A recent study, “VEGF and bFGF induction by nitric oxide is associated with hyperbaric oxygen-induced angiogenesis and muscle regeneration” published in weekly international peer-reviewed research journal Nature in February 2020 found hyperbaric oxygen therapy (HBOT) increased the development of new blood vessels (angiogenesis), therefore, stimulating injury recovery.
A key mechanism for promoting early recovery from muscle injury is reactive oxygen species (ROS), which generally manifests as the production of oxygen in tissues through the “increased dissolution of oxygen at high pressure.”
Nitric oxide (NO), a type of ROS, acts as a stabilizer of hypoxia-induced factor (HIF) 1α, stimulator of the secretion of vascular endothelial growth factor (VEGF) from endothelial cells and macrophages, and stimulator of the secretion of basic fibroblast growth factor (bFGF) from endothelial cells and macrophages—all of which are linked to the induction of angiogenesis.
The purpose of the study was to determine whether HBOT could bolster blood vessel development through NO production and induce muscle regeneration in contused rat skeletal muscle.
Researchers hypothesized HBOT increases ROS and NO levels and “subsequently induces secretion of bFGF [basic fibroblast growth factor], HGF [hepatocyte growth factor], and VEGF [vascular endothelial growth factor] to accelerate revascularization, thereby supporting muscle regeneration.”
They included 445 male 10-week-old Wistar rats with contusion injuries in the trial. Fifteen minutes after injury, the rats in the HBOT group were placed in the hyperbaric “chamber in which 100 percent oxygen was administered at 2.5 [atmospheres absolute (ATA)] pressure for two hours, with 15 minutes for compression, 120 minutes of exposure at 2.5 ATA, and 15 minutes of decompression under 100 percent oxygen.” HBOT was then administered once a day for five consecutive days.
“When looking to accelerate the return to competition, consider HBOT”
-Dr. Alan Katz
As part of the study, researchers also introduced two inhibitors—a ROS inhibitor (NAC) or NOS-specific inhibitor (L-NAME)—to observe their effects on the HBOT treatments.
In just three hours, VEGF levels increased, and in six hours, bFGF levels in the HBOT group grew significantly. Additionally, researchers observed a surge of immature blood vessels three days later, along with a rise of mature vessels three and seven days after injury.
The trial found HBOT significantly increased NO3−, VEGF, and bFGF levels and stabilized HIF1α within one day, and promoted blood vessel formation three to seven days, and muscle healing five to seven days after contusion.
The conclusions: HBOT enhances angiogenesis and muscle regeneration through generation of NO in the early phase after muscle contusion injury.
The study’s results underscore HBOT’s benefits in treating injured athletes and incorporation in recovery regimens. Hyperbaric Medical Solutions Medical Director, Dr. Alan Katz, praises the study, emphasizing HBOT’s effectiveness in promoting healing.
“In our practice, we often treat injured athletes, both professionals and weekend warriors, in an attempt to help them return to sports quicker,” he explains. “This article beautifully demonstrates the utility of using HBOT to accelerate healing in the injured athletes. The upregulation of VEGF and bFGF via stabilization of HIF 1 alpha allows for the promotion of angiogenesis and muscle regeneration."
“So when looking to accelerate the return to competition, consider HBOT,” adds Katz.
Contact Hyperbaric Medical Solutions to learn more about HBOT and how we can help you recover from your injury.