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Chronic Diseases as Barriers to Oxygen Delivery: A Unifying Hypothesis of Tissue Reoxygenation Therapy

  • G. A. PerdrizetEmail author
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 977)

Abstract

Modern medical practice has resulted in the accumulation of a growing number of incurable chronic diseases, many of which are inflammatory in nature. Inflammation establishes a hypoxic microenvironment within tissues, a condition of inflammatory hypoxia (IH). Tissues thus affected become severely compromised, are unable to elicit adaptive responses and eventually develop fibrosis and fixed microvascular deficits. Previous work has demonstrated that tissue hypoxia exits even within the simple human model of self-resolving inflammation, the tuberculin reaction. Failed resolution of IH establishes a vicious cycle within tissues that perpetuates tissue hypoxia and resists standard drug therapies. Diseases such as sepsis, chronic cutaneous wounds, kidney disease, traumatic brain injury, solid tumors, inflammatory bowel disease, and chronic bacterial infections (urinary tract infection, cystic fibrosis) are tissue specific manifestations of chronic IH. Successful reversal of IH, through tissue re-oxygenation therapy (TROT), will break this vicious cycle and restore tissue homeostasis. The examples of solid tumors and inflammatory bowel disease are presented to illustrate a theoretical framework to support this hypothesis. Re-oxygenation of compromised tissues must occur before successful treatment of these diverse chronic diseases can be expected.

Keywords

Chronic inflammation Hypoxia Hyperbaric oxygen Oxygen therapy Chronic disease 

Notes

Acknowledgements

Supported, in part, by the Ted and Michelle Gurnee Endowed Chair in Translational Research, Dept. of Emergency Medicine, UCSD, San Diego, CA.

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Emergency MedicineCenter for Wound Healing and Hyperbaric Medicine, UCSDSan DiegoUSA

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