Hyperbaric oxygen in chronic traumatic brain injury: oxygen, pressure, and gene therapy

Abstract

Hyperbaric oxygen therapy is a treatment for wounds in any location and of any duration that has been misunderstood for 353 years. Since 2008 it has been applied to the persistent post-concussion syndrome of mild traumatic brain injury by civilian and later military researchers with apparent conflicting results. The civilian studies are positive and the military-funded studies are a mixture of misinterpreted positive data, indeterminate data, and negative data. This has confused the medical, academic, and lay communities. The source of the confusion is a fundamental misunderstanding of the definition, principles, and mechanisms of action of hyperbaric oxygen therapy. This article argues that the traditional definition of hyperbaric oxygen therapy is arbitrary. The article establishes a scientific definition of hyperbaric oxygen therapy as a wound-healing therapy of combined increased atmospheric pressure and pressure of oxygen over ambient atmospheric pressure and pressure of oxygen whose main mechanisms of action are gene-mediated. Hyperbaric oxygen therapy exerts its wound-healing effects by expression and suppression of thousands of genes. The dominant gene actions are upregulation of trophic and anti-inflammatory genes and down-regulation of pro-inflammatory and apoptotic genes. The combination of genes affected depends on the different combinations of total pressure and pressure of oxygen. Understanding that hyperbaric oxygen therapy is a pressure and oxygen dose-dependent gene therapy allows for reconciliation of the conflicting TBI study results as outcomes of different doses of pressure and oxygen.

Neuroprotective effect of hyperbaric oxygen therapy in a juvenile rat model of repetitive mild traumatic brain injury

“…These findings are consistent to the previous study of ours and the others in adult rats (Huang et al, 2013;Yang et al, 2015). Among a collection of therapeutic strategies against neurological diseases (Dock et al, 2015;Li et al, 2015;Lioutas et al, 2015;Merali et al, 2015;Ploughman et al, 2015;Qi et al, 2015;Reuter et al, 2015;Schlunk et al, 2015;Soliman et al, 2015;Zhu et al, 2015), medical gas regimens have been extensively explored with the advantage of administration feasibility (Harch, 2015;Herrera et al, 2015;Hu et al, 2015;Ichihara et al, 2015;Langston and Toombs, 2015;Miller et al, 2015;Parra et al, 2015;Stoller, 2015;Weaver and Liu, 2015;Yan et al, 2015). Emerging evidence has shown HBO induces neuroprotection against a variety of neurological disorders including severe TBI (Huang and Obenaus, 2011).…”

Co-administration of tissue plasminogen activator and hyperbaric oxygen in ischemic stroke: a continued promise for neuroprotection

“…HBOT appears to be a potent way of oxygen delivery 131718. HBOT has been applied in the treatment of cerebral vascular diseases since the 1960s 1920.…”

Therapeutic Potentials of Synapses after Traumatic Brain Injury: A Comprehensive Review

“…Notably, aerobic exercises such as tai chi and yoga have been popularly promoted for its potential advantages in healthy and ill-attacked populations [62–67]; however, the frequency and burden of exercise after TBI differ from one to another and remain to be further elucidated [68]. …”