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How Hyperbaric Oxygen Therapy is Helping Those with Traumatic Brain Injury (TBI)

hbot-and-tbi-brain-injuryTraumatic brain injury (TBI) often leads to devastating results not because of the initial blow to the head, but instead because of the inflammatory processes that follow as a consequence of the hit. Thus, preventing or slowing the inflammation that occurs after the trauma to the head can vastly improve patient outcomes. Hyperbaric oxygen therapy (HBOT) has been shown in animal models to reduce this inflammation and thereby protect the brain from significant damage. Now, scientists help clarify exactly how HBOT has this advantageous effect on the brain. This new research was recently published in the journal Neuroimmunomodulation.

The scientists used four groups of mice: one without injury and without HBOT, one without injury with HBOT, one with TBI without HBOT, and one with TBI with HBOT. They expected that the final group, which had both TBI and the HBOT intervention would show significant differences in performance and in physiology before and after the treatment, whereas the other groups tested at different time points would not show these differences.

As expected, the researchers found that HBOT led to better motor performance and lower brain swelling, known as edema, in the group of mice that had TBI. After HBOT, these mice also had lower protein expression of elements that contribute to inflammation. Specifically, the expression of inflammasome components, IL-1b, IL-18, and high-mobility group box 1 were all reduced by HBOT following TBI.

These findings corroborate previous findings that HBOT is a beneficial intervention for TBI and help explain exactly how HBOT confers its positive impact on a traumatically injured brain. Future research will help identify the best ways to use this therapy to help patients who suffer trauma to the head.

Reference

Geng, F., Ma, Y., Xing, T., Zhuang, X., Zhu, J., & Yao, L. (2016). Effects of hyperbaric oxygen therapy on inflammasome signaling after traumatic brain injury. Neuroimmunomodulation. DOI: 10.1159/000445689

Study Shows Stem Cells Helping with Progressive Supranuclear Palsy (PSP)

progressive-supernuclear-palsyResearch has pointed strongly toward autologous adipose tissue-derived mesencymal stem cells (AdMSC‘s) as a treatment option for a number of neurological diseases. There is growing evidence that these cells can successfully differentiate into neurons in the brain, thereby protecting the brain against certain diseases of the central nervous system. Adipose tissue is particularly attractive when seeking to use mesenchymal stem cells (MSC’s) because it is easy to retrieve MSCs in this type of tissue. Now, a case study published in the Journal of Medical Case Reports demonstrates how AdMSC‘s were successfully used to treat a patient suffering from progressive supranuclear palsy (PSP), a disorder closely related to Parkinson’s disease.

There are currently no good treatment options for PSP. Dopaminergic drugs that are used for Parkinson’s disease are often implemented with PSP patients because of clinical similarities in these diseases. However, the benefits are both minor and short-lived. As described in this case report, researchers successfully used a novel form of therapy on a 71-year old South Korean man with PSP.

The man was examined before his treatment and continually for six months afterwards. The AdMSC protocol improved the patient’s performance on the Progressive Supranuclear Palsy Rating Scale (PSPRS) and improved both his cognitive performance and his ability to conduct daily activities. In addition to the treatment’s efficacy, it also bore limited safety concerns, as mild fever and short-term elevated blood pressure were the only adverse side affects observed with the procedure.

The patient underwent four intrathecal and five intravenous infusions infusions of AdMSC’s to increase the chances of clinical efficacy. Specifically, the strategy of the intrathecal infusions was to increase the likelihood of getting the AdMSC’s into the central nervous system. However, because the intrathecal cavity is narrow, the dosage that can be achieved through this route is limited. Thus, intravenous injections were administered as a way to increase the dosage amount. Though this success of AdMSC’s administration in PSP is just the beginning, it represents great potential for the use of stem cells in this rare but deadly disorder.

Reference

Choi, S.W., Park, K.B., Woo, S.K., Kang, S.K., & Ra, J.C. (2014). Treatment of progressive supranuclear palsy with autologous adipose tissue-derived mesenchymal stem cells: a case report. Journal of Medical Case Reports, 8(87), 1-5.

Stem Cells and Hyperbaric Oxygen Treatment Helping with Traumatic Brain Injury

Both Hyperbaric Oxygen (HBO) treatment and Mesenchymal Stem Cells (MSC‘s) have been used as interventions for patients suffering from Traumatic Brain Injury (TBI). Though each of these therapeutic approaches can confer benefits to patients, researchers have shown that combining the two techniques can yield better results for this population of patients than either method can achieve alone. The scientists published their findings in Neural Regeneration Research earlier this year.

The transplantation of MSC‘s and the use of HBO are each effective in treating TBI for different reasons. Mesenchymal stem cells can proliferate rapidly, differentiate into many different types of cells, and do not tend to cause adverse immune reactions. While HBO treatment can enhance the brain’s aerobic metabolism, providing brain tissue with more oxygen. All of these effects are helpful after TBI has occurred. However, MSC‘s alone can be limiting in their therapeutic potential because only a fraction of those that are transplanted differentiate into mature brain cells. Because hyperbaric oxygen treatment both protects injured tissue and also supports the differentiation and migration of MSC‘s, researchers hypothesized that combining the therapies would improve lead to better neurological and cognitive outcomes following TBI than either treatment would alone.

To test their idea, the scientists induced TBI in rats to establish a rat model of the condition. They then treated one group of rats with just HBO, transplanted MSC‘s in another group of rats that did not undergo HBO, and used both interventions in a final group of rats. The researchers then looked both at physiological markers associated with TBI, as well as cognitive performance on a learning and memory task.

The results showed that rats that underwent both MSC‘s transplantation and HBO had better neurological outcomes and better cognitive performance scores than rats that endured only one type of treatment. Given these promising findings in an animal model of TBI, future research will likely address the translatability of these findings to humans. Now that a proof-of-concept exercise has been successful, there is significant support for the potential of this combination treatment regimen to help people who experience TBI.

Reference

Zhou, H. X., Liu, Z. G., Liu, X. J., & Chen, Q. X. (2016). Umbilical cord-derived mesenchymal stem cell transplantation combined with hyperbaric oxygen treatment for repair of traumatic brain injury. Neural Regen Res, 11(1), 107-113. doi: 10.4103/1673-5374.175054

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