Oxidative stress assessment in breath-hold diving

  • Simona Mrakic-Sposta
  • Alessandra Vezzoli
  • Alex RizzatoEmail author
  • Cinzia Della Noce
  • Sandro Malacrida
  • Michela Montorsi
  • Matteo Paganini
  • Pasqua Cancellara
  • Gerardo Bosco
Original Article



Breath-hold diving results in significant changes in blood gases’ levels. Challenging variations in oxygen partial pressures may induce reactive oxygen species (ROS) production that exacerbate oxidative stress and, consequently, affect endothelial function. The aim of this study was to investigate the effects of breath-hold diving on oxidative stress damage, assessing ROS production. Nitric oxide metabolites, inducible nitric oxide synthase (iNOS), aminothiols, and renal function were evaluated too as markers of redox status and renal damage.


ROS production was assessed with electron paramagnetic resonance. Oxidative status values were measured at pre- and post-40 m dive in a deep swimming pool (Y-40) from six divers (mean age 46.6 ± 9.3 years; height 176 ± 4 cm; BMI 25 ± 2.9 kg/m2).


Significant (p < 0.05) increases at post-dive of ROS production rate (0.158 ± 0.003 vs 0.195 ± 0.006 μmol min−1), lipid peroxidation (8-isoprostane: 375.67 ± 195.62 vs 420.49 ± 232.31 pg mg−1 creatinine), nitrate (27.91 ± 19.71 vs 30.80 ± 20.44 μM), iNOS (31.30 ± 4.52 vs 35.68 ± 6.72 IU mL−1) and neopterin concentration (96.20 ± 40.41 vs 118.76 ± 27.84 μmol mol−1 creatinine) were recorded. Conversely, the antioxidant capacity significantly decreased (3.423 ± 0.089 vs 3.015 ± 0.284 mM) after immersion.


Overproduction of ROS and consequent oxidative damage to lipids of membrane and antioxidant capacity decreasing reflect also a hypoxic condition, which in the breath-hold diving typically occurs in the last few meters below the surface. iNOS produces NO in large quantities under the examined extreme conditions. Neopterin and creatinine concentration level increased, suggesting an “impairment of renal function” as a likely physiological response to PaO2 variations during dive activity.


Reactive oxygen species Nitric oxide Electron paramagnetic resonance Breath holding 





Electron paramagnetic resonance


High-performance liquid chromatography


Inducible nitric oxide synthase


Nitric oxide


Reactive oxygen species


Total antioxidant capacity


Tris-(2-carboxyethyl)-phosphine hydrochloride



The authors would like to thank the deepest swimming pool Y-40 THE DEEP JOY, (Montegrotto Terme—Padua Italy) and also thank the divers (M. Mardollo, P. Parzanese, A. Calesella, M. Lorenzi, T. D’Onofrio, R. Minelli, E. Pozzo, G. Calitri) for participating in this study.

Author contributions

All experiments were performed at the deepest swimming pool Y-40 THE DEEP JOY, (Montegrotto Terme—Padua Italy), at the university of Padova (Padova, Italy) and National Research Council (Milano, Italy). SMS contributed to the study design, data analysis, interpretation and drafting of the manuscript. AV, CDN and MM contributed to the data analysis and interpretation, critical review of the manuscript; AR, MP, SM and PC contributed to the data collection and critical review of the manuscript; GB contributed to the study design, data collection and data interpretation, and critical review of the manuscript. GB confirms the study objectives and procedures are honestly disclosed. All the authors approved the final version of the manuscript.

Compliance with ethical standards

Conflict of interest

None declared.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Simona Mrakic-Sposta
    • 1
  • Alessandra Vezzoli
    • 1
  • Alex Rizzato
    • 2
    Email author
  • Cinzia Della Noce
    • 1
  • Sandro Malacrida
    • 2
    • 3
  • Michela Montorsi
    • 4
  • Matteo Paganini
    • 2
  • Pasqua Cancellara
    • 2
  • Gerardo Bosco
    • 2
  1. 1.Institute of Clinical PhysiologyNational Research Council (CNR), ASST Grande Ospedale Metropolitano NiguardaMilanItaly
  2. 2.Environmental and Respiratory Physiology, Department of Biomedical SciencesUniversity of PadovaPaduaItaly
  3. 3.Institute of Mountain Emergency MedicineEurac ResearchBolzanoItaly
  4. 4.Department of Human Sciences and Promotion of the Quality of LifeSan Raffaele Roma Open UniversityMilanItaly

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