Hyperbaric Oxygen Therapy (HBOT) is a treatment involving the administration of oxygen at pressures higher than atmospheric pressure, with numerous potential indications such as radiation-induced tissue damage, chronic wounds, and more. HBOT significantly increases the amount of dissolved oxygen in tissues, thereby promoting wound healing.
However, this "hyperoxygenation" may also exert toxic effects, particularly through the production of reactive oxygen species (ROS), which can induce DNA damage and potentially promote mutagenesis, thereby increasing long-term neoplastic risk.
A single HBOT session is associated with a significant increase in ROS production, which may persist for up to 48 hours post-exposure, and is also linked to DNA damage. DNA repair is typically a rapid process, with the activation of protective mechanisms.
The effects of repeated HBOT sessions remain a matter of debate. Reported outcomes range from attenuation of genotoxicity, to exacerbation of DNA damage, or no effect at all (8). In patients with cancer or comorbidities associated with impaired DNA repair capacity, repeated HBOT could be more detrimental, potentially increasing genotoxic effects and cancer risk. This increased oxygen susceptibility in cancer patients has already been observed in normobaric conditions during abdominal surgery, where hyperoxygenation strategies were associated with increased mortality in this subgroup.
A potential pro-carcinogenic effect of HBOT in cancer patients has also been suggested in some case series, though not confirmed by larger studies.
Current literature on HBOT safety remains generally reassuring; however, the possibility of DNA damage and its potential long-term genotoxic consequences cannot be entirely excluded. This question is of particular importance given that many primary indications for HBOT involve patients with a history of malignancy or active cancer
Adults (≥18 years old)
Having signed an informed consent form
Affiliated with or beneficiary of a national health insurance system
Admitted to the hyperbaric medicine department for HBOT treatment
Patients with a contraindication to hyperbaric oxygen therapy (HBOT)
Pregnant, breastfeeding, or postpartum women
Patients deprived of liberty by judicial or administrative decision
Patients undergoing involuntary psychiatric treatment
Single group
Blood test
Biological/Vaccinea blood test before and after the first oxygen therapy session, as well as after the last session
Correlation between hyperbaric oxygen therapy and DNA damages
Tail DNA Percentage by the Comet Assay (cellular biology technique, single-cell gel electrophoresis)
reactive oxygen derivatives formation
8-hydroxy-2'-deoxyguanosine (8-OHdG) plasma levels
reactive oxygen derivatives formation
isoprostanes (8-isoprostane) plasma levels
Correlation between DNA damage and post-radic wound healing
Grade difference on the LENT-SOMA scale (Late Effects of Normal Tissues-Subjective, Objective, Management, Analytic)
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