Hyperbaric oxygen therapy stimulates colonic stem cells and induces mucosal healing in patients with refractory ulcerative colitis: a prospective case series

高压氧疗法刺激难治性溃疡性结肠炎患者的结肠干细胞并诱导粘膜愈合:前瞻性病例系列

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作者:Mohamed Bekheit, Nahed Baddour, Khaled Katri, Yousry Taher, Khaled El Tobgy, Essam Mousa

Background

Hyperbaric oxygen (HBO) is used as part of treatment in a variety of clinical conditions. Its use in the treatment of ulcerative colitis has been reported in few clinical reports.

Conclusions

HBOT is effective in the setting of refractory ulcerative colitis. The described protocol is necessary for successful treatment. HBOT stimulates colonic stem cells to promote healing.

Objective

We report the effect of HBO on refractory ulcerative colitis exploring one potential mechanism of action. Design: A review of records of patients with refractory ulcerative colitis who received HBO was conducted. Clinical and histopathological scoring was utilised to evaluate the response to HBO therapy (HBOT).

Results

All patients manifested clinical improvement by the 40th cycle of HBOT. The median number of stool frequency dropped from seven motions/day (range=3-20) to 1/day (range=0.5-3), which was significant (z=-4.6, p<0.001). None of the patients manifested persistent blood passage after HBOT (z=-3.2, p=0.002). The severity index significantly improved after HBOT (z=-4.97, p<0.001). Histologically, a significant reduction of the scores of activity was recorded accompanied by a significant increase in the proliferating cell nuclear antigen labelling index of the CD44 cells of the colonic mucosa (p=0.001). Conclusions: HBOT is effective in the setting of refractory ulcerative colitis. The described protocol is necessary for successful treatment. HBOT stimulates colonic stem cells to promote healing.

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