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Hyperbaric Oxygenation in Athletes: Standard Versus Low Pressure

केवल पंजीकृत उपयोगकर्ता ही लेखों का अनुवाद कर सकते हैं
साइन अप करने के लिए लॉग इन करें
लिंक क्लिपबोर्ड पर सहेजा गया है
स्थितिभर्ती
प्रायोजक
University of Padova
सहयोगी
Performa di Crocicchia Srl

कीवर्ड

सार

Currently, Hyperbaric Oxigen (HBO) is a widely used treatment for several conditions. There are 14 indications for HBO, officially recognized by the Undersea and Hyperbaric Medical Society (UHMS), but research is discovering other interesting applications.
HBO plays an important role in enhancing antioxidant defense mechanisms by increasing radical oxygen species (ROS) and nitric oxide species (NOS). This controlled oxidative stress has been shown to stop the vicious circle of inflammation - damage - hypoxia already seen in several diseases. Increased neoangiogenesis has been demonstrated at pressures of 2 atmospheres absolute (ATA), while effects helping ischemic tissues need pressures between 2.5 and 2.8 ATA to develop.
During sports activities, metabolism generates waste products - mostly CO2, lactic acid, but also ROS. HBO could be useful in modulating antioxidant mechanisms and helping cells in the recovery after training and sportive competitions.
The authors hypothesize that:
1. HBO can reduce oxidative stress in healthy professional athletes
2. HBO can ameliorate the lactic acid clearance after a maximal exercise
3. HBO at low pressures (L-HBO at 1.45 ATA) is at least comparable to conventional HBO (at 2.5 ATA) in reducing oxidative stress and ameliorating lactic acid clearance after a maximal exercise.
The Authors will include healthy athletes. These will be randomly assigned to a control group, a L-HBO group, or a HBO group. The Authors will assess oxidative stress changes and lactic acid clearance (testing it after a maximal exercise) before and after 20 L-HBO/HBO treatments, and after 2 months after the end of treatments.

विवरण

Subjects will be recruited through public announcements in local gyms and gathered to explain the protocol. Those willing to participate will sign a written informed consent and recruited. To be included, all the subjects will undergo a general medical screening to allow hyperbaric treatments. This will include weight, height, non-invasive arterial blood pressure, and heart rate measurements.

After inclusion, subjects will be randomly assigned to three arms using an electronic number generator by personnel not directly involved in the experiment:

- Arm 1(control): no intervention.

- Arm 2 (L-HBO): treated with oxygen at 1.45 ATA for 60 min (inclusive of compression and decompression times, and an air break of 3 minutes breathing air);

- Arm 3 (HBO): treated with oxygen at 2.5 ATA for 60 min (inclusive of compression and decompression times, and an air break of 3 minutes breathing air).

Subjects included in Arm 2 and 3 will undergo a total of 20 treatments. They will follow a personalized diet proportional to their energetic expenditure.

The Authors will identify 5 time-points in the protocol:

TIME 0 (T0): immediately after inclusion, before any treatment or experiment; TIME 1 (T1): standardized physical exercise 1, before HBO treatments; TIME 2 (T2): after HBO treatments ; TIME 3 (T3): standardized physical exercise 2, after the end of HBO treatments; TIME 4 (T4): 2 months after the end of HBO treatments.

The following exams will be performed on the included subjects:

- at T1 and T3, subjects will undergo a standardized physical stress test on a treadmill. Subjects will start with a fast walking at 4 km/h for 5 minutes, then will start running at 8 km/h for 3 minutes, and then speed will increase 2 km/h every 3 minutes until VO2 max or exhaustion is reached. Lactate production will be measured on capillary blood through finger stick at basal levels (before exercise), at the maximal threshold (VO2 max or exhaustion), then 5, 10, 15, 20, and 30 minutes after stopping the exercise while walking at 4 km/h (dynamic cool down).

- a standardized panel including Complete Blood Count (CBC), creatinine, Blood Urea Nitrogen (BUN), C reactive protein, and VES will be performed at T0, T2, and T4.

- oxidative stress markers will be analyzed on blood and urine samples, taken at several steps during the experimental period. On blood samples (T0; T1; T3), the Authors will measure IL-1 beta, IL-6, TNF-alfa, reactive oxygen species and total antioxidant capacity (by paramagnetic resonance), nitrite and nitrate (NO2/NO3) plasma concentration (by colorimetry based on the Griess reaction), inducible Nitric Oxide Synthase (by ELISA commercially available kit), total (tot) and reduced (red) aminothiols (by fluorescence spectroscopy). On urine samples (T0; T2; T4), the Authors will assess lipid peroxidation by measuring 8-isoprostane concentration (by competitive immunoassay).

Blood samples (approximately 6 ml) will be drawn from the veins of the forearms (preferentially on the non-dominant limb); plasma and erythrocytes will be separated by centrifuge at 1000×g for 10 min at 4°C. Urine samples will be collected by voluntary voiding in sterile containers. All samples will be stored in multiple aliquots at − 80 °C until assayed and thawed only once before analysis.

With this setting, blinding of patients and investigators will be impossible due to different structural characteristics. However, outcome assessors will be blinded to patients' allocation.

खजूर

अंतिम सत्यापित: 03/31/2020
पहले प्रस्तुत किया गया: 03/03/2020
अनुमानित नामांकन प्रस्तुत किया गया: 04/26/2020
पहले पोस्ट किया गया: 04/27/2020
अंतिम अद्यतन प्रस्तुत किया: 04/26/2020
अंतिम अद्यतन पोस्ट: 04/27/2020
वास्तविक अध्ययन प्रारंभ दिनांक: 03/02/2020
अनुमानित प्राथमिक समापन तिथि: 04/30/2020
अनुमानित अध्ययन पूर्णता तिथि: 05/31/2020

स्थिति या रोग

Oxidative Stress
Exercise-Induced Lactic Acidemia

हस्तक्षेप / उपचार

Combination Product: Low-pressure hyperbaric oxygenation (L-HBO)

Combination Product: Standard-pressure hyperbaric oxygenation (L-HBO)(HBO)

चरण

चरण 2

शाखा समूह

बांहहस्तक्षेप / उपचार
Experimental: Low-pressure hyperbaric oxygenation (L-HBO)
Low-pressure hyperbaric oxygen administration at 1.45 ATA for 60 minutes, inclusive of compression and decompression times, and a 3-minute air pause at the midtime. For a total of 20 sessions (3-4 per week).
Combination Product: Low-pressure hyperbaric oxygenation (L-HBO)
as previously described.
Experimental: Standard-pressure hyperbaric oxygenation (L-HBO)(HBO)
Standard pressure hyperbaric oxygen administration at 2.5 ATA for 60 minutes, inclusive of compression and decompression times, and a 3-minute air pause at the midtime. For a total of 20 non-consecutive sessions (3-4 per week).
Combination Product: Standard-pressure hyperbaric oxygenation (L-HBO)(HBO)
as previously described.
No Intervention: Control
Control group of athletes, no intervention.

पात्रता मापदंड

युग अध्ययन के लिए पात्र 18 Years सेवा 18 Years
सेक्स अध्ययन के लिए पात्रMale
स्वस्थ स्वयंसेवकों को स्वीकार करता हैहाँ
मानदंड

Inclusion Criteria:

- professional athletes

- performing at least 3 training sessions/week

Exclusion Criteria:

- previous pneumothorax

- problems with compensation maneuvers

- known epilepsy

- active smoker

परिणाम

प्राथमिक परिणाम उपाय

1. Reactive oxygen species production [On blood: Change from Baseline (T0) Reactive oxygen species production after the exercise test (Time 1: the day after baseline measurements), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

Reactive oxygen species production (μmol min−1) (by paramagnetic resonance)

2. Total antioxidant capacity [On blood: Change from Baseline (T0) Total antioxidant capacity after the exercise test (Time 1: the day after baseline measurements), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

Total antioxidant capacity (by paramagnetic resonance) (mM)

3. nitrite and nitrate (NO2/NO3) plasma concentration [On blood: Change from Baseline (T0) nitrite and nitrate (NO2/NO3) plasma concentration after the exercise test (Time 1: the day after baseline m), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

nitrite and nitrate (NO2/NO3) plasma concentration (by colorimetry based on the Griess reaction) (μM)

4. inducible Nitric Oxide Synthase [On blood: Change from Baseline (T0) inducible Nitric Oxide Synthase after the exercise test (Time 1:the day after baseline measurements), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

inducible Nitric Oxide Synthase (by ELISA commercially available kit) (IU mL−1)

5. aminothiols [On blood: Change from Baseline (T0) aminothiols concentration after the exercise test (Time 1: the day after baseline measurements), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

total (tot) and reduced (red) aminothiols (by fluorescence spectroscopy) (μmol L−1)

6. Cytokines [On blood: Change from Baseline (T0) Cytokines levels after the exercise test (Time 1: the day after baseline measurements), and at the completion of treatments after a second exercise test (Time 3: 5 weeks after the baseline)]

IL-1 beta, IL-6, TNF-alfa (pg ml−1)

7. lipid peroxidation [On Urine: Change from Baseline (T0) lipid peroxidation levels at one month (at the end of the treatments - Time 2), and two months after the end of the treatment (Time 4). Please see protocol for further details about "Ts"]

On urine samples, we will assess lipid peroxidation by measuring 8-isoprostane concentration (by competitive immunoassay) - (pg mg−1 creatinine)

माध्यमिक परिणाम उपाय

1. Lactic Acid Clearance [During the exercise we will assess lactic acid (by finger stick) at basal level, at the peak (reaching exhaustion: 80% of maximal cardiac frequency/ VO2 max/ subjective exhaustion), then at 5 minutes, 10 minutes, 15 minutes, 20 minutes and 30 minutes.]

Lactic Acid Clearance during active cool down after a maximal physical stress test (mmol/L)

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