Research Paper|Volume 13, Issue 22|pp 24500—24510

The effect of hyperbaric oxygen therapy on the pathophysiology of skin aging: a prospective clinical trial

Yafit Hachmo¹, Amir Hadanny^2,^3,⁴, Sonia Mendelovic⁵, Pnina Hillman⁵, Eyal Shapira⁶, Geva Landau⁶, Hadar Gattegno¹, Avi Zrachya¹, Malka Daniel-Kotovsky², Merav Catalogna², Gregory Fishlev², Erez Lang², Nir Polak², Keren Doenyas², Mony Friedman², Yonatan Zemel², Yair Bechor², Shai Efrati^1,^2,^3,⁷

¹Research and Development Unit, Shamir Medical Center, Zerifin, Israel
²The Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
³Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
⁴Bar Ilan University, Ramat-Gan, Israel
⁵Pathology Department, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
⁶Plastic Surgery Department, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
⁷Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel

* Equal contribution

Received: July 12, 2021Accepted: September 20, 2021Published: November 16, 2021

https://doi.org/10.18632/aging.203701

Copyright: © 2021 Hachmo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Skin biopsies can be used to evaluate physiological effects of aging targeted intervention at the tissue/cellular levels. Recent clinical trials have shown that hyperbaric oxygen therapy (HBOT) can target aging hallmarks, including telomere shortening, senescent cells clearance and angiogenesis. The aim of this study was to evaluate the effects of HBOT on the skin of a normal, non-pathological, aging population.

Methods: The study was performed as a prospective clinical trial. After signing informed consent and undergoing baseline evaluations, the subjects were assigned to a three-month control period followed by three months of HBOT daily sessions. Skin biopsies were taken at baseline, after three months of no intervention (control) and 1-2 weeks following the last HBOT session. Trichrome, Orecin, lipofuscin and CD31 staining were used to evaluate collagen fibers, elastic fibers, senescent cells and blood vessels, respectively.

Results: Out of the cohort of 70 participants in the normal aging population study, thirteen male patients (age 68.07±2.5y) gave consent for repeated skin biopsies. Following HBOT, there was a significant increase in collagen density (p<0.001, effect size(es)=1.10), elastic fiber length (p<0.0001, es=2.71) and the number of blood vessels (p=0.02, es=1.00). There was a significant decrease in fiber fragmentation (p=0.012) and in tissue senescent cells (p=0.03, es=0.84) post-HBOT. No changes were noted in elastic fiber density or thickness.

Conclusions: The study indicates, for the first time in humans, that HBOT can significantly modulate the pathophysiology of the skin aging in a healthy aging population. The demonstrated mechanisms include angiogenesis and senescent cell clearance.