Effect of Hyperbaric Oxygen on the Immunoreactivity to Substance P in the Nasal Mucosa of Cluster Headache Patients

Abstract

Exposure to hyperbaric oxygen has been shown to be effective in cluster headache, but the mechanism of the action is still not clear. Primary nociceptive neurons, containing neuropeptides such as substance P and particularly those innervating the nasal mucosa, could be involved in the pathogenesis of cluster headache. The present study evaluated the effect of an exposure to hyperbaric oxygen on the content of substance P in the nasal mucosa of patients affected by cluster headache. The results were compared with those observed in another group of cluster headache patients who underwent a placebo procedure. The samples of nasal mucosa were analyzed by immunocytochemical methods. A qualitative analysis of the slides was carried out by an operator under "blinded conditions". A marked decrease in the content of immunoreactivity for substance P was found in the patients exposed to hyperbaric oxygen. The decrease was statistically significant when compared with the findings of the placebo procedure. The results of the present study indicate that an influence on the content of peripheral neuropeptides could be involved in the mechanism of action of the beneficial effect of hyperbaric oxygen in cluster headache.

Hyperbaric oxygen therapy in chronic pain management

“…Di Sabato et al [13] investigated the effect of HBO on substance P in nasal mucosa in patients with cluster headache. A reduction in immunoreactivity to substance P was observed in patients receiving HBO.…”

Pain management and hyperbaric oxygen therapy

“…They also reported that HBOT reduced the number of subsequent attacks [14,15]. Di Sabato and colleagues conducted placebo-controlled studies to assess the efficacy of HBOT in cluster headache and to demonstrate the mechanism of action [16][17][18]. Improvement was observed in patients receiving HBOT, while patients in the placebo group failed to improve [18].…”

“…The effectiveness of various pharmacological and nonpharmacological methods of treating chronic pain is under investigation, since no completely satisfactory results have been obtained [4]. There are an increasing number of articles studying hyperbaric oxygen therapy (HBOT) as an adjunct in the treatment of various chronic pain syndromes [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. The aim of this article is to highlight the role and effectiveness of HBOT in the management of chronic pain.…”

Management of cluster headache in the Emergency Department

“…The mechanism for this effect has not been completely clarified but we can already verify the effect of exposure to hyperbaric condition on the content of the immunoreactivity to substance P in the nasal mucosa of CH patients [16,17]. One of the first experiments was based on 14 patients suffering from an episodic form of CH [18]. The diagnosis was made following the criteria of the International Headache Society [9].…”