The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study

Introduction: Patients with an uncontrolled glycemic index develop a wide variety of pathologies associated with diabetes, such as diabetic foot ulcers (DFUs). Hyperbaric oxygen therapy (HBOT) is an adjunctive therapy used to heal wounds and prevent lower extremity amputations in this population. Ob...

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Main Authors: Nadia Mabel Pérez-Vielma, María Magdalena Valencia Gutiérrez, Jennifer Viridiana Sánchez Camacho, José Enrique González Hernández, Ángel Miliar García, César Ochoa, Jonathan Labovitz, Modesto Gómez López
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Language:English
Published: Elsevier 2024-12-01
Series:Heliyon
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405844024166170
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author Nadia Mabel Pérez-Vielma
María Magdalena Valencia Gutiérrez
Jennifer Viridiana Sánchez Camacho
José Enrique González Hernández
Ángel Miliar García
César Ochoa
Jonathan Labovitz
Modesto Gómez López
author_facet Nadia Mabel Pérez-Vielma
María Magdalena Valencia Gutiérrez
Jennifer Viridiana Sánchez Camacho
José Enrique González Hernández
Ángel Miliar García
César Ochoa
Jonathan Labovitz
Modesto Gómez López
author_sort Nadia Mabel Pérez-Vielma
collection DOAJ
description Introduction: Patients with an uncontrolled glycemic index develop a wide variety of pathologies associated with diabetes, such as diabetic foot ulcers (DFUs). Hyperbaric oxygen therapy (HBOT) is an adjunctive therapy used to heal wounds and prevent lower extremity amputations in this population. Objective: This preliminary study aimed to evaluate how HBOT impacts inflammation in patients with Wagner stages 2–4 DFUs by analyzing its effect on the gene expression of key oxidative stress regulators SOD1, SOD2, and GPX2, of pro-inflammatory cytokines TNFα, IL-1β, IL-4, and IL-12, and of the NLRP3 inflammasome. Methods: The effect of HBOT was assessed in 15 patients with Wagner stages 2–4 DFUs that underwent 30 sessions in the hyperbaric chamber. This protocol is registered on Clinical Trials under the title Hyperbaric Oxygen Therapy in Diabetic Foot (July 15, 2024) with the number NCT06502808. Blood samples were collected, and relative gene expression was assessed by quantitative real-time polymerase chain reaction (qPCR). Results: The hyperbaric chamber treatment increased the expression of SOD1 and GPX2 genes (0.4 and 3 times, respectively) after 30 sessions compared to baseline levels. Similarly, the gene expression of pro-inflammatory cytokines IL-1β, IL-12, IL-4, and NLRP3 increased after 30 sessions (2.1, 0.4, 1.5, and 1.2, respectively), while the expression of the TNFα gene decreased (0.5 times). Clinically, the patients’ lesions were fully resolved. Conclusions: HBOT directly influences the gene expression of several potent antioxidants and pro-inflammatory cytokines, thus favoring angiogenesis and blood circulation in the extremities.
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spelling doaj-art-7a8e8b1a4aca4854ba73268c20dd98a92024-12-13T10:59:09ZengElsevierHeliyon2405-84402024-12-011023e40586The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary studyNadia Mabel Pérez-Vielma0María Magdalena Valencia Gutiérrez1Jennifer Viridiana Sánchez Camacho2José Enrique González Hernández3Ángel Miliar García4César Ochoa5Jonathan Labovitz6Modesto Gómez López7Sección de Estudios de Posgrado e Investigación, Centro Interdisciplinario de Ciencias de la Salud, Unidad Santo-Tomas, Instituto Politécnico Nacional, MéxicoSección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, MéxicoSección de Estudios de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, MéxicoClínica Especializada en el Manejo de Diabetes, CDMX, MéxicoLaboratorio de Biología Molecular, Escuela Superior de Medicina, Instituto Politécnico Nacional, MéxicoClinical Research Center at Western U Health, Western University of Health Sciences, Pomona, CA, USACollege of Podiatric Medicine, Western University of Health Sciences, Pomona, CA, USABiología Molecular del Proceso Inflamatorio, Escuela Superior de Medicina, Instituto Politécnico Nacional, México; Corresponding author. Escuela Superior de Medicina, Plan de San Luis y Díaz Mirón sin número, Santo Tomás, Miguel Hidalgo, 11360, Ciudad de México, CDMX, México.Introduction: Patients with an uncontrolled glycemic index develop a wide variety of pathologies associated with diabetes, such as diabetic foot ulcers (DFUs). Hyperbaric oxygen therapy (HBOT) is an adjunctive therapy used to heal wounds and prevent lower extremity amputations in this population. Objective: This preliminary study aimed to evaluate how HBOT impacts inflammation in patients with Wagner stages 2–4 DFUs by analyzing its effect on the gene expression of key oxidative stress regulators SOD1, SOD2, and GPX2, of pro-inflammatory cytokines TNFα, IL-1β, IL-4, and IL-12, and of the NLRP3 inflammasome. Methods: The effect of HBOT was assessed in 15 patients with Wagner stages 2–4 DFUs that underwent 30 sessions in the hyperbaric chamber. This protocol is registered on Clinical Trials under the title Hyperbaric Oxygen Therapy in Diabetic Foot (July 15, 2024) with the number NCT06502808. Blood samples were collected, and relative gene expression was assessed by quantitative real-time polymerase chain reaction (qPCR). Results: The hyperbaric chamber treatment increased the expression of SOD1 and GPX2 genes (0.4 and 3 times, respectively) after 30 sessions compared to baseline levels. Similarly, the gene expression of pro-inflammatory cytokines IL-1β, IL-12, IL-4, and NLRP3 increased after 30 sessions (2.1, 0.4, 1.5, and 1.2, respectively), while the expression of the TNFα gene decreased (0.5 times). Clinically, the patients’ lesions were fully resolved. Conclusions: HBOT directly influences the gene expression of several potent antioxidants and pro-inflammatory cytokines, thus favoring angiogenesis and blood circulation in the extremities.http://www.sciencedirect.com/science/article/pii/S2405844024166170Diabetic footGene expressionHyperbaric oxygen therapyOxidative stressInflammation
spellingShingle Nadia Mabel Pérez-Vielma
María Magdalena Valencia Gutiérrez
Jennifer Viridiana Sánchez Camacho
José Enrique González Hernández
Ángel Miliar García
César Ochoa
Jonathan Labovitz
Modesto Gómez López
The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
Heliyon
Diabetic foot
Gene expression
Hyperbaric oxygen therapy
Oxidative stress
Inflammation
title The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
title_full The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
title_fullStr The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
title_full_unstemmed The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
title_short The effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers: A preliminary study
title_sort effect of hyperbaric oxygen therapy on oxidative stress and inflammation in patients with diabetic foot ulcers a preliminary study
topic Diabetic foot
Gene expression
Hyperbaric oxygen therapy
Oxidative stress
Inflammation
url http://www.sciencedirect.com/science/article/pii/S2405844024166170
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