potential for the treatment of RA.