Applications of HBOT in rheumatologic pathologies

Hyperbaric Oxygenation Treatment (HBOT) is applied in inflammatory-based pathologies, such as those affecting bone tissues, motor apparatus, connective tissue and joints. These rheumatic diseases are usually treated in a multidisciplinary way, through therapeutic strategies to reduce inflammation, pain and improve the quality of life.

In hypoxia situations, low pO2 is responsible for cell damage and alterations in perfusion. Angiogenesis becomes slower and even nil, the function of fibroblasts decreases and the formation of collagen is compromised. At the cellular level, hyperoxia solves all these functions, since they are dependent on O2. HBOT plays an important protective role during ischemia situations, through the action of hyperoxia by reducing lipo-peroxidation in ischemia-reperfusion processes.

In disabling diseases such as rheumatoid arthritis (RA), characterized by the presence of pain and deterioration of quality of life, the use of HBOT favors the relief of pain and the reduction of joint inflammation. This relief is produced by an increase in enzymatic antioxidant capacity, which favors a decrease in lipid peroxides. The treatment of RA patients with HBOT gives good clinical results, both immediately and in the long term, thanks to the relief of systemic symptoms and the modulation of the immune response.

In other rheumatic diseases such as systemic lupus erythematosus (SLE) it has been observed that HBOT is able to inhibit the action of some pro-inflammatory cytokines, acting as an immune modulator. In patients with SLE and / or scleroderma, HBOT improves cognitive dysfunction.

Particularly in patients with FM, HBOT can improve symptoms and quality of life, since it improves perfusion and normalizes activity in brain areas related to pain. The pain relief favored by HBOT in FM is related to its ability to stimulate angiogenesis.

HBOT is also effective in the treatment of aggressive infections affecting the bones, such as osteomyelitis (OM). The use of HBOT increases the pO2 necessary for neovascularization, the reversal of ischemia, the acceleration of healing, and the inhibition of the growth of anaerobic micro-organisms by stimulating the phagocytic action of leukocytes in hypoxic tissues, promoting osteogenesis and the activation of osteoclasts in the removal of bone debris.

Hyperbaric oxygenation has direct and indirect antimicrobial effects and avoids the systemic inflammatory response, helping to delimit viable and non-viable tissue, reducing the extent of debridement, amputations, morbidity and mortality. In situations of bone necrosis, early damage to the microcirculation may appear, requiring the restoration of bone oxygenation. The use of HBOT in these conditions promotes the synthesis of collagen, the proliferation of fibroblasts, the neo-vascularization and reduction of edema, thanks to vasoconstriction and the increase of tissue oxygenation.

HBOT is used as adjuvant treatment in rheumatology to relieve pain, modulate the immune response, reduce inflammation, the risk of infections and amputations, accelerate recovery, reconstitute perfusion and improve quality of life. Particularly it is used as a coadjuvant treatment of auto-immune pathologies, connective tissue, chronic pain and bone infections.

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