Digestive Diseases and Sciences

, Volume 53, Issue 2, pp 481–485 | Cite as

Hyperbaric Oxygen Therapy Is as Effective as Dexamethasone in the Treatment of TNBS-E-Induced Experimental Colitis

  • Ozlen Atug
  • Hulya Hamzaoglu
  • Veysel Tahan
  • Inci Alican
  • Ozlem Kurtkaya
  • Emin Elbuken
  • Osman Ozdogan
  • Nurdan Tozun
Original Paper


Introduction Hyperbaric oxygen (HBO) has been demonstrated to be useful as an adjunctive therapy for Crohn’s disease. In the present study, HBO was tested as a treatment for trinitrobenzenesulfonic acid–ethanol (TNBS-E)-induced distal colitis, and its effects were compared with dexamethasone therapy. Methods A total of 48 Sprague-Dawley rats were separated into six groups: the control, and those treated with vehicle, TNBS-E, HBO, dexamethasone, or combined HBO + dexamethasone. The HBO treatment group was exposed to 100% HBO at 2 ATM for 75 min twice daily at 6-h intervals in a HBO chamber, both on the day of colitis induction and 3 days thereafter. Treatment with intraperitoneal dexamethasone twice daily was started 1 h before the induction of colitis and was continued for 7 days in the dexamethasone group. The rats were decapitated 8 days after the induction of colitis, and the colonic tissue wet weight, macroscopic and microscopic lesion score, and tissue myeloperoxidase (MPO) activity were determined. Results HBO therapy decreased the activity of experimental colitis measured by the tissue wet weight, macroscopic score, microscopic score, and MPO activity. The dexamethasone treatment significantly reduced the colitis activity as determined by the tissue MPO activity and wet weight. There were also decreases in the macroscopic and microscopic activity scores with the dexamethasone therapy; however, these changes were not statistically significant. The combined therapy with HBO and dexamethasone provided no additional benefit over HBO therapy alone. Conclusion HBO therapy can be a valuable therapeutic option in treatment of patients with inflammatory bowel disease. HBO therapy in the refractory patients deserves further, larger clinical studies.


Hyperbaric oxygen therapy Dexamethasone TNBS-E Experimental colitis Inflammatory bowel disease 


  1. 1.
    Rachmilewitz D, Karmeli F, Okon E, Rubenstein I, Better OS (1998) Hyperbaric oxygen: a novel modality to ameliorate experimental colitis. Gut 43:512–518PubMedCrossRefGoogle Scholar
  2. 2.
    Hamzaoglu I, Karahasanoglu T, Aydın S, Sahin DA, Carkman S, Sarıyar M, Alemdaroglu K (1998) The effects of hyperbaric oxygen therapy on normal and ischemic colon anastomoses. Am J Surg 176:458–461PubMedCrossRefGoogle Scholar
  3. 3.
    Basset BE, Bennett PB (1977) Introduction to the physical and physiological bases of hyperbaric oxygen therapy. In: Davis JC, Hunt TK (eds) Hyperbaric oxygen therapy. Undersea Medical Society, Bethesda, MD, 41, pp 11–24Google Scholar
  4. 4.
    Grim PS, Gottlieb LJ, Boddie A, Batson E (1990) Hyperbaric oxygen therapy. JAMA 263:2216–2220PubMedCrossRefGoogle Scholar
  5. 5.
    Kindwall EP (1994) A history of hyperbaric medicine. In: Kindwall EP (ed) Hyperbaric medicine practice. Best Publishing Company, Arizona, pp 2–16Google Scholar
  6. 6.
    Mustoe TA, Porras-Reyes BH (1993) Modulation of wound healing response in chronic irradiated tissues. Clin Plast Surg 20:465–472PubMedGoogle Scholar
  7. 7.
    Zamboni WA, Roth AC, Russell RC, Nemiroff PM, Casas L, Smoot EC (1989) The effect of acute hyperbaric oxygen therapy on axial pattern skin flap survival when administered during and after total ischemia. J Reconstr Microsurg 5:343–347PubMedCrossRefGoogle Scholar
  8. 8.
    Wattel F, Mathieu D, Coget JM, Billard V (1990) Hyperbaric oxygen therapy in chronic vascular wound management. Angiology 41:59–65PubMedCrossRefGoogle Scholar
  9. 9.
    Oriani G, Meazza D, Favales F, Pizzi GL, Aldeghi A, Faglia E (1990) Hyperbaric oxygen therapy in diabetic gangrene. J Hyperb Med 5:171–175Google Scholar
  10. 10.
    Hammarlund C, Sundberg T (1994) Hyperbaric oxygen reduced size of chronic leg ulcers: a randomized double-blind study. Plast Reconstr Surg 93:829–833PubMedCrossRefGoogle Scholar
  11. 11.
    Wallace JL, Whittle BJ, Boughton-Smith NK (1985) Prostaglandin protection of rat colonic mucosa from damage induced by ethanol. Dig Dis Sci 30:866–876PubMedCrossRefGoogle Scholar
  12. 12.
    Empey LR, Jewell LD, Garg ML, Thomson AB, Clandinin MT, Fedorak RN (1991) Fish oil-enriched diet is mucosal protective against acetic acid-induced colitis in rats. Can J Physiol Pharmacol 69:480–487PubMedGoogle Scholar
  13. 13.
    Krawisz JE, Sharon P, Stenson WF (1984) Quantitative assay for acute intestinal inflammation based on myeloperoxidase activity. Assessment of inflammation in rat and hamster models. Gastroenterology 87:1344–1350PubMedGoogle Scholar
  14. 14.
    Melamed Y, Shupak A, Bitterman H (1992) Medical problems associated with underwater diving. N Engl J Med 326:30–35PubMedCrossRefGoogle Scholar
  15. 15.
    Tibbles PM, Edelsberg JS (1996) Hyperbaric-oxygen therapy. N Engl J Med 334:1642–1648PubMedCrossRefGoogle Scholar
  16. 16.
    Lavy A, Weisz G, Adir Y, Ramon Y, Melamed Y, Eidelman S (1994) Hyperbaric oxygen for perianal Crohn’s disease. J Clin Gastroenterol 19:202–205PubMedCrossRefGoogle Scholar
  17. 17.
    Rothfuss A, Dennog C, Speit G (1998) Adaptive protection against the induction of oxidative DNA damage after hyperbaric oxygen treatment. Carcinogenesis 19:1913–1917PubMedCrossRefGoogle Scholar
  18. 18.
    Gulec B, Yasar M, Yildiz S, Oter S, Akay C, Deveci S, Sen D (2004) Effect of hyperbaric oxygen on experimental acute distal colitis. Physiol Res 53:493–499PubMedGoogle Scholar
  19. 19.
    Akin ML, Gulluoglu BM, Uluutku H, Erenoglu C, Elbuken E, Yildirim S, Celenk T (2002) Hyperbaric oxygen improves healing in experimental rat colitis. Undersea Hyperb Med 29:279–285PubMedGoogle Scholar
  20. 20.
    Gorgulu S, Yagci G, Kaymakcioglu N, Ozkara M, Kurt B, Ozcan A, Kaya O, Sadir S, Tufan T (2006) Hyperbaric oxygen enhances the efficiency of 5-aminosalicylic acid in acetic acid-induced colitis in rats. Dig Dis Sci 51:480–487PubMedCrossRefGoogle Scholar
  21. 21.
    Dağlı Ü, Balk M, Yücel D, Ülker A, Över H, Saydam G, Şahin B (1997) The role of reactive oxygen metabolites in ulcerative colitis. Inflamm Bowel Dis 3:260–264CrossRefGoogle Scholar
  22. 22.
    Wakefield AJ, Sawyerr AM, Dhillon AP, Pittilo RW, Rowles PM, Lewis AA, Pounder RE (1989) Pathogenesis of Crohn’s disease: multifocal gastrointestinal infarction. Lancet 2:1057–1062PubMedCrossRefGoogle Scholar
  23. 23.
    Tözün N, Hamzaoğlu HÖ (1997) İltihabi barsak hastalıklarında etyolojik faktörler. Güncel Gastroenteroloji 1/2:287–294Google Scholar
  24. 24.
    Bernstein LH, Frank MS, Brandt LJ, Boley SJ (1980) Healing of perianal Crohn’s disease with metronidazole. Gastroenterology 795:357–365Google Scholar
  25. 25.
    Rutgeerts P, Hiele M, Geboes K, Peeters M, Penninckx F, Aerts R, Kerremans R (1995) Controlled trial of metronidazole treatment for prevention of Crohn’s disease after ileal resection. Gastroenterology 108:1617–1621PubMedCrossRefGoogle Scholar
  26. 26.
    Prantera C, Zannoni F, Scribano ML, Berto E, Andreoli A, Kohn A, Luzi C (1996) An antibiotic regimen for the treatment of active Crohn’s disease: a randomized, controlled clinical trial of metronidazole plus ciprofloxacin. Am J Gastroenterol 91:328–332PubMedGoogle Scholar
  27. 27.
    Turunen UM, Farkkila MA, Hakala K, Seppala K, Sivonen A, Ogren M, Vuoristo M, Valtonen VV, Miettinen TA (1998) Long-term treatment of ulcerative colitis with ciprofloxacin: a prospective, double-blind, placebo-controlled study. Gastroenterology 115:1072–1078PubMedCrossRefGoogle Scholar
  28. 28.
    Weisz G, Lavy A, Adir Y, Melamed Y, Rubin D, Eidelman S, Pollack S (1997) Modification of in vivo and in vitro TNF α, IL-1 and IL-6 secretion by circulating monocytes during hyperbaric oxygen treatment in patients with perianal Crohn’s disease. J Clin Immunol 17:154–159PubMedCrossRefGoogle Scholar
  29. 29.
    Radermacher P, Frey G, Berger R (1997) Hyperbaric oxygen therapy—intensive care in a hostile environment. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin, pp 827–835Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Ozlen Atug
    • 1
  • Hulya Hamzaoglu
    • 1
  • Veysel Tahan
    • 1
  • Inci Alican
    • 2
  • Ozlem Kurtkaya
    • 2
  • Emin Elbuken
    • 3
  • Osman Ozdogan
    • 1
  • Nurdan Tozun
    • 1
  1. 1.Department of GastroenterologyMarmara University School of Medicine IstanbulTurkey
  2. 2.Department of PhysiologyMarmara University School of MedicineIstanbulTurkey
  3. 3.Department of Undersea MedicineGulhane Military Medical SchoolAnkaraTurkey

Personalised recommendations