Hyperbaric oxygen therapy stimulates colonic stem cells and induces mucosal healing in patients with refractory
Mohamed Bekheit1, Nahed Baddour2, Khaled Katri3
1Department of Surgery, El Kabbary General Hospital, Alexandria, Egypt; Department of Surgery, Faculty of Medicine, Alexandria Main University Hospital, Alexandria, Egypt.
Background:
Hyperbaric oxygen (HBO) is used as part of treatment in a variety of clinical conditions. Its use in the treatment of ulcerative colitis has been reported in few clinical reports.
Objective:
We report the effect of HBO on refractory ulcerative colitis exploring one potential mechanism of action.
Design:
A review of records of patients with refractory ulcerative colitis who received HBO was conducted. Clinical and histopathological scoring was utilised to evaluate the response to HBO therapy (HBOT).
Results:
All patients manifested clinical improvement by the 40th cycle of HBOT. The median number of stool frequency dropped from seven motions/day (range=3-20) to 1/day (range=0.5-3), which was significant (z=-4.6, p<0.001). None of the patients manifested persistent blood passage after HBOT (z=-3.2, p=0.002). The severity index significantly improved after HBOT (z=-4.97, p<0.001). Histologically, a significant reduction of the scores of activity was recorded accompanied by a significant increase in the proliferating cell nuclear antigen labelling index of the CD44 cells of the colonic mucosa (p=0.001).
Conclusions:
HBOT is effective in the setting of refractory ulcerative colitis. The described protocol is necessary for successful treatment. HBOT stimulates colonic stem cells to promote healing.
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