" The dream of eternal life permeates human culture. Currently available options to combat the aging process include intermittent fasting, physical exercise, anti-aging drug or supplement therapy, stem cell therapy, and young plasma transfusion. Recently, hyperbaric oxygenation for anti-aging has been attracting increasing public attention. Some clinical studies have reported that hyperbaric oxygen therapy can lengthen telomeres by 20% and make cells 25 years younger. Hyperbaric oxygen therapy can also improve cognition and eliminate age spots. How does hyperbaric oxygen anti-aging actually work?
The dream of eternal life permeates human culture. Aging is an unchanging natural law and an unavoidable objective fact.
Current options to combat the aging process include intermittent fasting, physical exercise, anti-aging drug or supplement therapy, stem cell therapy, and young plasma transfusions. The previously described gene editing treatments are still in the animal experimental stage.
In the previous period, this number introduced some anti-aging drugs or supplements one after another, such as NMN (NMN, ageless miracle drug?) The first issue of this issue introduced some anti-aging drugs or supplements such as NMN (NMN, the miracle drug?), Coenzyme Q10 (the miracle agent for heart health, is it a fraud? The "ageless drug" GlyNAC, brain tonic, astaxanthin, etc. In general, these treatments work differently in humans than in experimental animals, and their anti-aging efficacy is not clear.
It has long been recognized that oxygen is closely related to both life survival and aging. Hyperbaric oxygen therapy has received increasing attention in the field of anti-aging research.
The paradoxical relationship between oxygen and aging
Life cannot be lived without oxygen. But the truth is that more oxygen is not better. There is a paradoxical relationship between oxygen and aging.
Oxygen is also thought to be a key factor in the aging process. Oxygen is a source of reactive oxygen species (ROS), and excessive production of ROS can induce macromolecular oxidative damage, including lipid peroxidation, protein dysfunction, and DNA damage, all of which contribute to aging.
It should be noted that the relationship between oxygen levels and aging is in a complex and delicate balance. Both very low and very high atmospheric oxygen levels can lead to increased oxidative stress and accelerated aging.
Hyperbaric oxygen is a non-invasive technique that delivers 100% pure oxygen at pressures in excess of one atmosphere. Usually, single or short-term hyperbaric oxygen therapy is associated with significantly higher levels of ROS in the body, and the accumulation of ROS leads to oxidative stress and is detrimental to anti-aging therapy.
It has been reported that after multiple hyperbaric oxygen treatments, oxidative stress levels remain largely unchanged in healthy young people and there are signs of depletion of ROS generation capacity. The cytoprotective antioxidant response was more pronounced after repeated hyperbaric oxygen exposure.
This means that hyperbaric oxygen therapy is a biphasic process: increased oxidative stress and accelerated aging with a single or short-term treatment, and increased antioxidant protection and delayed aging with multiple hyperbaric oxygen treatments.
Clinical research on hyperbaric oxygen for anti-aging
Hyperbaric oxygen is widely used as a proven treatment for medical emergencies such as non-healing wounds, infections, strokes, sudden deafness, severe anemia, and carbon monoxide poisoning and decompression sickness.
In hyperbaric anti-aging, there are only preclinical and small clinical studies available. Clinical studies from Israel on 35 healthy older adults over 64 years of age treated with hyperbaric oxygen for 60 sessions over 3 months found increased expression of 1342 genes and also decreased expression of 570 genes. The altered expression of some genes was associated with reduced cancer risk and stem cell activation.
Notably, the types of genes with altered expression varied considerably between individuals. In addition, only 19 genes remained significantly different 2 weeks after the end of hyperbaric treatment.
Through a review of previous literature, hyperbaric oxygen therapy has shown great potential to improve cognition, inhibit intrinsic skin aging and photoaging, improve glucose metabolism, enhance cardiac and pulmonary function, and prevent bone and muscle loss, among other features of aging.
Possible mechanisms of hyperbaric oxygen anti-aging
By providing a high-pressure, oxygen-rich confined environment, hyperbaric oxygen therapy can effectively increase plasma dissolved oxygen levels and arterial partial pressure of oxygen, causing a wide range of cellular, biochemical and physiological changes throughout the body. Several mechanistic studies have reported that hyperbaric oxygen therapy facilitates tissue homeostasis and regeneration by promoting angiogenesis, reducing inflammation, enhancing antioxidant defense, and stimulating stem cells.
The targets of hyperbaric oxygen action in vivo overlap considerably with those of aging-related diseases. sirtuin1 (SIRT1) is considered a major metabolic stimulator of mitochondrial biosynthesis and part of the cellular defense mechanism against oxidative stress. With increasing age, SIRT1 decreases accordingly.
After repeated intermittent hyperoxia exposure or prolonged hyperbaric oxygenation, the hyperoxic state generates excess ROS, increases NAD+ levels, activates SIRT1, and induces mitochondrial biosynthesis and antioxidant responses. High ROS levels simultaneously induce the production of multiple endogenous antioxidant factors, and the latter have a significantly longer elimination half-life than ROS in vivo.
Hyperbaric oxygen therapy can down-regulate the expression of SASP to a certain extent, reduce the pro-aging effect of senescent cells and remove senescent cells from the body. Targeting telomere shortening, which is closely associated with aging, hyperbaric oxygen therapy observed a 10%-37% reduction in the number of senescent cells and a significant increase in telomere length of more than 20%, which is equivalent to an average of 25 years younger.
Problems in the application of hyperbaric oxygen for anti-aging
The first is that the potential side effects of hyperbaric oxygen therapy cannot be ignored. There is a risk of some minor complications during hyperbaric oxygen therapy, the most common of which are claustrophobia and pneumatic injuries. Among the barotrauma, ear barotrauma is the most common, while others include pulmonary barotrauma and sinus barotrauma. In addition, hyperbaric myopia caused by hyperbaric oxygen therapy has been reported. Fortunately, the vast majority of subjects can recover spontaneously from the common complications.
In addition, studies have reported that hyperbaric oxygen therapy can increase arterial blood pressure, especially in those patients with prior hypertension.
The second issue is how to choose the appropriate hyperbaric oxygen treatment protocol, which varies widely among clinical studies.
Hyperbaric oxygen therapy is defined by the Society of Diving and Hyperbaric Medicine as breathing close to 100% oxygen at a minimum of 2 atmospheres of pressure in a closed chamber.
Some of the studies used continuous hyperoxia protocols. In one clinical trial investigating whether hyperbaric oxygen therapy improved cognition, healthy volunteers wore masks and received 2 atmospheres of 100% oxygen for 45 minutes. In a clinical trial of hyperbaric oxygen therapy for patients with diabetes combined with hypertension, subjects received 100% pure oxygen at 2-2.5 atmospheres in a hyperbaric chamber for 60-90 minutes five times per week.
In addition, there are clinical trials using intermittent hyperoxia exposure protocols. This protocol uses 100% pure oxygen at 2 atmospheres and treats for 90 minutes five times per week. Each treatment alternated between 20 minutes of mask hyperbaric oxygen therapy and 5 minutes of natural air rest. The hyperbaric oxygen pressure compression and decompression rate was controlled at 1 meter per minute.
In addition to the use of 100% pure oxygen, some studies have also used light hyperbaric oxygen protocols. In the treatment of melanin pigmentation or age spots for healthy men or women, the hyperbaric oxygen regimen used was 1.25 atmospheres, 32% oxygen, 2-3 treatments per week for 1 hour each.
Applicable population for hyperbaric oxygen anti-aging applications
Although hyperbaric oxygen has great potential for anti-aging applications, not all populations are suitable for anti-aging treatment with hyperbaric oxygen.
In some cases, hyperbaric oxygen therapy is absolutely contraindicated, such as pneumothorax. In addition, hyperbaric oxygen therapy may not be indicated in cases of pregnancy, hereditary spherocytosis, asthma, or heart failure.
(1) Although excess oxygen accelerates aging, hyperbaric oxygen therapy has a positive effect on anti-aging without exceeding the toxicity threshold.
(2) Single or short-term hyperbaric oxygen therapy causes oxidative damage, but long-term or repeated intermittent hyperbaric oxygen therapy is thought to be beneficial in increasing cellular antioxidant capacity and delaying cellular aging.
(3) Previous literature has used different atmospheric pressures, oxygen concentrations, and hyperbaric oxygen treatment frequencies and treatment periods. The hyperbaric oxygen treatment protocols used in different clinical studies vary widely, and it is unknown which protocol is more effective for anti-aging treatment.
(4) Long-term hyperbaric oxygen therapy is not a completely harmless method. The health benefits need to be weighed against the risk and cost ratios when using hyperbaric methods of anti-aging treatment.
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