Hyperbaric oxygen therapy (HBOT) is a type of treatment used to accelerate the healing of stubborn wounds and infections in which cells are starved for oxygen. Patients who undergo HBOT enter a special chamber and breathe in pure oxygen in air pressure levels up to three times higher than average. By pumping enough oxygen into the bloodstream, HBOT could hasten the repair of damaged tissue and restore normal body function.
But as the TAU researchers said in their report, which appeared in the journal Aging, HBOT has significant senolytic effects, meaning it can clear aging or senescent cells that are no longer capable of dividing. This high-pressure oxygen therapy can also increase the length of telomeres, which grow shorter as part of the normal cell aging process.
"Today telomere shortening is considered the ‘Holy Grail’ of the biology of aging," said Professor Shai Efrati, an associate professor at TAU and the study's senior author, in a release from TAU. "Researchers around the world are trying to develop pharmacological and environmental interventions that enable telomere elongation. Our HBOT protocol was able to achieve this, proving that the aging process can in fact be reversed at the basic cellular-molecular level."
What is hyperbaric oxygen therapy?
The first hyperbaric chamber in the U.S. was built in 1861 in New York to treat nervous system-related conditions. But the use of a high-pressure environment for medical treatment did not catch on until the early 1900s when Orville Cunningham, a professor of anesthesia and famous hyperbaric practitioner, successfully treated a colleague who was near death due to influenza with HBOT.
Cunningham observed that people who lived at higher elevations had higher mortality rates than those who lived at sea level, prompting him to believe that barometric pressure had something to do with this discrepancy. He later on built the largest hyperbaric chamber ever constructed in Cleveland, which became known as the "Cunningham Sanitarium."
During Cunningham's time, patients would live in the five-stories-tall chamber for up to two weeks, cycling between normal and high-pressure environments. Today, however, HBOT therapy is conducted in one- to two-hour sessions only during which patients are asked to either sit or lie comfortably inside a hyperbaric oxygen chamber and take deep breaths.
The influx of oxygen is believed to not only help fight bacterial infections but also to stimulate the release of growth factors and the activity of stem cells, which promote the body's natural ability to heal. HBOT also prompts antioxidants to scavenge free radicals, preventing these harmful molecules from disrupting the process of tissue repair. Additionally, HBOT promotes the formation of new collagen, skin cells and blood vessels, all of which are necessary for healing.
Modern HBOT is now approved for use in the treatment of a variety of conditions, which range from burns, cyanide and carbon monoxide poisoning and decompression sickness to bone infection (osteomyelitis), severe anemia, brain abscess, traumatic brain injury, gangrene, deafness and diabetic foot ulcer.
HBOT: an exciting therapy that can combat aging
"For many years our team has been engaged in hyperbaric research and therapy – treatments based on protocols of exposure to high-pressure oxygen at various concentrations inside a pressure chamber," said Efrati, who is also the founder and director of the Sagol Center for Hyperbaric Medicine and Research, the largest hyperbaric treatment center worldwide.
"Our achievements over the years included the improvement of brain functions damaged by age, stroke or brain injury. In the current study we wished to examine the impact of HBOT on healthy and independent aging adults, and to discover whether such treatments can slow down, stop or even reverse the normal aging process at the cellular level."
Efrati and his team focused on two key hallmarks of the aging process, namely, cellular senescence and the shortening of telomeres -- the protective caps that prevent chromosomes from fraying. These short, repetitive DNA sequences naturally get shorter each time cells undergo division and DNA replication. The progressive shortening of telomeres leads to cell aging (senescence) as well as other events (i.e., apoptosis or cancer development) that affect a person's health and lifespan.
For their experiment, the researchers recruited 35 healthy adults aged 64 and above to receive 60 daily HBOT exposures. They collected blood samples at baseline, at the 30th and 60th sessions, and one or two weeks after the last HBOT session. From there, they assessed changes in telomere length in the peripheral blood mononuclear cells (PBMCs) -- a mixture of different types of white blood cells -- of the participants.
The researchers found that HBOT increased the length of PMBC telomeres by more than 20 percent. The most significant increase was observed in cells known as B lymphocytes, which are the immune cells responsible for producing antibodies. At the 30th HBOT session, telomere length in these cells increased by almost 26 percent. It further increased by nearly 30 percent at the 60th session and by 38 percent after the last hyperbaric treatment.
The researchers also found that HBOT decreased the number of senescent T helper cells by around 37 percent after the last session. The number of senescent cytotoxic T cells -- immune cells that kill infected cells and tumors -- also decreased by nearly 11 percent at this point. According to the researchers, these results clearly demonstrate the ability of HBOT to stop and even reverse aging. (Related: A lack of oxygen accelerates aging: Researchers find a link between sleep-disordered breathing and rapid aging.)
"Until now, interventions such as lifestyle modifications and intense exercise were shown to have some inhibiting effect on telomere shortening," said Dr. Amir Hadanny, one of the lead authors of the study. "But in our study, only three months of HBOT were able to elongate telomeres at rates far beyond any currently available interventions or lifestyle modifications. With this pioneering study, we have opened a door for further research on the cellular impact of HBOT and its potential for reversing the aging process."
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