Effects of Hyperbaric Oxygen Therapy in Children with Severe Atopic Dermatitis

Abstract

In the course of atopic dermatitis (AD), the overactivity of the immune system, associated with predominant Th2 lymphocyte responses, is observed, which leads to an increased inflammatory reaction. Cases of a severe course of atopic dermatitis lead to the search for new therapeutic options. The aim of this study was to assess the effects of hyperbaric oxygen therapy (HBOT) treatment for severe cases of AD in children. A total of 15 children with severe AD underwent therapy. The influence of HBOT on the clinical course of AD and immunomodulatory effect of the therapy was analyzed by the SCORAD and objective SCORAD (oSCORAD) scales and by determining the serum concentration of immunological parameters (blood: nTreg lymphocytes, CD4+CD25highCD127-FOXP3+, NKT lymphocytes CD3+, CD16/56+, and serum: total IgE, cytokines IL-4, IL-6, and IL-10, before and after the 30-day treatment cycle). The study showed a significant effect of the therapy on the improvement of the skin condition. In all children, a reduction in the extent and intensity of skin lesions, reduction of redness, swelling, oozing/crusting, scratch marks and skin lichenification after HBOT was observed. Patients also reported a reduction in the intensity of pruritus and an improvement in sleep quality after therapy. In all children, a statistically significant decrease in the serum level of IgE was observed. However, no statistically significant changes in the blood levels of IL-4, IL-6 and IL-10, as well as the percentage of CD4+CD25highCD127−FOXP3+ Treg and NKT lymphocytes, were found. In conclusion, the use of hyperbaric therapy has a positive impact on treatment results in children with a severe course of atopic dermatitis.

Efficacy of procedural treatments for pediatric hidradenitis suppurativa: A systematic review

“…HBOT is known to promote wound healing via angiogenesis, collagen/fibroblast synthesis, and antimicrobial activity 54,55 . HBOT has been used successfully and safely to treat children with severe atopic dermatitis 56 . A RCT of 43 adult patients with HS reported that subjects who were treated with adjunct HBOT had an improved response to oral clindamycin and rifampin compared to those who only received antibiotic therapy.…”

“…54,55 HBOT has been used successfully and safely to treat children with severe atopic dermatitis. 56 A RCT of 43 adult patients with HS reported that subjects who were treated with adjunct HBOT had an improved response to oral clindamycin and rifampin compared to those who only received antibiotic therapy. Further investigations are needed to characterize this potential synergistic benefit in the pediatric population.…”