Hyperbaric oxygen influences chronic wound healing - a cellular level review

Area of Science:

• Cellular Biology
• Wound Healing Research
• Hyperbaric Medicine

Background:

• Chronic wounds present significant clinical challenges with variable treatment outcomes.
• Hyperbaric oxygen therapy (HBOT) is a potential therapeutic modality with debated efficacy.
• Understanding HBOT's cellular effects is crucial for optimizing chronic wound management.

Purpose of the Study:

• To review the cellular-level effects of HBOT on chronic wound healing models.
• To elucidate the mechanisms underlying HBOT's potential therapeutic benefits.
• To discuss the limitations of translating in vitro and animal model findings to clinical practice.

Main Methods:

• Literature review of studies investigating HBOT effects on cell cultures and animal models of chronic wounds.
• Analysis of HBOT's impact on reactive oxygen/nitrogen species (ROS/RNS) production.
• Examination of HBOT's influence on Hypoxia-inducible factor 1 (HIF-1) and Heat Shock Proteins (HSP).

Main Results:

• HBOT increases ROS/RNS production, influencing both therapeutic and toxic effects.
• HBOT paradoxically elevates HIF-1 concentration, stimulating growth factor production.
• HBOT promotes fibroblast growth, collagen synthesis, and exhibits antimicrobial properties while suppressing matrix metalloproteinases.

Conclusions:

• HBOT demonstrates multifaceted cellular effects beneficial for wound healing, including growth factor stimulation and antimicrobial activity.
• The paradoxical elevation of HIF-1 and support of HSP synthesis are key mechanisms.
• Further research is needed to bridge the gap between preclinical findings and clinical application in chronic wound care.