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Vezzoli A, Mrakic-Sposta S, Brizzolari A, Balestra C, Camporesi EM, Bosco G. Oxy-Inflammation in Humans during Underwater Activities. Int J Mol Sci 2024; 25:3060. [PMID: 38474303 DOI: 10.3390/ijms25053060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
Underwater activities are characterized by an imbalance between reactive oxygen/nitrogen species (RONS) and antioxidant mechanisms, which can be associated with an inflammatory response, depending on O2 availability. This review explores the oxidative stress mechanisms and related inflammation status (Oxy-Inflammation) in underwater activities such as breath-hold (BH) diving, Self-Contained Underwater Breathing Apparatus (SCUBA) and Closed-Circuit Rebreather (CCR) diving, and saturation diving. Divers are exposed to hypoxic and hyperoxic conditions, amplified by environmental conditions, hyperbaric pressure, cold water, different types of breathing gases, and air/non-air mixtures. The "diving response", including physiological adaptation, cardiovascular stress, increased arterial blood pressure, peripheral vasoconstriction, altered blood gas values, and risk of bubble formation during decompression, are reported.
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Affiliation(s)
- Alessandra Vezzoli
- Institute of Clinical Physiology-National Research Council (CNR-IFC), 20142 Milano, Italy
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
| | - Simona Mrakic-Sposta
- Institute of Clinical Physiology-National Research Council (CNR-IFC), 20142 Milano, Italy
| | - Andrea Brizzolari
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
| | - Costantino Balestra
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1160 Brussels, Belgium
- Physical Activity Teaching Unit, Motor Sciences Department, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
- DAN Europe Research Division (Roseto-Brussels), 1160 Brussels, Belgium
| | | | - Gerardo Bosco
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
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Cialoni D, Brizzolari A, Sponsiello N, Lancellotti V, Bosco G, Marroni A, Barassi A. Serum Amino Acid Profile Changes After Repetitive Breath-Hold Dives: A Preliminary Study. SPORTS MEDICINE - OPEN 2022; 8:80. [PMID: 35723766 PMCID: PMC9209628 DOI: 10.1186/s40798-022-00474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/06/2022] [Indexed: 12/04/2022]
Abstract
Background The aim of this work was to investigate the serum amino acid (AA) changes after a breath-hold diving (BH-diving) training session under several aspects including energy need, fatigue tolerance, nitric oxide (NO) production, antioxidant synthesis and hypoxia adaptation. Twelve trained BH-divers were investigated during an open sea training session and sampled for blood 30 min before the training session, 30 min and 4 h after the training session. Serum samples were assayed for AA changes related to energy request (alanine, histidine, isoleucine, leucine, lysine, methionine, proline threonine, valine), fatigue tolerance (ornithine, phenylalanine, tyrosine), nitric oxide production (citrulline), antioxidant synthesis (cystine, glutamate, glycine) and hypoxia adaptation (serine, taurine). Main results Concerning the AA used as an energy support during physical effort, we found statistically significant decreases for all the investigated AA at T1 and a gradual return to the basal value at T2 even if alanine, proline and theonine still showed a slight significant reduction at this time. Also, the changes related to the AA involved in tolerance to physical effort showed a statistically significant decrease only at T1 respect to pre-diving value and a returned to normal value at T2. Citrulline, involved in NO production, showed a clear significant reduction both at T1 and T2. Concerning AA involved in endogenous antioxidant synthesis, the behaviour of the three AA investigated is different: we found a statistically significant increase in cystine both at T1 and T2, while glycine showed a statistically significant reduction (T1 and T2). Glutamate did not show any statistical difference. Finally, we found a statistically significant decrease in the AA investigated in other hypoxia conditions serine and taurine (T1 and T2). Conclusions Our data seem to indicate that the energetic metabolic request is in large part supported by AA used as substrate for fuel metabolism and that also fatigue tolerance, NO production and antioxidant synthesis are supported by AA. Finally, there are interesting data related to the hypoxia stimulus that indirectly may confirm that the muscle apparatus works under strong exposure conditions notwithstanding the very short/low intensity of exercise, due to the intermittent hypoxia caused by repetitive diving.
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Theunissen S, Balestra C, Bolognési S, Borgers G, Vissenaeken D, Obeid G, Germonpré P, Honoré PM, De Bels D. Effects of Acute Hypobaric Hypoxia Exposure on Cardiovascular Function in Unacclimatized Healthy Subjects: A "Rapid Ascent" Hypobaric Chamber Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095394. [PMID: 35564787 PMCID: PMC9102089 DOI: 10.3390/ijerph19095394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 11/16/2022]
Abstract
Background: This study aimed to observe the effects of a fast acute ascent to simulated high altitudes on cardiovascular function both in the main arteries and in peripheral circulation. Methods: We examined 17 healthy volunteers, between 18 and 50 years old, at sea level, at 3842 m of hypobaric hypoxia and after return to sea level. Cardiac output (CO) was measured with Doppler transthoracic echocardiography. Oxygen delivery was estimated as the product of CO and peripheral oxygen saturation (SpO2). The brachial artery’s flow-mediated dilation (FMD) was measured with the ultrasound method. Post-occlusion reactive hyperemia (PORH) was assessed by digital plethysmography. Results: During altitude stay, peripheral oxygen saturation decreased (84.9 ± 4.2% of pre-ascent values; p < 0.001). None of the volunteers presented any hypoxia-related symptoms. Nevertheless, an increase in cardiac output (143.2 ± 36.2% of pre-ascent values, p < 0.001) and oxygen delivery index (120.6 ± 28.4% of pre-ascent values; p > 0.05) was observed. FMD decreased (97.3 ± 4.5% of pre-ascent values; p < 0.05) and PORH did not change throughout the whole experiment. Τhe observed changes disappeared after return to sea level, and normoxia re-ensued. Conclusions: Acute exposure to hypobaric hypoxia resulted in decreased oxygen saturation and increased compensatory heart rate, cardiac output and oxygen delivery. Pre-occlusion vascular diameters increase probably due to the reduction in systemic vascular resistance preventing flow-mediated dilation from increasing. Mean Arterial Pressure possibly decrease for the same reason without altering post-occlusive reactive hyperemia throughout the whole experiment, which shows that compensation mechanisms that increase oxygen delivery are effective.
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Affiliation(s)
- Sigrid Theunissen
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1160 Brussels, Belgium;
- Correspondence: (S.T.); (C.B.)
| | - Costantino Balestra
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1160 Brussels, Belgium;
- Physical Activity Teaching Unit, Motor Sciences Department, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
- DAN Europe Research Division (Roseto-Brussels), 1160 Brussels, Belgium
- Correspondence: (S.T.); (C.B.)
| | - Sébastien Bolognési
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1160 Brussels, Belgium;
| | - Guy Borgers
- Hypobaric Centre, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (G.B.); (D.V.)
| | - Dirk Vissenaeken
- Hypobaric Centre, Queen Astrid Military Hospital, 1120 Brussels, Belgium; (G.B.); (D.V.)
| | - Georges Obeid
- Military Hospital Queen Elizabeth, 1120 Brussels, Belgium; (G.O.); (P.G.)
| | - Peter Germonpré
- Military Hospital Queen Elizabeth, 1120 Brussels, Belgium; (G.O.); (P.G.)
| | - Patrick M. Honoré
- Department of Intensive Care Medicine, CHU-Brugmann, 1020 Brussels, Belgium; (P.M.H.); (D.D.B.)
| | - David De Bels
- Department of Intensive Care Medicine, CHU-Brugmann, 1020 Brussels, Belgium; (P.M.H.); (D.D.B.)
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Breath-Hold Diving-Related Decompression Sickness with Brain Involvement: From Neuroimaging to Pathophysiology. Tomography 2022; 8:1172-1183. [PMID: 35645382 PMCID: PMC9149941 DOI: 10.3390/tomography8030096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
Central nervous system involvement related to decompression sickness (DCS) is a very rare complication of breath-hold diving. So far, it has been postulated that repeated dives with short surface intervals represent a key factor in the development of breath-holding-related DCS. We report the case of a breath-hold diver who, after repeated immersion, developed DCS with brain involvement. After treatment in a hyperbaric chamber, there was a clinical improvement in the symptoms. Magnetic resonance imaging of the brain showed hyperintense lesions in long-time repetition sequences (FLAIR, T2WI) in the left frontal and right temporal lobes. Diffusion-weighted imaging (DWI) sequences and the apparent diffusion coefficient (ADC) map were characteristic of vasogenic edema, allowing us to exclude the ischemic nature of the process. These findings, together with the acute clinical presentation, the resolution of lesions in evolutionary radiological controls and the possible involvement of blood–brain barrier/endothelial dysfunction in DCS, could suggest a new form of posterior reversible encephalopathy syndrome (PRES)-like presentation of DCS. This would represent a novel mechanism to explain the pathophysiology of this entity. We conducted a literature review, analyzing the pathophysiological and neuroimaging characteristics of DCS in breath-hold diving based on a case of this rare disease.
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Effect of SCUBA Diving on Ophthalmic Parameters. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030408. [PMID: 35334584 PMCID: PMC8949343 DOI: 10.3390/medicina58030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
Background and Objective: Several cases of central serous chorioretinopathy (CSC) in divers have been reported in our medical retina center over the past few years. This study was designed to evaluate possible changes induced by SCUBA diving in ophthalmic parameters and especially subfoveal choroidal thickness (SFCT), since the choroid seems to play a crucial role in physiopathology of CSC. Materials and Methods: Intraocular pressure (IOP), SFCT, pachymetry, flow-mediated dilation (FMD), blood pressure, and heart rate were measured in 15 healthy volunteer divers before diving, 30 and 60 min after a standard deep dive of 25 m depth for 25 min in a dedicated diving pool (NEMO 33). Results: SFCT reduces significantly to 96.63 ± 13.89% of pre-dive values (p = 0.016) 30 min after diving. It recovers after 60 min reaching control values. IOP decreases to 88.05 ± 10.04% of pre-dive value at 30 min, then increases to 91.42 ± 10.35% of its pre-dive value (both p < 0.0001). Pachymetry shows a slight variation, but is significantly increased to 101.63 ± 1.01% (p = 0.0159) of the pre-dive value, and returns to control level after 60 min. FMD pre-dive was 107 ± 6.7% (p < 0.0001), but post-dive showed a diminished increase to 103 ± 6.5% (p = 0.0132). The pre-post difference was significant (p = 0.03). Conclusion: Endothelial dysfunction leading to arterial stiffness after diving may explain the reduced SFCT observed, but SCUBA diving seems to have miscellaneous consequences on eye parameters. Despite this clear influence on SFCT, no clear relationship between CSC and SCUBA diving can be drawn.
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Levenez M, Lambrechts K, Mrakic-Sposta S, Vezzoli A, Germonpré P, Pique H, Virgili F, Bosco G, Lafère P, Balestra C. Full-Face Mask Use during SCUBA Diving Counters Related Oxidative Stress and Endothelial Dysfunction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020965. [PMID: 35055791 PMCID: PMC8776018 DOI: 10.3390/ijerph19020965] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 12/29/2022]
Abstract
Impaired flow mediated dilation (FMD), an index of vascular stress, is known after SCUBA diving. This is related to a dysfunction of nitric oxide (NO) availability and a disturbance of the redox status, possibly induced by hyperoxic/hyperbaric gas breathing. SCUBA diving is usually performed with a mask only covering “half face” (HF) and therefore forcing oral breathing. Nasal NO production is involved in vascular homeostasis and, as consequence, can significantly reduce NO possibly promoting vascular dysfunction. More recently, the utilization of “full-face” (FF) mask, allowing nasal breathing, became more frequent, but no reports are available describing their effects on vascular functions in comparison with HF masks. In this study we assessed and compared the effects of a standard shallow dive (20 min at 10 m) wearing either FF or a HF mask on different markers of vascular function (FMD), oxidative stress (ROS, 8-iso-PGF2α) and NO availability and metabolism (NO2, NOx and 3-NT and iNOS expression). Data from a dive breathing a hypoxic (16% O2 at depth) gas mixture with HF mask are shown allowing hyperoxic/hypoxic exposure. Our data suggest that nasal breathing might significantly reduce the occurrence of vascular dysfunction possibly due to better maintenance of NO production and bioavailability, resulting in a better ability to counter reactive oxygen and nitrogen species. Besides the obvious outcomes in terms of SCUBA diving safety, our data permit a better understanding of the effects of oxygen concentrations, either in normal conditions or as a strategy to induce selected responses in health and disease.
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Affiliation(s)
- Morgan Levenez
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
| | - Kate Lambrechts
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
| | - Simona Mrakic-Sposta
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell’Ospedale Maggiore, 20162 Milano, Italy; (S.M.-S.); (A.V.)
| | - Alessandra Vezzoli
- Institute of Clinical Physiology, National Research Council (IFC-CNR), Piazza dell’Ospedale Maggiore, 20162 Milano, Italy; (S.M.-S.); (A.V.)
| | - Peter Germonpré
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
- Hyperbaric Centre, Queen Astrid Military Hospital, 1120 Brussels, Belgium
- DAN Europe Research Division, Contrada Padune, 64026 Roseto, Italy
| | - Hadrien Pique
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
| | - Fabio Virgili
- Council for Agricultural Research and Economics—Food and Nutrition Research Centre (CREA-AN), Via Ardeatina 548, 00187 Rome, Italy
- Correspondence: (F.V.); (C.B.)
| | - Gerardo Bosco
- Environmental Physiology & Medicine Laboratory, Department of Biomedical Sciences, University of Padova, 35122 Padova, Italy;
| | - Pierre Lafère
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
- DAN Europe Research Division, Contrada Padune, 64026 Roseto, Italy
| | - Costantino Balestra
- Environmental, Occupational, Aging (Integrative) Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), 1180 Brussels, Belgium; (M.L.); (K.L.); (P.G.); (H.P.); (P.L.)
- DAN Europe Research Division, Contrada Padune, 64026 Roseto, Italy
- Physical Activity Teaching Unit, Motor Sciences Department, Université Libre de Bruxelles (ULB), 1050 Brussels, Belgium
- Correspondence: (F.V.); (C.B.)
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Hayashi S, Otsuki T. Acute increase in arterial stiffness after swimming in cooler water. Clin Physiol Funct Imaging 2021; 41:426-433. [PMID: 34092007 DOI: 10.1111/cpf.12717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/01/2021] [Indexed: 11/29/2022]
Abstract
Cold stimuli increase arterial stiffness, but it has not been explored whether arterial stiffness increases after swimming in cooler water. To investigate the effects of water temperature on changes in arterial stiffness after swimming, 13 men participated in three trials of 20-min swimming in 25 and 30°C water (S25 and S30, respectively) and sitting at poolside (CON) in random order. There were no significant differences between the S25 and S30 trials in mean swimming distance (719 vs. 722 m) and heart rate reserve during swimming (63% vs. 63%). Sublingual temperature was lower after swimming in 25°C water versus before swimming. Aortic pulse wave velocity (aortic PWV, an index of central arterial stiffness based on applanation tonometry) and brachial-ankle pulse wave velocity (baPWV, an index of systemic arterial stiffness based on air plethysmography) were higher 30 min after versus before swimming in 25°C water. Aortic PWV recovered to pre-swimming levels by 60 min after swimming in 25°C water, but baPWV was higher even at 60 min after swimming. PWVs did not change in the CON and S30 trials. Systemic vascular resistance based on Doppler ultrasonography did not change, but forearm vascular resistance based on strain-gauge plethysmography was higher 30 and 60 min after swimming in 25°C water. Heart rate was higher, but stroke volume was lower 30 min after swimming in 25°C water, resulting in no detectable change in cardiac output. In conclusion, arterial stiffness increases acutely after moderate-intensity swimming in cooler water.
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Affiliation(s)
- Suguru Hayashi
- Graduate School of Sport and Health Sciences, Ryutsu Keizai University, Ryugasaki, Japan
| | - Takeshi Otsuki
- Faculty of Sport and Health Sciences, Ryutsu Keizai University, Ryugasaki, Japan
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Barak OF, Janjic N, Drvis I, Mijacika T, Mudnic I, Coombs GB, Thom SR, Madic D, Dujic Z. Vascular dysfunction following breath-hold diving. Can J Physiol Pharmacol 2020; 98:124-130. [PMID: 31505129 DOI: 10.1139/cjpp-2019-0341] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The pathogenesis of predominantly neurological decompression sickness (DCS) is multifactorial. In SCUBA diving, besides gas bubbles, DCS has been linked to microparticle release, impaired endothelial function, and platelet activation. This study focused on vascular damage and its potential role in the genesis of DCS in breath-hold diving. Eleven breath-hold divers participated in a field study comprising eight deep breath-hold dives with short surface periods and repetitive breath-hold dives lasting for 6 h. Endothelium-dependent vasodilation of the brachial artery, via flow-mediated dilation (FMD), and the number of microparticles (MPs) were assessed before and after each protocol. All measures were analyzed by two-way within-subject ANOVA (2 × 2 ANOVA; factors: time and protocol). Absolute FMD was reduced following both diving protocols (p < 0.001), with no interaction (p = 0.288) or main effect of protocol (p = 0.151). There was a significant difference in the total number of circulating MPs between protocols (p = 0.007), where both increased post-dive (p = 0.012). The number of CD31+/CD41- and CD66b+ MP subtypes, although different between protocols (p < 0.001), also increased by 41.0% ± 56.6% (p = 0.050) and 60.0% ± 53.2% (p = 0.045) following deep and repetitive breath-hold dives, respectively. Both deep and repetitive breath-hold diving lead to endothelial dysfunction that may play an important role in the genesis of neurological DCS.
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Affiliation(s)
- Otto F Barak
- Faculty of Medicine, University of Novi Sad, Serbia.,Faculty of Sports and Physical Education, University of Novi Sad, Serbia
| | | | - Ivan Drvis
- School of Kinesiology, University of Zagreb, Croatia
| | | | | | - Geoff B Coombs
- School of Health and Exercise Sciences, University of British Columbia Okanagan, Kelowna, BC V1V 1V7, Canada
| | - Stephen R Thom
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Dejan Madic
- Faculty of Sports and Physical Education, University of Novi Sad, Serbia
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Imbert JP, Egi SM, Germonpré P, Balestra C. Static Metabolic Bubbles as Precursors of Vascular Gas Emboli During Divers' Decompression: A Hypothesis Explaining Bubbling Variability. Front Physiol 2019; 10:807. [PMID: 31354506 PMCID: PMC6638188 DOI: 10.3389/fphys.2019.00807] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 06/06/2019] [Indexed: 12/15/2022] Open
Abstract
Introduction The risk for decompression sickness (DCS) after hyperbaric exposures (such as SCUBA diving) has been linked to the presence and quantity of vascular gas emboli (VGE) after surfacing from the dive. These VGE can be semi-quantified by ultrasound Doppler and quantified via precordial echocardiography. However, for an identical dive, VGE monitoring of divers shows variations related to individual susceptibility, and, for a same diver, dive-to-dive variations which may be influenced by pre-dive pre-conditioning. These variations are not explained by currently used algorithms. In this paper, we present a new hypothesis: individual metabolic processes, through the oxygen window (OW) or Inherent Unsaturation of tissues, modulate the presence and volume of static metabolic bubbles (SMB) that in turn act as precursors of circulating VGE after a dive. Methods We derive a coherent system of assumptions to describe static gas bubbles, located on the vessel endothelium at hydrophobic sites, that would be activated during decompression and become the source of VGE. We first refer to the OW and show that it creates a local tissue unsaturation that can generate and stabilize static gas phases in the diver at the surface. We then use Non-extensive thermodynamics to derive an equilibrium equation that avoids any geometrical description. The final equation links the SMB volume directly to the metabolism. Results and Discussion Our model introduces a stable population of small gas pockets of an intermediate size between the nanobubbles nucleating on the active sites and the VGE detected in the venous blood. The resulting equation, when checked against our own previously published data and the relevant scientific literature, supports both individual variation and the induced differences observed in pre-conditioning experiments. It also explains the variability in VGE counts based on age, fitness, type and frequency of physical activities. Finally, it fits into the general scheme of the arterial bubble assumption for the description of the DCS risk. Conclusion Metabolism characterization of the pre-dive SMB population opens new possibilities for decompression algorithms by considering the diver's individual susceptibility and recent history (life style, exercise) to predict the level of VGE during and after decompression.
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Affiliation(s)
| | - Salih Murat Egi
- Department of Computer Engineering, Galatasaray University, Istanbul, Turkey.,DAN Europe Research Division, Divers Alert Network (DAN), Roseto, Italy
| | - Peter Germonpré
- DAN Europe Research Division, Divers Alert Network (DAN), Roseto, Italy.,Centre for Hyperbaric Oxygen Therapy, Military Hospital Brussels, Brussels, Belgium
| | - Costantino Balestra
- DAN Europe Research Division, Divers Alert Network (DAN), Roseto, Italy.,Environmental, Occupational and Ageing Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium
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10
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Walsh C, Ovenden N, Stride E, Cheema U. Quantification of cell-bubble interactions in a 3D engineered tissue phantom. Sci Rep 2017; 7:6331. [PMID: 28740100 PMCID: PMC5524813 DOI: 10.1038/s41598-017-06678-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 06/14/2017] [Indexed: 12/23/2022] Open
Abstract
Understanding cell-bubble interactions is crucial for preventing bubble related pathologies and harnessing their potential therapeutic benefits. Bubbles can occur in the body as a result of therapeutic intravenous administration, surgery, infections or decompression. Subsequent interactions with living cells, may result in pathological responses such as decompression sickness (DCS). This work investigates the interactions that occur between bubbles formed during decompression and cells in a 3D engineered tissue phantom. Increasing the tissue phantoms' cellular density resulted in decreased dissolved O2 (DO) concentrations (p = 0.0003) measured using real-time O2 monitoring. Direct microscopic observation of these phantoms, revealed a significant (p = 0.0024) corresponding reduction in bubble nucleation. No significant difference in growth rate or maximum size of the bubbles was measured (p = 0.99 and 0.23). These results show that bubble nucleation is dominated by DO concentration (affected by cellular metabolism), rather than potential nucleation sites provided by cell-surfaces. Consequent bubble growth depends not only on DO concentration but also on competition for dissolved gas. Cell death was found to significantly increase (p = 0.0116) following a bubble-forming decompression. By comparison to 2D experiments; the more biomimetic 3D geometry and extracellular matrix in this work, provide data more applicable for understanding and developing models of in vivo bubble dynamics.
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Affiliation(s)
- C Walsh
- Centre for Mathematics and Physics in the Life Sciences and Experimental Biology (CoMPLEX), UCL Physics Building Gower Street, London, WC1E 6BT, UK.
- UCL Institute of Orthopaedics and Musculoskeletal Science, London, UK.
- Department of Mathematics, University College London, London, UK.
| | - N Ovenden
- Department of Mathematics, University College London, London, UK
| | - E Stride
- Institute of Biomedical Engineering, Old Road Campus Research Building, University of Oxford, Oxford, UK
| | - U Cheema
- UCL Institute of Orthopaedics and Musculoskeletal Science, London, UK
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11
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Venous gas emboli are involved in post-dive macro, but not microvascular dysfunction. Eur J Appl Physiol 2017; 117:335-344. [DOI: 10.1007/s00421-017-3537-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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Wang Q, Guerrero F, Mazur A, Lambrechts K, Buzzacott P, Belhomme M, Theron M. Reactive Oxygen Species, Mitochondria, and Endothelial Cell Death during In Vitro Simulated Dives. Med Sci Sports Exerc 2016; 47:1362-71. [PMID: 25380471 DOI: 10.1249/mss.0000000000000563] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE Excessive reactive oxygen species (ROS) is considered a consequence of hyperoxia and a major contributor to diving-derived vascular endothelial damage and decompression sickness. The aims of this work were: 1) to directly observe endothelial ROS production during simulated air dives as well as its relation with both mitochondrial activity and cell survival; and 2) to determine which ambient factor during air diving (hydrostatic pressure or oxygen and/or nitrogen partial pressure) is responsible for the observed modifications. METHODS In vitro diving simulation was performed with bovine arterial endothelial cells under real-time observation. The effects of air diving, hydrostatic, oxygen and nitrogen pressures, and N-acetylcysteine (NAC) treatment on mitochondrial ROS generation, mitochondrial membrane potential and cellular survival during simulation were investigated. RESULTS Vascular endothelial cells performing air diving simulation suffered excessive mitochondrial ROS, mitochondrial depolarization, and cell death. These effects were prevented by NAC: after NAC treatment, the cells presented no difference in damage from nondiving cells. Oxygen diving showed a higher effect on ROS generation but lower impacts on mitochondrial depolarization and cell death than hydrostatic or nitrogen diving. Nitrogen diving had no effect on the inductions of ROS, mito-depolarization, or cell death. CONCLUSION This study is the first direct observation of mitochondrial ROS production, mitochondrial membrane potential and cell survival during diving. Simulated air SCUBA diving induces excessive ROS production, which leads to mitochondrial depolarization and endothelial cell death. Oxygen partial pressure plays a crucial role in the production of ROS. Deleterious effects of hyperoxia-induced ROS are potentiated by hydrostatic pressure. These findings hold new implications for the pathogenesis of diving-derived endothelial dysfunction.
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Affiliation(s)
- Qiong Wang
- Laboratory ORPHY, Department of UFR Sciences and Technologies, European University of Bretagne, University of Brest, Brest, FRANCE
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Mazur A, Lambrechts K, Wang Q, Belhomme M, Theron M, Buzzacott P, Guerrero F. Influence of decompression sickness on vasocontraction of isolated rat vessels. J Appl Physiol (1985) 2016; 120:784-91. [PMID: 26769950 DOI: 10.1152/japplphysiol.00139.2015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 01/12/2016] [Indexed: 01/03/2023] Open
Abstract
Studies conducted in divers indicate that endothelium function is impaired following a dive even without decompression sickness (DCS). Our previous experiment conducted on rat isolated vessels showed no differences in endothelium-dependent vasodilation after a simulated dive even in the presence of DCS, while contractile response to phenylephrine was progressively impaired with increased decompression stress. This study aimed to further investigate the effect of DCS on vascular smooth muscle. Thirty-two male Sprague-Dawley rats were submitted to the same hyperbaric protocol and classified according to the severity of DCS: no-DCS (without clinical symptoms), mild-DCS, or severe-DCS (dead within 1 h). A control group remained at atmospheric pressure. Isometric tension was measured in rings of abdominal aorta and mesenteric arteries. Single dose contraction was assessed with KCl solution. Dose-response curves were obtained with phenylephrine and endothelin-1. Phenylephrine-induced contraction was observed in the presence of antioxidant tempol. Additionally, plasma concentrations of angiotensin II, angiotensin-converting enzyme, and thiobarbituric acid reactive substances (TBARS) were assessed. Response to phenylephrine was impaired only among mild-DCS in both vessels. Dose-response curves to endothelin-1 were impaired after mild-DCS in mesenteric and severe-DCS in aorta. KCl-induced contraction was affected after hyperbaric exposure regardless of DCS status in aorta only. These results confirm postdive vascular dysfunction is dependent on the type of vessel. It further evidenced that vascular dysfunction is triggered by DCS rather than by diving itself and suggest the influence of circulating factor/s. Diving-induced impairment of the L-type voltage-dependent Ca(2+) channels and/or influence of renin-angiotensin system is proposed.
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Affiliation(s)
- Aleksandra Mazur
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - Kate Lambrechts
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - Qiong Wang
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - Marc Belhomme
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - Michael Theron
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - Peter Buzzacott
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
| | - François Guerrero
- EA4324-ORPHY Laboratory, Université de Bretagne Occidentale, Brest, France
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Balestra C, Cimino F, Theunissen S, Snoeck T, Provyn S, Canali R, Bonina A, Virgili F. A red orange extract modulates the vascular response to a recreational dive: a pilot study on the effect of anthocyanins on the physiological consequences of scuba diving. Nat Prod Res 2015; 30:2101-6. [PMID: 26548425 DOI: 10.1080/14786419.2015.1107062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Nutritional antioxidants have been proposed as an expedient strategy to counter the potentially deleterious effects of scuba diving on endothelial function, flow-mediated dilation (FMD) and heart function. Sixteen volunteers performing a single standard dive (20 min at 33 m) according to US Navy diving procedures were randomly assigned to two groups: one was administered with two doses of 200 mg of an anthocyanins (AC)-rich extract from red oranges, 12 and 4 h before diving. Anthocyanins supplementation significantly modulated the effects of diving on haematocrit, body water distribution and FMD. AC administration significantly reduces the potentially harmful endothelial effects of a recreational single dive. The lack of any significant effect on the most common markers of plasma antioxidant capacity suggests that the mechanism underlying this protective activity is independent of the putative antioxidant effect of AC and possibly involves cellular signalling modulation of the response to high oxygen.
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Affiliation(s)
- C Balestra
- a Environmental and Occupational (Integrative) Physiology Laboratory , Haute Ecole Paul Henri Spaak , Brussels , Belgium
| | - F Cimino
- b Department Farmaco-Biologico, School of Pharmacy , University of Messina , Messina , Italy
| | - S Theunissen
- a Environmental and Occupational (Integrative) Physiology Laboratory , Haute Ecole Paul Henri Spaak , Brussels , Belgium
| | - T Snoeck
- c Department of Experimental Anatomy , Vrije Universiteit Brussel , Brussels , Belgium
| | - S Provyn
- c Department of Experimental Anatomy , Vrije Universiteit Brussel , Brussels , Belgium
| | - R Canali
- d Council for Agricultural Research and Economics - Food and Nutrition Research Centre (C.R.A. - NUT) , Rome , Italy
| | | | - F Virgili
- d Council for Agricultural Research and Economics - Food and Nutrition Research Centre (C.R.A. - NUT) , Rome , Italy
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