Effects of Hyperbaric Oxygen Therapy on the Increase of iNOS and NFKB Expressions and the Acceleration of Wound Healing Process during Inflammation and Proliferation Phases

Abstract

Wound is one of the most common causes of morbidity in developing countries. Hyperbaric Oxygen Therapy (HBO), which can improve tissue oxygenation and stimulate the formation of H2O2 as a secondary messenger to Nuclear Factor Kappa Beta (NFKB) Phosporylation, has increasingly been used in wound treatment. Principal mechanism of HBO is based on intracellular generation of Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS), including Nitric Oxide (NO). In the wound area, moreover, the great amount of NO is mostly generated by the enzyme inducible Nitric Oxide Synthase (iNOS) through NFKB pathway. The beneficial effects of NO in wound repair may be attributed to its functional influences on angiogenesis, inflammation, cell proliferation, matrix deposition and remodeling.Accordingly, this research aims to determine whether Hyperbaric Oxygen Therapy (HBO) can improve iNOS and NFKB expressions and wound healing process. This research used a ‘Randomized control group pre test-post test design’ with twenty-eight wistar rats. These rats were divided into 4 groups (random allocation), namely treatment group 1 receiving 5 sessions of HBO theraphy, treatment group 2 receiving 10 sessions of HBO theraphy, and two control groups, each of which receives the same number of session as each of the two treatment groups yet without HBO theraphy. The result showed Hyperbaric oxygen therapy can improve iNOS expression (p=0.001), NFKB expression (p=0.04) and wound healing process (p=0.002) significantly in the treatment group receiving the five sesions of HBO theraphy at 2.4 ATA for 3x30 minutes. On the other hand, in the treatment group receiving the ten-session HBO theraphy, only iNOS expression (p=0.002) and NFKB expression (p=0.03) were significantly increased, while wound healing process cannot be improved. Therefore, further researches are required to focus on both the repetition time interval after provision of five-session hyperbaric oxygen therapy (during recovery period) and the use of HBO as adjuvant therapy for various types of wounds.