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A Systematic Review of Oxygen Therapy for the Management of Medication-Related Osteonecrosis of the Jaw (MRONJ). APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9051026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) can be a life changing iatrogenic complication of antiresorptive and antiangiogenic drug therapy. It is most often associated with high doses of these medications that are used to prevent skeletal-related events in patients with cancer and bone pathologies. Unfortunately, managing MRONJ lesions has proven difficult and remains a major challenge for clinicians. Due to the lack of efficacy in treating MRONJ by surgical modalities (local debridement and free flap reconstruction), the nonsurgical management of MRONJ is still advocated to aid healing or avoid disease progression. The aim of this systematic review is to identify, analyse and understand the published evidence related to the success of oxygen therapies such as ozone (OT) and hyperbaric oxygen (HBO) in treating MRONJ. Material and methods: A multi-database (PubMed, MEDLINE, EMBASE, CINAHL and Cochrane CENTRAL) systematic search was performed by three authors. The identified articles were independently assessed for their risk of bias. Any type of study evaluating humans treated with antiresorptive and antiangiogenic drugs were considered. The aim is primarily to evaluate the success of OT and HBO in resolving MRONJ and secondarily to identify any improvements in quality of life (QoL), rate of complications, time-to-event and severity of side effects related to these treatments. Results: In total, just 13 studies were eligible for analysis. A pooled total of 313 patients (HBO group n = 82; OT group n = 231) described in these studies have shown good tolerance for oxygen therapies. Complete resolution of MRONJ was reported in 44.58% of OT patients but only 5.17% of the HBO group. Progression of MRONJ was reported only in the HBO studies in 10.34% of cases (6 patients). The quality of evidence was low or very low in all studies. This was due to limitations in how the studies were designed, run and reported. Conclusions: Based on the limited data available, it is difficult to suggest OT is better or worse than HBO or whether it is better than a placebo. As the level of evidence available is low, this necessitates larger well-designed trials to justify these interventions for patients affected by MRONJ.
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Kang JI, Park KM, Park KD. Oxygen-generating alginate hydrogels as a bioactive acellular matrix for facilitating wound healing. J IND ENG CHEM 2019. [DOI: 10.1016/j.jiec.2018.09.048] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Parotto M, Ouzounian M, Djaiani G. Spinal Cord Protection in Elective Thoracoabdominal Aortic Procedures. J Cardiothorac Vasc Anesth 2019; 33:200-208. [DOI: 10.1053/j.jvca.2018.05.044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Indexed: 11/11/2022]
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54
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Hyperbaric oxygen-generating hydrogels. Biomaterials 2018; 182:234-244. [DOI: 10.1016/j.biomaterials.2018.08.032] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/14/2018] [Accepted: 08/14/2018] [Indexed: 12/11/2022]
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Chernoff G, Bryan N, Park AM. Mesothelial Stem Cells and Stromal Vascular Fraction. Facial Plast Surg Clin North Am 2018; 26:487-501. [DOI: 10.1016/j.fsc.2018.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Harrison LE, Giardina C, Hightower LE, Anderson C, Perdrizet GA. Might hyperbaric oxygen therapy (HBOT) reduce renal injury in diabetic people with diabetes mellitus? From preclinical models to human metabolomics. Cell Stress Chaperones 2018; 23:1143-1152. [PMID: 30374882 PMCID: PMC6237687 DOI: 10.1007/s12192-018-0944-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/03/2018] [Accepted: 10/04/2018] [Indexed: 02/06/2023] Open
Abstract
Diabetic kidney disease (DKD) is the leading cause of end-stage renal failure in the western world. Current treatment of diabetic kidney disease relies on nutritional management and drug therapies to achieve metabolic control. Here, we discuss the potential application of hyperbaric oxygen therapy (HBOT) for the treatment of diabetic kidney disease (DKD), a treatment which requires patients to breathe in 100% oxygen at elevated ambient pressures. HBOT has traditionally been used to diabetic foot ulcers (DFU) refractory to conventional medical treatments. Successful clinic responses seen in the DFU provide the underlying therapeutic rationale for testing HBOT in the setting of DKD. Both the DFU and DKD have microvascular endothelial disease as a common underlying pathologic feature. Supporting evidence for HBOT of DKD comes from previous animal studies and from our preliminary prospective clinical trial reported here. We report urinary metabolomic data obtained from patients undergoing HBOT for DFU, before and after exposure to 6 weeks of HBOT. The preliminary data support the concept that HBOT can reduce biomarkers of renal injury, oxidant stress, and mitochondrial dysfunction in patients receiving HBOT for DFU. Further studies are needed to confirm these initial findings and correlate them with simultaneous measures of renal function. HBOT is a safe and effective treatment for DFU and could also be for individuals with DKD.
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Affiliation(s)
- Lauren E Harrison
- Department of Molecular and Cell Biology, University of Connecticut, 91 N Eagleville Road, U3125, Storrs, CT, 06269, USA.
| | - Charles Giardina
- Department of Molecular and Cell Biology, University of Connecticut, 91 N Eagleville Road, U3125, Storrs, CT, 06269, USA
| | - Lawrence E Hightower
- Department of Molecular and Cell Biology, University of Connecticut, 91 N Eagleville Road, U3125, Storrs, CT, 06269, USA
| | - Caesar Anderson
- Department of Emergency Medicine, UC San Diego Health System, Wound Care and Hyperbaric Medicine, Encinitas, CA, 92024, USA
| | - George A Perdrizet
- Department of Surgery, Hartford Health Care and the Hospital of Central Connecticut, Wound Care and Hyperbaric Medicine, New Britain, CT, 06050, USA
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Ohtake T, Mochida Y, Ishioka K, Oka M, Maesato K, Moriya H, Hidaka S, Higashide S, Ioji T, Fujita Y, Kawamoto A, Fukushima M, Kobayashi S. Autologous Granulocyte Colony-Stimulating Factor-Mobilized Peripheral Blood CD34 Positive Cell Transplantation for Hemodialysis Patients with Critical Limb Ischemia: A Prospective Phase II Clinical Trial. Stem Cells Transl Med 2018; 7:774-782. [PMID: 30059194 PMCID: PMC6216433 DOI: 10.1002/sctm.18-0104] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/22/2018] [Accepted: 06/05/2018] [Indexed: 12/29/2022] Open
Abstract
Critical limb ischemia (CLI) is a devastating disease in patients undergoing hemodialysis (HD). Based on the unsatisfactory results of autologous mononuclear cell transplantation for patients with CLI undergoing HD, we conducted a phase II clinical trial to evaluate the safety and efficacy of granulocyte colony‐stimulating factor (G‐CSF)‐mobilized peripheral blood‐derived autologous purified CD34 positive (CD34+) cell transplantation for CLI in patients undergoing HD. Six patients with CLI (two with Rutherford category 4 and four with Rutherford category 5) were enrolled. As for primary endpoint, there were no major adverse events related to this therapy. As for efficacy, the amputation‐free survival rate was 100% at 1 year after cell therapy. Both rest pain scale and ulcer size were significantly improved as early as 4 weeks after therapy compared with baseline (p < .01), and three out of five ulcers completely healed within 12 weeks after cell transplantation. Clinical severity, including Fontaine scale and Rutherford category, significantly improved at 24 weeks after cell transplantation (p < .05), and further improved at 52 weeks (p < .01) compared with baseline. The improvement rate from CLI stage to non‐CLI stage was 83.3% at 52 weeks. Toe skin perfusion pressure and absolute claudication distance were also significantly improved. In conclusion, G‐CSF‐mobilized peripheral blood CD34+ cell transplantation was safe, feasible, and effective for patients with CLI undergoing HD. stem cells translational medicine2018;7:774–782
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Affiliation(s)
- Takayasu Ohtake
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan.,Division of Regenerative Medicine, Department of Center for Clinical and Translational Science, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Yasuhiro Mochida
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Kunihiro Ishioka
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Machiko Oka
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Kyoko Maesato
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Hidekazu Moriya
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Sumi Hidaka
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Satoshi Higashide
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Tetsuya Ioji
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Yasuyuki Fujita
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Atsuhiko Kawamoto
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Masanori Fukushima
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Shuzo Kobayashi
- Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Kamakura, Japan.,Division of Regenerative Medicine, Department of Center for Clinical and Translational Science, Shonan Kamakura General Hospital, Kamakura, Japan
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Peña-Villalobos I, Casanova-Maldonado I, Lois P, Prieto C, Pizarro C, Lattus J, Osorio G, Palma V. Hyperbaric Oxygen Increases Stem Cell Proliferation, Angiogenesis and Wound-Healing Ability of WJ-MSCs in Diabetic Mice. Front Physiol 2018; 9:995. [PMID: 30104981 PMCID: PMC6078002 DOI: 10.3389/fphys.2018.00995] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 07/06/2018] [Indexed: 01/23/2023] Open
Abstract
Hyperbaric oxygen therapy (HBOT) is effective for the medical treatment of diverse diseases, infections, and tissue injury. In fact, in recent years there is growing evidence on the beneficial effect of HBOT on non-healing ischemic wounds. However, there is still yet discussion on how this treatment could benefit from combination with regenerative medicine strategies. Here we analyzed the effects of HBOT on three specific aspects of tissue growth, maintenance, and regeneration: (i) modulation of adult rodent (Mus musculus) intestinal stem cell turnover rates; (ii) angiogenesis dynamics during the development of the chorio-allantoic membrane (CAM) in Gallus gallus embryos; (iii) and wound-healing in a spontaneous type II diabetic mouse model with a low capacity to regenerate skin. To analyze these aspects of tissue growth, maintenance, and regeneration, we used HBOT alone or in combination with cellular therapy. Specifically, Wharton Jelly Mesenchymal Stem cells (WJ-MSC) were embedded in a commercial collagen-scaffold. HBOT did not affect the metabolic rate of adult mice nor of chicken embryos. Notwithstanding, HBOT modified the proliferation rate of stem cells in the mice small intestinal crypts, increased angiogenesis in the CAM, and improved wound-healing and tissue repair in diabetic mice. Moreover, our study demonstrates that combining stem cell therapy and HBOT has a collaborative effect on wound-healing. In summary, our data underscore the importance of oxygen tension as a regulator of stem cell biology and support the potential use of oxygenation in clinical treatments.
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Affiliation(s)
- Isaac Peña-Villalobos
- Laboratorio de Ecofisiología Animal, Departamento de Ecología, Universidad de Chile, Santiago, Chile
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
| | - Ignacio Casanova-Maldonado
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
| | - Pablo Lois
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
| | - Catalina Prieto
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
| | - Carolina Pizarro
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
| | - José Lattus
- Campus Oriente, Department of Obstetrics and Gynecology, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Verónica Palma
- Laboratorio de Células Troncales y Biología del Desarrollo, Departamento de Biología, Universidad de Chile, Santiago, Chile
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59
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Hyperbaric oxygen can induce angiogenesis and recover erectile function. Int J Impot Res 2018; 30:292-299. [DOI: 10.1038/s41443-018-0023-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/29/2018] [Accepted: 04/07/2018] [Indexed: 01/28/2023]
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Daly S, Thorpe M, Rockswold S, Hubbard M, Bergman T, Samadani U, Rockswold G. Hyperbaric Oxygen Therapy in the Treatment of Acute Severe Traumatic Brain Injury: A Systematic Review. J Neurotrauma 2018; 35:623-629. [PMID: 29132229 PMCID: PMC6909681 DOI: 10.1089/neu.2017.5225] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
There has been no major advancement in a quarter of a century for the treatment of acute severe traumatic brain injury (TBI). This review summarizes 40 years of clinical and pre-clinical research on the treatment of acute TBI with hyperbaric oxygen therapy (HBO2) in the context of an impending National Institute of Neurologic Disorders and Stroke-funded, multi-center, randomized, adaptive Phase II clinical trial -the Hyperbaric Oxygen Brain Injury Treatment (HOBIT) trial. Thirty studies (eight clinical and 22 pre-clinical) that administered HBO2 within 30 days of a TBI were identified from PubMed searches. The pre-clinical studies consistently reported positive treatment effects across a variety of outcome measures with almost no safety concerns, thus providing strong proof-of-concept evidence for treating severe TBI in the acute setting. Of the eight clinical studies reviewed, four were based on the senior author's (GR) investigation of HBO2 as a treatment for acute severe TBI. These studies provided evidence that HBO2 significantly improves physiologic measures without causing cerebral or pulmonary toxicity and can potentially improve clinical outcome. These results were consistent across the other four reviewed clinical studies, thus providing preliminary clinical data supporting the HOBIT trial. This comprehensive review demonstrates that HBO2 has the potential to be the first significant treatment in the acute phase of severe TBI.
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Affiliation(s)
- Samuel Daly
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
- University of Minnesota Medical School, Minneapolis, Minnesota
| | - Maxwell Thorpe
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
| | - Sarah Rockswold
- Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, Minnesota
| | - Molly Hubbard
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Thomas Bergman
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Uzma Samadani
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
| | - Gaylan Rockswold
- Department of Surgery, Hennepin County Medical Center, Minneapolis, Minnesota
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota
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Passavanti G, Tanasi P, Brauzzi M, Pagni M, Norgini E, Aloisi A. Can Hyperbaric Oxygenation Therapy (HOT) Modify the Blood Testosterone Concentration? Urologia 2018. [DOI: 10.1177/039156031007700109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Testosterone has a modulating effect on inflammatory and healing processes. In this study, we evaluate whether hyperbaric oxygenation therapy (HOT) modifies the blood concentration of total testosterone (TT) in patients treated for different pathologies. Materials and Methods Fourteen male patients (23–72 years old) were treated with 90-min HOT sessions (range 4 to 23 sessions) as an adjuvant to the following conditions: leg fractures, osteonecrosis, diabetic foot, firearm injuries, complicated arthroprosthesis and underwater diving embolism. As controls, six healthy male volunteers (37–51 years old) were subjected to 10 HOT sessions. Testosterone plasma levels were determined immediately before the first HOT session and the day after the last session. Results At the end of treatment, 12 patients fully recovered and 2 (diabetic foot patients) showed a marked improvement. Testosterone significantly increased after hyperbaric oxygenation therapy in both patients and controls (ANOVA, p<0.004). Discussion We conclude that hyperbaric oxygenation therapy increases the blood concentration of total testosterone in patients as well as in healthy men. This finding raises new questions and indicates the need to investigate the causes of this increase and its therapeutic significance. Since testosterone modulates inflammation and healing processes, it is possible that hormonal changes are the mechanisms affected by hyperbaric oxygenation therapy.
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Affiliation(s)
| | - P. Tanasi
- Dpt of HOT and advanced dressings Misericordia Hospital
| | - M. Brauzzi
- Dpt of HOT and advanced dressings Misericordia Hospital
| | - M.R. Pagni
- Dpt of HOT and advanced dressings Misericordia Hospital
| | - E. Norgini
- Dpt of HOT and advanced dressings Misericordia Hospital
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Fernández Canedo I, Padilla España L, Francisco Millán Cayetano J, Repiso Jiménez JB, Pérez Delgado M, de Troya Martín M. Hyperbaric oxygen therapy: An alternative treatment for radiation-induced cutaneous ulcers. Australas J Dermatol 2017; 59:e203-e207. [DOI: 10.1111/ajd.12763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 10/30/2017] [Indexed: 01/11/2023]
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A Molecular and Clinical Review of Stem Cell Therapy in Critical Limb Ischemia. Stem Cells Int 2017; 2017:3750829. [PMID: 29358955 PMCID: PMC5735649 DOI: 10.1155/2017/3750829] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/05/2017] [Indexed: 12/20/2022] Open
Abstract
Peripheral artery disease (PAD) is one of the major vascular complications in individuals suffering from diabetes and in the elderly that can progress to critical limb ischemia (CLI), portending significant burden in terms of patient morbidity and mortality. Over the last two decades, stem cell therapy (SCT) has risen as an attractive alternative to traditional surgical and/or endovascular revascularization to treat this disorder. The primary benefit of SCT is to induce therapeutic neovascularization and promote collateral vessel formation to increase blood flow in the ischemic limb and soft tissue. Existing evidence provides a solid rationale for ongoing in-depth studies aimed at advancing current SCT that may change the way PAD/CLI patients are treated.
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Aguiar P, Amaral C, Rodrigues A, de Souza A. A diabetic foot ulcer treated with hydrogel and hyperbaric oxygen therapy: a case study. J Wound Care 2017; 26:692-695. [DOI: 10.12968/jowc.2017.26.11.692] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P. Aguiar
- Federal University Hospital of Rio Grande, Rio Grande do Sul Brazil
| | - C. Amaral
- Hyperbaric Oxygen Therapy Clinic of Rio Grande
| | - A. Rodrigues
- Pharmacy Technician, Federal University Hospital of Rio Grande, Rio Grande do Sul Brazil
| | - A.H. de Souza
- Lecturer, Universidade Luterana do Brasil, Rio Grande, Rio Grande do Sul, Brazil
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Stem cell therapy for abrogating stroke-induced neuroinflammation and relevant secondary cell death mechanisms. Prog Neurobiol 2017; 158:94-131. [PMID: 28743464 DOI: 10.1016/j.pneurobio.2017.07.004] [Citation(s) in RCA: 171] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/18/2017] [Accepted: 07/18/2017] [Indexed: 12/13/2022]
Abstract
Ischemic stroke is a leading cause of death worldwide. A key secondary cell death mechanism mediating neurological damage following the initial episode of ischemic stroke is the upregulation of endogenous neuroinflammatory processes to levels that destroy hypoxic tissue local to the area of insult, induce apoptosis, and initiate a feedback loop of inflammatory cascades that can expand the region of damage. Stem cell therapy has emerged as an experimental treatment for stroke, and accumulating evidence supports the therapeutic efficacy of stem cells to abrogate stroke-induced inflammation. In this review, we investigate clinically relevant stem cell types, such as hematopoietic stem cells (HSCs), mesenchymal stem cells (MSCs), endothelial progenitor cells (EPCs), very small embryonic-like stem cells (VSELs), neural stem cells (NSCs), extraembryonic stem cells, adipose tissue-derived stem cells, breast milk-derived stem cells, menstrual blood-derived stem cells, dental tissue-derived stem cells, induced pluripotent stem cells (iPSCs), teratocarcinoma-derived Ntera2/D1 neuron-like cells (NT2N), c-mycER(TAM) modified NSCs (CTX0E03), and notch-transfected mesenchymal stromal cells (SB623), comparing their potential efficacy to sequester stroke-induced neuroinflammation and their feasibility as translational clinical cell sources. To this end, we highlight that MSCs, with a proven track record of safety and efficacy as a transplantable cell for hematologic diseases, stand as an attractive cell type that confers superior anti-inflammatory effects in stroke both in vitro and in vivo. That stem cells can mount a robust anti-inflammatory action against stroke complements the regenerative processes of cell replacement and neurotrophic factor secretion conventionally ascribed to cell-based therapy in neurological disorders.
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Nonhealing Wounds Caused by Brown Spider Bites: Application of Hyperbaric Oxygen Therapy. Adv Skin Wound Care 2017; 29:560-566. [PMID: 27846029 DOI: 10.1097/01.asw.0000504578.06579.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bites by Loxosceles spiders (also known as recluse spiders or brown spiders) can cause necrotic ulcerations of various sizes and dimensions. The current standard of care for brown spider bites includes analgesics, ice, compression, elevation, antihistamines, and surgical debridement. Hyperbaric oxygen therapy (HBOT) in the treatment of brown spider bites has been administered in the early stage of ulceration, or 2 to 6 days after the bite. Unfortunately, the diagnosis of spider bite-related ulcers is often delayed and weeks or months may elapse before HBOT is considered. OBJECTIVE To evaluate the effect of HBOT on nonhealing wounds caused by brown spider bites in the late, chronic, nonhealing stage. METHODS Analysis of 3 patients with brown spider-bite healing wounds treated at The Sagol Center for Hyperbaric Medicine and Research in Israel. Patients presented 2 to 3 months after failure of other therapies including topical dressings, antibiotics, and corticosteroids. All patients were treated with daily 2 ATA (atmospheres absolute) with 100% oxygen HBOT sessions. RESULTS All 3 patients were previously healthy without any chronic disease. Their ages were 30, 42, and 73 years. They were treated once daily for 13, 17, and 31 sessions, respectively. The wounds of all 3 patients healed, and there was no need for additional surgical intervention. There were no significant adverse events in any of the patients. CONCLUSIONS Microvascular injury related to brown spider bites may culminate in ischemic nonhealing wounds even in a relatively young, healthy population. Hyperbaric oxygen therapy should be considered as a valuable therapeutic tool even months after the bite.
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Abstract
GENERAL PURPOSE To provide information about hyperbaric oxygen therapy (HBOT), its mechanisms, indications and safe applications based on clinical evidence. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant should be better able to:1. Recall the physiology of wound healing and the mechanisms of action of HBOT.2. Identify current applications of HBOT based on clinical evidence as well as its risks and contraindications. ABSTRACT Treating chronic wounds and infections are challenging medical problems worldwide. Hyperbaric oxygen therapy (HBOT), the administration of 100% oxygen at pressures greater than 1.4 atmosphere absolute in a series of treatments, can be used as an adjunctive therapy in many wound care settings because it improves oxygenation and neovascularization and decreases inflammation in chronic wounds. A growing number of studies support the benefits of HBOT for enhancing wound healing and decreasing the likelihood of negative events such as amputation. However, many practitioners are unfamiliar with HBOT. This article provides a general introduction to HBOT, reviews the physiology and mechanisms of behind HBOT, discusses all the indications for HBOT, and explores in-depth the clinical evidence for HBOT in the treatment of arterial insufficiencies, diabetic ulcers, delayed radiation injury, and chronic refractory osteomyelitis.
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Ilic D, Yau S. Latest developments in the field of stem cell research and regenerative medicine compiled from publicly available information and press releases from nonacademic institutions, 1 January-28 February 2017. Regen Med 2017. [PMID: 28621222 DOI: 10.2217/rme-2017-0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Dusko Ilic
- Faculty of Science & Medicine, King's College London, UK
| | - Sharon Yau
- Cellular Therapy from Bench to Market Program, Faculty of Science & Medicine, King's College London, London, UK
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69
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Heyboer M, Sharma D, Santiago W, McCulloch N. Hyperbaric Oxygen Therapy: Side Effects Defined and Quantified. Adv Wound Care (New Rochelle) 2017; 6:210-224. [PMID: 28616361 PMCID: PMC5467109 DOI: 10.1089/wound.2016.0718] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/26/2017] [Indexed: 12/20/2022] Open
Abstract
Significance: Hyperbaric oxygen therapy (HBOT) is an important advanced therapy in the treatment of problem wounds, including diabetic foot ulcers and late effect radiation injury. HBOT remains among the safest therapies used today. Nonetheless, there are side effects associated with HBOT. It is important for providers to be able to identify, understand, and quantify these side effects for prevention, management, and informed consent. Recent Advances: The past two decades have seen significant advancements in our understanding of the underlying mechanisms of HBOT. This has led to a better understanding of the underlying reason for clinical benefit. It has also led to a better understanding of its side effects. Moreover, more recent literature allows for better quantification of these side effects. This review will highlight these side effects. Critical Issues: Wound healing in the case of problem nonhealing wounds requires the use of various advanced treatment modalities, including HBOT. HBOT has been shown to significantly improve healing rates in certain problem wounds, including advanced diabetic foot ulcers and late effect radiation injury. It is provided in a variety of clinical settings by providers with varying levels of expertise. It is important for those providing this therapy to understand the potential side effects. Future Directions: Research in HBOT has led to significant advancements in the area of wound healing. At the same time, there remains a variety of treatment protocols used at different institutions. It is important to quantify risk and benefit at different treatment pressures and times to better standardize treatment and improve patient care.
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Affiliation(s)
- Marvin Heyboer
- Division of Hyperbaric Medicine and Wound Care, Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Deepali Sharma
- Division of Hyperbaric Medicine and Wound Care, Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - William Santiago
- Division of Hyperbaric Medicine and Wound Care, Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York
| | - Norman McCulloch
- Division of Hyperbaric Medicine and Wound Care, Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York
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Schulze J, Kaiser O, Paasche G, Lamm H, Pich A, Hoffmann A, Lenarz T, Warnecke A. Effect of hyperbaric oxygen on BDNF-release and neuroprotection: Investigations with human mesenchymal stem cells and genetically modified NIH3T3 fibroblasts as putative cell therapeutics. PLoS One 2017; 12:e0178182. [PMID: 28542481 PMCID: PMC5441643 DOI: 10.1371/journal.pone.0178182] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 05/09/2017] [Indexed: 12/30/2022] Open
Abstract
Hyperbaric oxygen therapy (HBOT) is a noninvasive widely applied treatment that increases the oxygen pressure in tissues. In cochlear implant (CI) research, intracochlear application of neurotrophic factors (NTFs) is able to improve survival of spiral ganglion neurons (SGN) after deafness. Cell-based delivery of NTFs such as brain-derived neurotrophic factor (BDNF) may be realized by cell-coating of the surface of the CI electrode. Human mesenchymal stem cells (MSC) secrete a variety of different neurotrophic factors and may be used for the development of a biohybrid electrode in order to release endogenously-derived neuroprotective factors for the protection of residual SGN and for a guided outgrowth of dendrites in the direction of the CI electrode. HBOT could be used to influence cell behaviour after transplantation to the inner ear. The aim of this study was to investigate the effect of HBOT on the proliferation, BDNF-release and secretion of neuroprotective factors. Thus, model cells (an immortalized fibroblast cell line (NIH3T3)–native and genetically modified) and MSCs were repeatedly (3 x – 10 x) exposed to 100% oxygen at different pressures. The effects of HBO on cell proliferation were investigated in relation to normoxic and normobaric conditions (NOR). Moreover, the neuroprotective and neuroregenerative effects of HBO-treated cells were analysed by cultivation of SGN in conditioned medium. Both, the genetically modified NIH3T3/BDNF and native NIH3T3 fibroblasts, showed a highly significant increased proliferation after five days of HBOT in comparison to normoxic controls. By contrast, the number of MSCs was decreased in MSCs treated with 2.0 bar of HBO. Treating SGN cultures with supernatants of fibroblasts and MSCs significantly increased the survival rate of SGN. HBO treatment did not influence (increase / reduce) this effect. Secretome analysis showed that HBO treatment altered the protein expression pattern in MSCs.
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Affiliation(s)
- Jennifer Schulze
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all”, Hannover, Germany
- * E-mail:
| | - Odett Kaiser
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all”, Hannover, Germany
| | - Gerrit Paasche
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all”, Hannover, Germany
| | - Hans Lamm
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
| | - Andreas Pich
- Core Facility Proteomics, Hannover Medical School, Hannover, Germany
| | - Andrea Hoffmann
- Department of Orthopaedic Surgery, Hannover Medical School, Hannover, Germany
| | - Thomas Lenarz
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all”, Hannover, Germany
| | - Athanasia Warnecke
- Department of Otorhinolaryngology, Head and Neck Surgery, Hannover Medical School, Hannover, Germany
- Cluster of Excellence “Hearing4all”, Hannover, Germany
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71
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Gottrup F, Dissemond J, Baines C, Frykberg R, Jensen PØ, Kot J, Kröger K, Longobardi P. Use of Oxygen Therapies in Wound Healing. J Wound Care 2017; 26:S1-S43. [DOI: 10.12968/jowc.2017.26.sup5.s1] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Finn Gottrup
- University of Southern Denmark, Copenhagen Wound Healing Center, Department of Dermatology, D42, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark
| | - Joachim Dissemond
- Department of Dermatology, Venerology and Allergology, University Hospital of Essen, Hufelandstr. 55, 45147 Essen, Germany
| | - Carol Baines
- Royal Hobart Hospital, Hobart, Tasmania, Australia
| | - Robert Frykberg
- University of Arizona College of Medicine-Phoenix, AZ 85012 Phoenix, Arizona, USA
| | - Peter Østrup Jensen
- Department of Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Denmark and Department of Clinical Microbiology, Rigshospitalet, Copenhagen, Denmark
| | - Jacek Kot
- National Center for Hyperbaric Medicine, Medical University of Gdansk, Powstania Styczniowego Str. 9B, 81-519 Gdynia, Poland
| | - Knut Kröger
- Department of Vascular Medicine, HELIOS Klinikum Krefeld, 47805 Krefeld, Germany
| | - Pasquale Longobardi
- Affiliate Researcher Institute for Life Sciences, Scuola Superiore Sant'Anna (SSSA) Pisa, Italy Medical Director Centro iperbarico, Ravenna, Italy
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72
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Combined effect of substance P and curcumin on cutaneous wound healing in diabetic rats. J Surg Res 2017; 212:130-145. [DOI: 10.1016/j.jss.2017.01.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 01/14/2017] [Accepted: 01/18/2017] [Indexed: 12/19/2022]
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Dunnill C, Patton T, Brennan J, Barrett J, Dryden M, Cooke J, Leaper D, Georgopoulos NT. Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process. Int Wound J 2017; 14:89-96. [PMID: 26688157 PMCID: PMC7950185 DOI: 10.1111/iwj.12557] [Citation(s) in RCA: 654] [Impact Index Per Article: 93.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/17/2015] [Accepted: 11/18/2015] [Indexed: 12/15/2022] Open
Abstract
Reactive oxygen species (ROS) play a pivotal role in the orchestration of the normal wound-healing response. They act as secondary messengers to many immunocytes and non-lymphoid cells, which are involved in the repair process, and appear to be important in coordinating the recruitment of lymphoid cells to the wound site and effective tissue repair. ROS also possess the ability to regulate the formation of blood vessels (angiogenesis) at the wound site and the optimal perfusion of blood into the wound-healing area. ROS act in the host's defence through phagocytes that induce an ROS burst onto the pathogens present in wounds, leading to their destruction, and during this period, excess ROS leakage into the surrounding environment has further bacteriostatic effects. In light of these important roles of ROS in wound healing and the continued quest for therapeutic strategies to treat wounds in general and chronic wounds, such as diabetic foot ulcers, venous and arterial leg ulcers and pressure ulcers in particular, the manipulation of ROS represents a promising avenue for improving wound-healing responses when they are stalled. This article presents a review of the evidence supporting the critical role of ROS in wound healing and infection control at the wound site, and some of the new emerging concepts associated with ROS modulation and its potential in improving wound healing are discussed.
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Affiliation(s)
- Christopher Dunnill
- Institute of Skin Integrity and Infection PreventionUniversity of HuddersfieldHuddersfieldUK
- Department of Biological Sciences, School of Applied SciencesUniversity of HuddersfieldHuddersfieldUK
| | | | | | | | - Matthew Dryden
- Department of MicrobiologyHampshire Hospitals NHS Foundation TrustWinchesterUK
- Rare and Imported Pathogens Laboratory (RIPL)Public Health EnglandPorton DownUK
| | - Jonathan Cooke
- Centre for Infection Prevention and Management, Division of MedicineImperial CollegeLondonUK
- Manchester Pharmacy SchoolFaculty of Medical and Human Sciences, University of ManchesterManchesterUK
| | - David Leaper
- Institute of Skin Integrity and Infection PreventionUniversity of HuddersfieldHuddersfieldUK
| | - Nikolaos T Georgopoulos
- Institute of Skin Integrity and Infection PreventionUniversity of HuddersfieldHuddersfieldUK
- Department of Biological Sciences, School of Applied SciencesUniversity of HuddersfieldHuddersfieldUK
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74
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Oscarsson N, Ny L, Mölne J, Lind F, Ricksten SE, Seeman-Lodding H, Giglio D. Hyperbaric oxygen treatment reverses radiation induced pro-fibrotic and oxidative stress responses in a rat model. Free Radic Biol Med 2017; 103:248-255. [PMID: 28034833 DOI: 10.1016/j.freeradbiomed.2016.12.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/10/2016] [Accepted: 12/24/2016] [Indexed: 12/19/2022]
Abstract
PURPOSE Radiotherapy is effective in the treatment of tumors in the pelvic area but is associated with side effects such as cystitis and proctitis. Hyperbaric Oxygen Therapy (HBOT) has emerged as a treatment modality for radiation-induced side effects. In a rat model for radiation cystitis, we studied the effects of HBOT on oxidative stress and pro-fibrotic factors. MATERIALS AND METHODS Sedated Sprague-Dawley rats underwent bladder irradiation of 20Gy with and without 20 sessions of HBOT during a fortnight. Control animals were treated with and without HBOT. All four groups of animals were euthanized 28 days later. Histopathological examinations, immunohistochemistry and quantitative polymerase chain reaction (qPCR) were used to analyze changes in oxidative stress (8-OHdG), anti-oxidative responses (SOD-1, SOD2, HO-1 and NRFα) and a panel of Th1-type and Th2-type cytokines (IL-1β, IL-4, IL-5, IL-6, IL-10, IL-13, TNF-α, TGF-β, IFN-γ) in the urinary bladder. RESULTS Bladder irradiation increased the expression of 8-OHdG, SOD2, HO-1, NRFα, IL-10, TNF-α and tended to increase TGF-β. These changes were completely reversed by HBOT while HBOT in control animals had no effects on the studied markers for oxidative stress, anti-oxidative responses and Th1-type and Th2-type cytokines. CONCLUSIONS Radiation induced a significant elevation of oxidative stress, antioxidants and pro-fibrotic factors in our animal model for radiation cystitis that were completely reversed and normalized by HBOT. Our findings indicate that HBOT may prevent radiation-induced changes by affecting oxidative stress and inflammatory cascades induced by radiation. SUMMARY Radiotherapy may cause the development of chronic inflammation and fibrosis, significantly impairing organ function. We hypothesized that bladder irradiation induces an oxidative stress reaction, thereby triggering the redox system and thus initiating an inflammatory and pro-fibrotic response. We aimed to assess whether these changes would be reversed by hyperbaric oxygen using an animal model for radiation cystitis. Our study show that hyperbaric oxygen therapy may reverse oxidative stress and pro-inflammatory factors induced by radiation.
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Affiliation(s)
- N Oscarsson
- Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - L Ny
- Department of Oncology, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - J Mölne
- Department of Pathology, Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - F Lind
- Section of Anesthesiology and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - S-E Ricksten
- Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - H Seeman-Lodding
- Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden
| | - D Giglio
- Department of Oncology, Institute of Clinical Sciences, the Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Pharmacology, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University of Gothenburg, Sweden
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75
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Long Y, Tan J, Nie Y, Lu Y, Mei X, Tu C. Hyperbaric oxygen therapy is safe and effective for the treatment of sleep disorders in children with cerebral palsy. Neurol Res 2017; 39:239-247. [PMID: 28079475 DOI: 10.1080/01616412.2016.1275454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Ying Long
- Department of Hyperbaric Oxygen Treatment, Shenzhen People’s Hospital, Shenzhen, P. R. China
| | - Jiewen Tan
- Department of Hyperbaric Oxygen Treatment, Sun Yat-Sen, Memorial Hospital, Sun Yat-Sen University, Guangzhou, P. R. China
- Xinhua College, Sun Yat-sen University, Guangzhou, P. R. China
| | - Yulin Nie
- Department of Hyperbaric Oxygen Treatment, 2nd Hospital of Longgang District, Shenzhen, China
| | - Yu Lu
- Department of Hyperbaric Oxygen Treatment, Shenzhen People’s Hospital, Shenzhen, P. R. China
| | - Xiufang Mei
- Department of Hyperbaric Oxygen Treatment, Shenzhen People’s Hospital, Shenzhen, P. R. China
| | - Chaoqun Tu
- Department of Hyperbaric Oxygen Treatment, Shenzhen People’s Hospital, Shenzhen, P. R. China
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76
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Zang L, Hao H, Liu J, Li Y, Han W, Mu Y. Mesenchymal stem cell therapy in type 2 diabetes mellitus. Diabetol Metab Syndr 2017; 9:36. [PMID: 28515792 PMCID: PMC5433043 DOI: 10.1186/s13098-017-0233-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/05/2017] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM), which is characterized by the combination of relative insulin deficiency and insulin resistance, cannot be reversed with existing therapeutic strategies. Transplantation of insulin-producing cells (IPCs) was once thought to be the most promising strategy for treating diabetes, but the pace from the laboratory to clinical application has been obstructed due to its drawbacks. Mesenchymal stem cells (MSCs) harbor differentiation potential, immunosuppressive properties, and anti-inflammatory effects, and they are considered an ideal candidate cell type for treatment of DM. MSC-related research has demonstrated exciting therapeutic effects in glycemic control both in vivo and in vitro, and these results now have been translated into clinical practice. However, some critical potential problems have emerged from current clinical trials. Multi-center, large-scale, double-blind, and placebo-controlled studies with strict supervision are required before MSC transplantation can become a routine therapeutic approach for T2DM. We briefly review the molecular mechanism of MSC treatment for T2DM as well as the merits and drawbacks identified in current clinical trials.
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Affiliation(s)
- Li Zang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Haojie Hao
- Department of Molecular Biology, Institute of Basic Medicine, College of Life Science, Chinese PLA General Hospital, Beijing, 100853 China
| | - Jiejie Liu
- Department of Molecular Biology, Institute of Basic Medicine, College of Life Science, Chinese PLA General Hospital, Beijing, 100853 China
| | - Yijun Li
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, 100853 China
| | - Weidong Han
- Department of Molecular Biology, Institute of Basic Medicine, College of Life Science, Chinese PLA General Hospital, Beijing, 100853 China
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, 100853 China
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77
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Poff AM, Kernagis D, D'Agostino DP. Hyperbaric Environment: Oxygen and Cellular Damage versus Protection. Compr Physiol 2016; 7:213-234. [PMID: 28135004 DOI: 10.1002/cphy.c150032] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The elevation of tissue pO2 induced by hyperbaric oxygen (HBO) is a physiological stimulus that elicits a variety of cellular responses. These effects are largely mediated by, or in response to, an increase in the production of reactive oxygen and nitrogen species (RONS). The major consequences of elevated RONS include increased oxidative stress and enhanced antioxidant capacity, and modulation of redox-sensitive cell signaling pathways. Interestingly, these phenomena underlie both the therapeutic and potentially toxic effects of HBO. Emerging evidence indicates that supporting mitochondrial health is a potential method of enhancing the therapeutic efficacy of, and preventing oxygen toxicity during, HBO. This review will focus on the cellular consequences of HBO, and explore how these processes mediate a delicate balance of cellular protection versus damage. © 2017 American Physiological Society. Compr Physiol 7:213-234, 2017.
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Affiliation(s)
- Angela M Poff
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Dawn Kernagis
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Dominic P D'Agostino
- Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.,Institute for Human and Machine Cognition, Pensacola, Florida, USA
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78
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Teguh DN, Bol Raap R, Struikmans H, Verhoef C, Koppert LB, Koole A, Huang Y, van Hulst RA. Hyperbaric oxygen therapy for late radiation-induced tissue toxicity: prospectively patient-reported outcome measures in breast cancer patients. Radiat Oncol 2016; 11:130. [PMID: 27682427 PMCID: PMC5041335 DOI: 10.1186/s13014-016-0700-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 09/13/2016] [Indexed: 12/20/2022] Open
Abstract
Introduction This study examines patient reported outcome measures of women undergoing hyperbaric oxygen treatment (HBOT) after breast-conserving therapy. Method Included were 57 women treated with HBOT for late radiation-induced tissue toxicity (LRITT) referred in the period January 2014-December 2015. HBOT consisted of (on average) 47 sessions. In total, 80 min of 100 % O2 was administered under increased pressure of 2.4 ATA. Quality of life was assessed before and after treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23, and a NRS pain score. Results Fifty-seven women were available for evaluation before and after treatment. Before HBOT, patients had severe complaints of pain in the arm/shoulder (46 %), swollen arm/hand (14 %), difficulty to raise arm or move it sideways (45 %), pain in the area of the affected breast (67 %), swollen area of the affected breast (45 %), oversensitivity of the affected breast (54 %), and skin problems on/in the area of the affected breast (32 %); post HBOT, severe complaints were still experienced in 17, 7, 22, 15, 13, 15, and 11 % of the women, respectively. Differences were all significant. The NRS pain score improved at least 1 point (range 0–10) in 81 % of the patients (p < 0.05). Conclusion In these breast cancer patients treated with HBOT for LRITT, the patient-reported outcomes were positive and improvements were observed. HBOT was a well-tolerated treatment for LRITT and its side-effects were both minimal and reversible.
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Affiliation(s)
- David N Teguh
- Hyperbaar Geneeskundig Centrum Rijswijk, Treubstraat 5a, 2288 EG, Rijswijk, The Netherlands. .,Department of Surgery/Hyperbaric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - René Bol Raap
- Hyperbaar Geneeskundig Centrum Rijswijk, Treubstraat 5a, 2288 EG, Rijswijk, The Netherlands
| | - Henk Struikmans
- Department of Radiation Oncology, Leiden University Medical Centre, Leiden, The Netherlands.,Radiotherapy Centre West, Medical Centre Haaglanden, The Hague, The Netherlands
| | - Cees Verhoef
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Linetta B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Arne Koole
- Hyperbaar Geneeskundig Centrum Rijswijk, Treubstraat 5a, 2288 EG, Rijswijk, The Netherlands
| | - Yadi Huang
- University of Leuven, Leuven, The Netherlands
| | - Rob A van Hulst
- Hyperbaar Geneeskundig Centrum Rijswijk, Treubstraat 5a, 2288 EG, Rijswijk, The Netherlands.,Department of Anesthesiology/Hyperbaric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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79
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Li G, Yu F, Lei T, Gao H, Li P, Sun Y, Huang H, Mu Q. Bone marrow mesenchymal stem cell therapy in ischemic stroke: mechanisms of action and treatment optimization strategies. Neural Regen Res 2016; 11:1015-24. [PMID: 27482235 PMCID: PMC4962565 DOI: 10.4103/1673-5374.184506] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction, angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action, and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke. We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.
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Affiliation(s)
- Guihong Li
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China; Department of Neurosurgery, Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Fengbo Yu
- School of Pharmacy, Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Ting Lei
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Haijun Gao
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Peiwen Li
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Yuxue Sun
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Haiyan Huang
- Department of Neurosurgery, the First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Qingchun Mu
- Department of Neurosurgery, Hongqi Hospital of Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
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80
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Gallagher KA, Goldstein LJ, Thom SR, Velazquez OC. Hyperbaric Oxygen and Bone Marrow–Derived Endothelial Progenitor Cells in Diabetic Wound Healing. Vascular 2016; 14:328-37. [PMID: 17150153 DOI: 10.2310/6670.2006.00057] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Endothelial progenitor cells (EPCs) are the key cellular effectors of postnatal vasculogenesis and play a central role in wound healing. In diabetes, there is a significant impairment in the number and function of circulating and wound-tissue EPC. Recent evidence indicates, that tissue-level hyperoxia achieved by therapeutic hyperbaric oxygen protocols (HBO2) can increase the mobilization of EPC from the bone marrow into peripheral blood. In this paper we review the recent reports on hyperoxia-mediated mobilization of bone marrow-derived EPC and postulate avenues of future research in this area as it applies to improving healing in chronic wounds affected by diabetes and peripheral arterial disease (PAD).
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Affiliation(s)
- Katherine A Gallagher
- Department of Surgery, Institute for Environmental Medicine, University of Pennsylvania Medical Center, Philadelphia 19124, USA
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81
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Ceponis P, Keilman C, Guerry C, Freiberger JJ. Hyperbaric oxygen therapy and osteonecrosis. Oral Dis 2016; 23:141-151. [PMID: 27062390 DOI: 10.1111/odi.12489] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/24/2016] [Indexed: 12/18/2022]
Abstract
Osteonecrosis of the jaw may be caused by radiation, medication, or infection. Optimal therapy requires a multimodal approach that combines surgery with adjuvant treatments. This review focuses on the use of adjunctive hyperbaric oxygen therapy for this condition. In addition to evidence regarding the basic and clinical science behind hyperbaric oxygen therapy, controversies in the field and economic implications are discussed.
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Affiliation(s)
- P Ceponis
- Hyperbaric Division, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Royal Canadian Medical Service, Canadian Armed Forces, Ottawa, ON, Canada
| | - C Keilman
- Hyperbaric Division, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - C Guerry
- Hyperbaric Division, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - J J Freiberger
- Hyperbaric Division, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
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82
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Anderson CA, Hare MA, Perdrizet GA. Wound Healing Devices Brief Vignettes. Adv Wound Care (New Rochelle) 2016; 5:185-190. [PMID: 27076996 DOI: 10.1089/wound.2015.0651] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Significance: The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications. Recent Advances: The published literature on the use of medical devices for wound healing continues to support the use of hyperbaric oxygen therapy, negative pressure wound therapy, and most recently electrical stimulation. Critical Issue: To inform wound healing practitioners of the evidence for or against the use of medical devices for wound healing. This information will aid the practitioner in deciding which technology should be accepted or rejected for clinical use. Future Directions: To produce high quality, randomized controlled trials or acquire outcome-based registry databases to further test and improve the knowledge base as it relates to the use of medical devices in wound care.
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Affiliation(s)
- Caesar A. Anderson
- Department of Emergency Medicine, Centers for Wound Healing and Hyperbaric Medicine, University of California, San Diego, San Diego, California
| | - Marc A. Hare
- Department of Emergency Medicine, Centers for Wound Healing and Hyperbaric Medicine, University of California, San Diego, San Diego, California
| | - George A. Perdrizet
- Department of Emergency Medicine, Centers for Wound Healing and Hyperbaric Medicine, University of California, San Diego, San Diego, California
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83
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Nevens D, Nuyts S. The role of stem cells in the prevention and treatment of radiation-induced xerostomia in patients with head and neck cancer. Cancer Med 2016; 5:1147-53. [PMID: 26880659 PMCID: PMC4924373 DOI: 10.1002/cam4.609] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 11/11/2022] Open
Abstract
Xerostomia is an important complication following radiotherapy (RT) for head and neck cancer. Current treatment approaches are insufficient and can only temporarily relieve symptoms. New insights into the physiopathology of radiation‐induced xerostomia might help us in this regard. This review discusses the current knowledge of salivary gland stem cells in radiation‐induced xerostomia and their value in the prevention and treatment of this complication. Salivary gland stem cell transplantation, bone marrow‐derived cell mobilization, molecular regulation of parotid stem cells, stem cell sparing RT, and adaptive RT are promising techniques that are discussed in this study.
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Affiliation(s)
- Daan Nevens
- Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Sandra Nuyts
- Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
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84
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Glover M, Smerdon GR, Andreyev HJ, Benton BE, Bothma P, Firth O, Gothard L, Harrison J, Ignatescu M, Laden G, Martin S, Maynard L, McCann D, Penny CEL, Phillips S, Sharp G, Yarnold J. Hyperbaric oxygen for patients with chronic bowel dysfunction after pelvic radiotherapy (HOT2): a randomised, double-blind, sham-controlled phase 3 trial. Lancet Oncol 2016; 17:224-233. [PMID: 26703894 PMCID: PMC4737893 DOI: 10.1016/s1470-2045(15)00461-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/16/2015] [Accepted: 10/27/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Hyperbaric oxygen has been used as a therapy for patients experiencing chronic intestinal syndromes after pelvic radiotherapy for decades, yet the evidence to support the use of this therapy is based almost exclusively on non-randomised studies. We aimed to provide conclusive results for the clinical benefits of hyperbaric oxygen in patients with chronic bowel dysfunction after radiotherapy for pelvic malignancies. METHODS HOT2 was a double-blind, sham-controlled, phase 3 randomised study of patients (≥18 years) with chronic gastrointestinal symptoms for 12 months or more after radiotherapy and which persisted despite at least 3 months of optimal medical therapy and no evidence of cancer recurrence. Participants were stratified by participating hyperbaric centre and randomly assigned (2:1) by a computer-generated list (block size nine or 12) to receive treatment with hyperbaric oxygen therapy or sham. Participants in the active treatment group breathed 100% oxygen at 2·4 atmospheres of absolute pressure (ATA) and the control group breathed 21% oxygen at 1·3 ATA; both treatment groups received 90-min air pressure exposures once daily for 5 days per week for a total of 8 weeks (total of 40 exposures). Staff at the participating hyperbaric medicine facilities knew the allocated treatment, but patients, clinicians, nurse practitioners, and other health-care professionals associated with patients' care were masked to treatment allocation. Primary endpoints were changes in the bowel component of the modified Inflammatory Bowel Disease Questionnaire (IBDQ) score and the IBDQ rectal bleeding score 12 months after start of treatment relative to baseline. The primary outcome was analysed in a modified intention-to-treat population, excluding patients who did not provide IBDQ scores within a predetermined time-frame. All patients have completed 12 months of follow-up and the final analysis is complete. The trial is registered with the ISRCTN registry, number ISRCTN86894066. FINDINGS Between Aug 14, 2009, and Oct 23, 2012, 84 participants were randomly assigned: 55 to hyperbaric oxygen and 29 to sham control. 75 (89%) participants received 40 pressure exposures, all participants returned the IBDQ at baseline, 75 (89%) participants returned the IBDQ at 2 weeks post-treatment, and 79 (94%) participants returned the IBDQ at 12 months post-start of treatment. Patients were excluded from analyses of co-primary endpoints if they had missing IBDQ scores for intestinal function or rectal bleeding at baseline or at 12 months. In an analysis of 46 participants in the active treatment group and 23 participants in the control group, we found no significant differences in the change of IBDQ bowel component score (median change from baseline to 12 months of 4 (IQR -3 to 11) in the treatment group vs 4 (-6 to 9) in the sham group; Mann-Whitney U score 0·67, p=0·50). In an analysis of 29 participants in the active treatment group and 11 participants in the sham group with rectal bleeding at baseline, we also found no significant differences in the change of IBDQ rectal bleeding score (median change from baseline to 12 months of 3 [1 to 3] in the treatment group vs 1 [1 to 2] in the sham group; U score 1·69, p=0·092). Common adverse events in both groups were eye refractive changes (three [11%] of 28 patients in the control group vs 16 [30%] of 53 patients in the treatment group), increased fatigue (three [11%] vs two [4%]), and ear pain (six [21%] vs 15 [28%]). Eight serious adverse events were reported in eight patients: two were reported in two patients in the control group (tonsillitis requiring surgery [grade 3]; recurrent cancer of the vulva [grade 4]) and six serious adverse events were reported in six patients in the treatment group (malignant spinal cord compression requiring surgery [grade 3]; malignant paraortic lymph node involvement requiring surgery [grade 3]; recurrence of vomiting and dehydration [grade 3]; diarrhoea and fever associated with Campylobacter infection [grade 3]; recurrence of abdominal pain, bloating, diarrhoea, and urinary tract infection [grade 3]; aneurysm [grade 4]), none of which were deemed treatment-related. INTERPRETATION We found no evidence that patients with radiation-induced chronic gastrointestinal symptoms, including those patients with rectal bleeding, benefit from hyperbaric oxygen therapy. These findings contrast with evidence used to justify current practices, and more level 1 evidence is urgently needed. FUNDING Cancer Research UK and National Health Service (NHS) funding to the National Institute of Health Research Biomedical Research Centre at The Royal Marsden and the Institute of Cancer Research.
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Affiliation(s)
- Mark Glover
- Hyperbaric Medicine Unit, St Richard's Hospital, Chichester, UK
| | | | | | | | - Pieter Bothma
- Whipps Cross University Hospital, Leytonstone, London & East of England Hyperbaric Unit, Great Yarmouth, UK
| | - Oliver Firth
- London Diving Chamber, Hospital of St John and St Elizabeth, London, UK
| | - Lone Gothard
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - John Harrison
- North West Emergency Recompression Unit, Murrayfield Hospital, Wirral, UK
| | | | - Gerard Laden
- North of England Medical and Hyperbaric Services, Spire Hull & East Riding Hospital, Kingston-upon-Hull, UK
| | - Sue Martin
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - Lauren Maynard
- Clinical Trials and Statistics Unit at the Institute of Cancer Research, London, UK
| | | | | | | | - Grace Sharp
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK
| | - John Yarnold
- Division of Radiotherapy and Imaging, Institute of Cancer Research, London, UK.
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85
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Thom SR, Hampton M, Troiano MA, Mirza Z, Malay DS, Shannon S, Jennato NB, Donohue CM, Hoffstad O, Woltereck D, Yang M, Yu K, Bhopale VM, Kovtun S, Margolis DJ. Measurements of CD34+/CD45-dim Stem Cells Predict Healing of Diabetic Neuropathic Wounds. Diabetes 2016; 65:486-97. [PMID: 26487786 PMCID: PMC4747459 DOI: 10.2337/db15-0517] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/14/2015] [Indexed: 12/12/2022]
Abstract
Management of neuropathic foot ulcers in patients with diabetes (DFUs) has changed little over the past decade, and there is currently no objective method to gauge probability of successful healing. We hypothesized that studies of stem/progenitor cells (SPCs) in the early weeks of standard wound management could predict who will heal within 16 weeks. Blood and debrided wound margins were collected for 8 weeks from 100 patients undergoing weekly evaluations and treatment. SPC number and intracellular content of hypoxia-inducible factors (HIFs) were evaluated by flow cytometry and immunohistochemistry. More SPCs entered the bloodstream in the first 2 weeks of care in patients who healed (n = 37) than in those who did not (n = 63). Logistic regression demonstrated that the number of blood-borne SPCs and the cellular content of HIFs at study entry and the first-week follow-up visit predicted healing. Strong correlations were found among week-to-week assessments of blood-borne SPC HIF factors. We conclude that assays of SPCs during the first weeks of care in patients with DFUs can provide insight into how well wounds will respond and may aid with decisions on the use of adjunctive measures.
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Affiliation(s)
- Stephen R Thom
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Michelle Hampton
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Michael A Troiano
- Podiatric Surgery and Medicine, Penn Presbyterian Medical Center, Philadelphia, PA
| | - Ziad Mirza
- Department of Medicine, Greater Baltimore Medical Center, Baltimore, MD
| | - D Scot Malay
- Podiatric Surgery and Medicine, Penn Presbyterian Medical Center, Philadelphia, PA
| | - Steven Shannon
- Podiatric Surgery and Medicine, Penn Presbyterian Medical Center, Philadelphia, PA
| | - Nathan B Jennato
- Podiatric Surgery and Medicine, Penn Presbyterian Medical Center, Philadelphia, PA
| | | | - Ole Hoffstad
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Diana Woltereck
- Department of Medicine, Greater Baltimore Medical Center, Baltimore, MD
| | - Ming Yang
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Kevin Yu
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Veena M Bhopale
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Svitlana Kovtun
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - David J Margolis
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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86
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Acauan MD, Figueiredo MAZ, Cherubini K, Gomes APN, Salum FG. Radiotherapy-induced salivary dysfunction: Structural changes, pathogenetic mechanisms and therapies. Arch Oral Biol 2015; 60:1802-10. [DOI: 10.1016/j.archoralbio.2015.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 01/01/2023]
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87
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Sun G, Peng H. HIF-1α-induced microRNA-210 reduces hypoxia-induced osteoblast MG-63 cell apoptosis. Biosci Biotechnol Biochem 2015; 79:1232-9. [PMID: 26037388 DOI: 10.1080/09168451.2014.1003128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To better understand the ischemic-hypoxia-induced fracture healing impairment, we determined in this study the microRNA-210 expression in broken bone specimens and in osteoblasts under hypoxia and then determined the influence of microRNA-210 overexpression on the osteoblast cell proliferation and apoptosis. Results demonstrated that microRNA-210 expression was upregulated with an association with HIF-1α overexpression in clinical human catagmatic tissues and was upregulated HIF-1α-dependently in response to hypoxia in osteoblast MG-63 cells. CCK-8 assay indicated that microRNA-210 upregulation by microRNA-210 mimics reduced the chemotherapeutic 5-FU-induced osteoblast cell death, and colony formation assay demonstrated that microRNA-210 mimics promoted osteoblast cells growth. Moreover, the microRNA-210 mimics transfection inhibited the hypoxia-induced MG-63 cell apoptosis via inhibiting the activation of caspase 3 and caspase 9. Therefore, our research indicated a protective role of microRNA-210 in response to hypoxia. And microRNA-210 might serve as a protective role in bone fracture healing.
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Affiliation(s)
- Guanwen Sun
- a Orthopaedics Department , Renmin Hospital of Wuhan University , Wuhan , China
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88
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Spanou A, Lyritis GP, Chronopoulos E, Tournis S. Management of bisphosphonate-related osteonecrosis of the jaw: a literature review. Oral Dis 2015; 21:927-36. [PMID: 25732104 DOI: 10.1111/odi.12333] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 02/08/2014] [Accepted: 02/24/2015] [Indexed: 12/31/2022]
Abstract
Osteonecrosis of the jaw (ONJ) is a serious side effect of bisphosphonate use in patients with osteoporosis, Paget's disease, hypercalcemia of malignancy, metastatic bone disease and multiple myeloma, although recently this complication has also been reported in patients under non-bisphosphonate medication, such as denosumab and bevacizumab. The occurrence of ONJ is higher in oncology patients treated with high-dose iv bisphosphonates than in osteoporosis patients treated with oral bisphosphonates. Although multiple hypotheses have been proposed, the exact pathogenic mechanism of ONJ still remains unclear. As treatment protocols based on randomized controlled trials (RCTs) do not exist, we critically reviewed the existing data concerning the management of bisphosphonate-related osteonecrosis of the jaw, including the most recent data for the use of teriparatide and hyperbaric oxygen.
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Affiliation(s)
- A Spanou
- Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece
| | - G P Lyritis
- Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece
| | - E Chronopoulos
- Postgraduate Course on Metabolic Bone Disease, Faculty of Medicine, University of Athens, Athens, Greece.,2nd Orthopaedic Department, Konstantopoulion Hospital, University of Athens, Athens, Greece
| | - S Tournis
- Laboratory for Research of the Musculoskeletal System 'Th. Garofalidis', Medical School, KAT Hospital, University of Athens, Athens, Greece
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89
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Svalestad J, Hellem S, Thorsen E, Johannessen AC. Effect of hyperbaric oxygen treatment on irradiated oral mucosa: microvessel density. Int J Oral Maxillofac Surg 2015; 44:301-7. [PMID: 25604154 DOI: 10.1016/j.ijom.2014.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 11/07/2014] [Accepted: 12/19/2014] [Indexed: 11/15/2022]
Abstract
The aim of this study was to evaluate the effect of hyperbaric oxygen therapy (HBOT) on microvascular tissue and cell proliferation in the oral mucosa. Twenty patients, aged 51-78 years, were allocated randomly to a treatment or a control group. All had a history of radiotherapy (50-70 Gy) to the orofacial region 2-6 years previously. Tissue samples were taken from the irradiated buccal oral mucosa before HBOT and at 6 months after treatment. In the control group, tissue samples were taken on two occasions, 6 months apart. The samples were subjected to immunohistochemistry staining: double staining with CD31 and D2-40 for microvessels, or Ki-67 for the analysis of cell proliferation. Blood vessel density and area were significantly increased after HBOT (P=0.002-0.041). D2-40-positive lymphatic vessels were significantly increased in number and area in the sub-epithelial area (P=0.002 and P=0.019, respectively). No significant differences were observed in the control group. There were no significant differences in Ki-67-expressing epithelial cells between the two groups. It is concluded that the density and area of blood and lymphatic vessels in the irradiated mucosa are increased by HBOT 6 months after therapy. Epithelial cell proliferation is not affected by HBOT.
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Affiliation(s)
- J Svalestad
- Department of Clinical Dentistry - Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway.
| | - S Hellem
- Department of Clinical Dentistry - Oral and Maxillofacial Surgery, University of Bergen, Bergen, Norway
| | - E Thorsen
- Hyperbaric Medical Unit, Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - A C Johannessen
- Department of Clinical Medicine, The Gade Laboratory for Pathology, University of Bergen, Bergen, Norway; Department of Pathology, Haukeland University Hospital, Bergen, Norway
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90
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Grassmann JP, Schneppendahl J, Sager M, Hakimi AR, Herten M, Loegters TT, Wild M, Hakimi M, Windolf J, Jungbluth P. The effect of bone marrow concentrate and hyperbaric oxygen therapy on bone repair. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2015; 26:5331. [PMID: 25577213 DOI: 10.1007/s10856-014-5331-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 07/27/2014] [Indexed: 06/04/2023]
Abstract
Neoangiogenesis represents an essential part of bone regeneration. Therefore the improvement of neovascularization is the subject of various research approaches. In addition autologous mesenchymal stem cells concentrate in combination with bone substitute materials have been shown to support bone regeneration. In a rabbit model we examined the proposed synergistic effect of hyperbaric oxygen therapy (HBOT) and bone marrow concentrate (BMC) with porous calcium phosphate granules (CPG) on neoangiogenesis and osseous consolidation of a critical- size defect. The animal groups treated with HBOT showed a significantly higher microvessel density (MVD) by immunhistochemistry. Furthermore HBOT groups presented a significantly larger amount of new bone formation histomorphometrically as well as radiologically. We conclude that the increase in perfusion as a result of increased angiogenesis may play a key role in the effects of HBOT and consequently promotes bone healing.
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Affiliation(s)
- J P Grassmann
- Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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91
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Jackson PC, Wilks D, Rawlins J, Matteucci PL. Combined use of hyperbaric oxygen and sprayed keratinocyte suspension to tackle a difficult wound. Ann R Coll Surg Engl 2014; 96:e20-2. [PMID: 25198965 DOI: 10.1308/003588414x13946184903487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This is the first reported case in the literature to combine the use of a well established therapy to achieve wound healing (ie hyperbaric oxygen treatment) and a novel sprayed keratinocyte suspension technique to treat a challenging wound successfully. The merits and potential issues associated with these treatments are outlined and the case is detailed.
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Affiliation(s)
- P C Jackson
- Hull and East Yorkshire Hospitals NHS Trust, UK
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92
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Fosen KM, Thom SR. Hyperbaric oxygen, vasculogenic stem cells, and wound healing. Antioxid Redox Signal 2014; 21:1634-47. [PMID: 24730726 PMCID: PMC4175035 DOI: 10.1089/ars.2014.5940] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 04/14/2014] [Indexed: 12/15/2022]
Abstract
SIGNIFICANCE Oxidative stress is recognized as playing a role in stem cell mobilization from peripheral sites and also cell function. RECENT ADVANCES This review focuses on the impact of hyperoxia on vasculogenic stem cells and elements of wound healing. CRITICAL ISSUES Components of the wound-healing process in which oxidative stress has a positive impact on the various cells involved in wound healing are highlighted. A slightly different view of wound-healing physiology is adopted by departing from the often used notion of sequential stages: hemostatic, inflammatory, proliferative, and remodeling and instead organizes the cascade of wound healing as overlapping events or waves pertaining to reactive oxygen species, lactate, and nitric oxide. This was done because hyperoxia has effects of a number of cell signaling events that converge to influence cell recruitment/chemotaxis and gene regulation/protein synthesis responses which mediate wound healing. FUTURE DIRECTIONS Our alternative perspective of the stages of wound healing eases recognition of the multiple sites where oxidative stress has an impact on wound healing. This aids the focus on mechanistic events and the interplay among various cell types and biochemical processes. It also highlights the areas where additional research is needed.
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Affiliation(s)
- Katina M. Fosen
- Department of Emergency Medicine, Institute for Environmental Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Stephen R. Thom
- Department of Emergency Medicine, University of Maryland, Baltimore, Maryland
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93
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Abstract
Hyperbaric oxygen (HBO2) is the inhalation of 100% oxygen at pressures > 1.4 times atmospheric pressure. Hyperbaric oxygen can be delivered in monoplace (single person) or multiplace (multi-person) chambers. Most clinical HBO2 exposures are between 2 and 2.4 atm abs for approximately 2 hours. Hyperbaric oxygen causes the blood and tissue oxygen levels to increase, reduces the volume of intravascular and tissue bubbles (to treat decompression sickness [DCS] and arterial gas embolism [AGE]), and accelerates wash-out of other gases, such as nitrogen or carbon monoxide (CO), which is important for DCS, AGE, and CO poisoning. Hyperbaric oxygen favorably modulates ischemia-reperfusion injury by transiently inhibiting neutrophil-endothelial interactions, which is important for patients with DCS, AGE, CO poisoning, and potentially other acute ischemic conditions. Because of enhanced oxygen delivery, HBO2 is used for acute crush injury, ischemic flaps and grafts, acute central retinal arterial occlusion, other acute arterial occlusions, and idiopathic sudden sensorineural hearing loss. Hyperbaric oxygen has antimicrobial effects and is offered for patients with limb- or life-threatening infections, such as clostridial gas gangrene and necrotizing fasciitis. The most common US indication for HBO2 is the treatment of ischemic wounds (eg, diabetic lower extremity wounds, late effects of radiation, and refractory osteomyelitis). In ischemic wounds, HBO2 can deliver sufficient oxygen to the nonhealing wound to stimulate angiogenesis and healing through multiple mechanisms, including increased collagen production, increased growth factor receptor numbers, upregulation of vascular endothelial growth factor, increased circulating endothelial progenitor cells, and improvement in neutrophil-mediated host defense. Clinical trials support efficacy of HBO2 for acute CO poisoning, diabetic lower extremity wounds, crush injury, and radiation necrosis. Most hyperbaric chambers are associated with wound care centers and may be hospital based or nonhospital based. We review some of the disorders treated with HBO2 that hospital-based clinicians may be asked to evaluate.
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Affiliation(s)
- Lindell K Weaver
- Medical Director and Division Chief, Hyperbaric Medicine, LDS Hospital, Salt Lake City, UT; Intermountain Medical Center, Murray, UT; Professor of Medicine, University of Utah School of Medicine, Salt Lake City, UT.
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94
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Peng HS, Liao MB, Zhang MY, Xie Y, Xu L, Zhang YJ, Zheng XFS, Wang HY, Chen YF. Synergistic inhibitory effect of hyperbaric oxygen combined with sorafenib on hepatoma cells. PLoS One 2014; 9:e100814. [PMID: 24956259 PMCID: PMC4067386 DOI: 10.1371/journal.pone.0100814] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 05/29/2014] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Hypoxia is a common phenomenon in solid tumors, associated with chemotherapy and radiotherapy resistance, recurrence and metastasis. Hyperbaric oxygen (HBO) therapy can increase tissue oxygen pressure and content to prevent the resistance, recurrence and metastasis of cancer. Presently, Sorafenib is a first-line drug, targeted for hepatocellular carcinoma (HCC) but effective in only a small portion of patients and can induce hypoxia. The purpose of this study is to investigate the effect of HBO in combination with sorafenib on hepatoma cells. METHODS Hepatoma cell lines (BEL-7402 and SK-Hep1) were treated with HBO at 2 atmosphere absolute pressure for 80 min per day or combined with sorafenib or cisplatin. At different time points, cells were tested for cell growth, colony formation, apoptosis, cell cycle and migration. Finally, miRNA from the hepatoma cells was detected by microRNA array and validated by qRT-PCR. RESULTS Although HBO, sorafenib or cisplatin alone could inhibit growth of hepatoma cells, HBO combined with sorafenib or cisplatin resulted in much greater synergistic growth inhibition (cell proliferation and colony formation) in hepatoma cells. Similarly, the synergistic effect of HBO and sorafenib on induction of apoptosis was also observed in hepatoma cells. HBO induced G1 arrest in SK-Hep1 not in BEL-7402 cells, but enhanced cell cycle arrest induced by sorafenib in BEL-7402 treated cells. However, HBO had no obvious effect on the migration of hepatoma cells, and microRNA array analysis showed that hepatoma cells with HBO treatment had significantly different microRNA expression profiles from those with blank control. CONCLUSIONS We show for the first time that HBO combined with sorafenib results in synergistic growth inhibition and apoptosis in hepatoma cells, suggesting a potential application of HBO combined with sorafenib in HCC patients. Additionally, we also show that HBO significantly altered microRNA expression in hepatoma cells.
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Affiliation(s)
- Hai-Shan Peng
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Ming-Bin Liao
- Hyperbaric Oxygen Therapy Center, Affiliated Guangzhou First People's Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mei-Yin Zhang
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yin Xie
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Li Xu
- Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yao-Jun Zhang
- Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - X. F. Steven Zheng
- Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Hui-Yun Wang
- State Key Laboratory of Oncology in South China, Guangzhou, China
- Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
- * E-mail: (YFC); (HYW)
| | - Yi-Fei Chen
- Hyperbaric Oxygen Therapy Center, Affiliated Guangzhou First People's Hospital of Guangzhou Medical University, Guangzhou, China
- * E-mail: (YFC); (HYW)
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95
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Heyboer M, Grant WD, Byrne J, Pons P, Morgan M, Iqbal B, Wojcik SM. Hyperbaric oxygen for the treatment of nonhealing arterial insufficiency ulcers. Wound Repair Regen 2014; 22:351-5. [DOI: 10.1111/wrr.12176] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/05/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Marvin Heyboer
- Department of Emergency Medicine, Division of Hyperbaric Medicine and Wound Care; SUNY Upstate Medical University; Syracuse New York
| | - William D. Grant
- Department of Emergency Medicine, Division of Hyperbaric Medicine and Wound Care; SUNY Upstate Medical University; Syracuse New York
| | - Joseph Byrne
- Center for Wound Care and Hyperbaric Medicine; St. Joseph's Hospital; Fayetteville New York
| | - Paula Pons
- Center for Wound Care and Hyperbaric Medicine; St. Joseph's Hospital; Fayetteville New York
| | - Monica Morgan
- Department of Emergency Medicine, Division of Hyperbaric Medicine and Wound Care; SUNY Upstate Medical University; Syracuse New York
| | - Bilal Iqbal
- School of Medicine; SUNY Upstate Medical University; Syracuse
| | - Susan M. Wojcik
- Department of Emergency Medicine, Division of Hyperbaric Medicine and Wound Care; SUNY Upstate Medical University; Syracuse New York
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96
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Heyboer M, Milovanova TN, Wojcik S, Grant W, Chin M, Hardy KR, Lambert DS, Logue C, Thom SR. CD34+/CD45-dim stem cell mobilization by hyperbaric oxygen - changes with oxygen dosage. Stem Cell Res 2014; 12:638-45. [PMID: 24642336 PMCID: PMC4037447 DOI: 10.1016/j.scr.2014.02.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/14/2014] [Accepted: 02/22/2014] [Indexed: 11/16/2022] Open
Abstract
Because hyperbaric oxygen treatment mobilizes bone marrow derived-stem/progenitor cells by a free radical mediated mechanism, we hypothesized that there may be differences in mobilization efficiency based on exposure to different oxygen partial pressures. Blood from twenty consecutive patients was obtained before and after the 1st, 10th and 20th treatment at two clinical centers using protocols involving exposures to oxygen at either 2.0 or 2.5 atmospheres absolute (ATA). Post-treatment values of CD34+, CD45-dim leukocytes were always 2-fold greater than the pre-treatment values for both protocols. Values for those treated at 2.5 ATA were significantly greater than those treated at 2.0 ATA by factors of 1.9 to 3-fold after the 10th and before and after the 20th treatments. Intracellular content of hypoxia inducible factors -1, -2, and -3, thioredoxin-1 and poly-ADP-ribose polymerase assessed in permeabilized CD34+ cells with fluorophore-conjugated antibodies were twice as high in all post- versus pre-treatment samples with no significant differences between 2.0 and 2.5 ATA protocols. We conclude that putative progenitor cell mobilization is higher with 2.5 versus 2.0 ATA treatments, and all newly mobilized cells exhibit higher concentrations of an array of regulatory proteins.
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Affiliation(s)
- Marvin Heyboer
- Department of Emergency Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Tatyana N Milovanova
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Susan Wojcik
- Department of Emergency Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - William Grant
- Department of Emergency Medicine, State University of New York Upstate Medical University, Syracuse, NY, USA
| | - Mary Chin
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kevin R Hardy
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David S Lambert
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christopher Logue
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Stephen R Thom
- Institute for Environmental Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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97
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Chan XHS, Koh CE, Glover M, Bryson P, Travis SPL, Mortensen NJ. Healing under pressure: hyperbaric oxygen and myocutaneous flap repair for extreme persistent perineal sinus after proctectomy for inflammatory bowel disease. Colorectal Dis 2014; 16:186-90. [PMID: 24267200 DOI: 10.1111/codi.12500] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 09/15/2013] [Indexed: 02/08/2023]
Abstract
AIM Persistent perineal sinus (PPS) following proctectomy for inflammatory bowel disease affects about 50% of patients. Up to 33% of cases of PPS remain unhealed at 12 months and the most refractory cases are unhealed at 24 months despite optimal conventional therapy. Reports of hyperbaric oxygen therapy (HBOT) for chronic wounds and Crohn's perianal disease led us to explore perioperative HBOT with rectus abdominis myocutaneous (RAM) flap repair in a highly selected group of patients with extreme PPS who had failed all other interventions. METHOD Patients with extreme PPS received preoperative HBOT (a 90-min session at 2.2-2.4 atmospheres, five times per week for 5-6 weeks, for a total of up to 30 sessions), before abdominoperineal PPS excision and perineal reconstruction with vertical or transverse RAM flap repair within 2-4 weeks of completing HBOT. Postoperative HBOT (10 further 90-min sessions) was administered within 2 weeks where practicable. RESULTS Between 2007 and 2011, four patients with extreme PPS underwent RAM flap repair with preoperative HBOT; two also received postoperative HBOT. The median (range) duration of PPS before HBOT was 88.5 (23-156) months. All patients had previously failed multiple (5 to > 35) surgical procedures. Complete healing occurred in all patients at a median (range) follow-up of 2.5 (2-3) months. There were no further hospital admissions for PPS at a median (range) follow-up of 35 (8-64) months. CONCLUSION Hyperbaric oxygen therapy combined with PPS excision and perineal reconstruction with a RAM flap led to complete perineal healing in four patients with extreme PPS and appears a safe and effective extension to the therapeutic pathway for exceptionally treatment-refractory PPS.
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Affiliation(s)
- X H S Chan
- Department of Colorectal Surgery, Oxford University Hospitals NHS Trust, Oxford, UK
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98
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Management of radiotherapy-induced salivary hypofunction and consequent xerostomia in patients with oral or head and neck cancer: meta-analysis and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:595-607. [PMID: 24650370 DOI: 10.1016/j.oooo.2014.01.229] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 01/27/2014] [Accepted: 01/29/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To analyze the efficacy of various treatment options for radiation-induced hyposalivation in patients with head and neck cancer. STUDY DESIGN A literature review and meta-analysis was performed on all appropriate literature identified via MEDLINE/PubMed. RESULTS Fourteen articles were identified that met inclusion criteria for review, and 8 articles qualified for inclusion in the meta-analysis. The available literature addressed both objective and subjective responses of hyposalivation, xerostomia, or both to cholinergic agonists (such as pilocarpine and cevimeline), salivary substitutes, hyperbaric oxygen, and acupuncture. CONCLUSIONS This analysis indicated that cholinergic agonists were more effective in treating radiation-induced hyposalivation compared with salivary substitutes, hyperbaric oxygen, and acupuncture. However, other treatment modalities, such as salivary substitutes and hyperbaric oxygen, were also found to subjectively improve patients' perception of xerostomia.
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99
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Turner L, Mupparapu M, Akintoye SO. Review of the complications associated with treatment of oropharyngeal cancer: a guide for the dental practitioner. QUINTESSENCE INTERNATIONAL (BERLIN, GERMANY : 1985) 2014; 44:267-79. [PMID: 23444208 DOI: 10.3290/j.qi.a29050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Oropharyngeal cancer (OPC) is the sixth most common cancer worldwide. Focus on risk factors, improved diagnostic methods and effective management strategies have made it possible to successfully treat OPC. However, the 5-year survival rate has not improved for several years due to multiple treatment complications, tissue morbidity, loss of function, and diminished quality of life. Survivors are faced with complications like oral mucositis, hyposalivation, osteoradionecrosis, tissue fibrosis, morbidity from jaw resection, disfigurement, and loss of function that further diminish quality of life. The aim of this review is to highlight major complications associated with treatment of OPC via a literature search and review of available options for identification and management of these complications. DATA SOURCES Relevant publications on oral complications of OPC therapy were thoroughly reviewed from the literature published between the years 1988 and 2012. We evaluated reported incidence, prevalence, and risk factors for oral complications of chemotherapy and radiotherapy for OPC. The authors conducted an electronic search using English language databases, namely PubMed Plus, Medline (Pre-Medline and Medline), Cochrane Database of Systematic Reviews (evidence-based medicine), Dentistry & Oral Sciences Source, A ccessScience, Embase, Evidence-Based Medicine Reviews Multifile, Google Scholar, ISI Journal Citation Reports, and Ovid Multi-Database. CONCLUSION We identified the most common complications associated with the treatment of oral cancers. Based on the information gathered, there is evidence that survival of OPC extends beyond eradication of the diseased tissue. Understanding the potential treatment complications and utilizing available resources to prevent and minimize them are important. Caring for OPC survivors should be a multidisciplinary team approach involving the dentist, oncologist, internist, and social worker to improve the currently stagnant 5-year survival rate of OPC. More emphasis on improved quality of life after elimination of the cancer will ultimately improve OPC survivorship.
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Hyperbaric Oxygen Reduces Matrix Metalloproteinases in Ischemic Wounds through a Redox-Dependent Mechanism. J Invest Dermatol 2014; 134:237-246. [DOI: 10.1038/jid.2013.301] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 05/15/2013] [Accepted: 06/06/2013] [Indexed: 12/15/2022]
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