Hypoxic Conditioning as a New Therapeutic Modality

Vergès, Samuel; Chacaroun, Samarmar; Godin‐Ribuot, Diane; Baillieul, Sébastien

doi:10.3389/fped.2015.00058

Cited by 103 publications

(95 citation statements)

References 122 publications

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“…The principal goal of this type of IH is to define the characteristics of the IH model inducing protective and therapeutic effects in contrast to models having deleterious effects 26. The protective effect of IH is based on several mechanisms inducing a positive adaptation of the human body to hypoxia stimuli 21,27. Four mechanisms play a role in this adaptation: (i) preconditioning effects, (ii) concomitant exercise training, (iii) long-term facilitation, and (iv) cardio- and neurovascular protection.…”

Section: Experimental Studies On Ihmentioning

confidence: 99%

Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

Sforza¹,

Roche²

2016

110

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Obstructive sleep apnea (OSA) is a prevalent sleep disorder considered as an independent risk factor for cardiovascular consequences, such as systemic arterial hypertension, ischemic heart disease, cardiac arrhythmias, metabolic disorders, and cognitive dysfunction. The pathogenesis of OSA-related consequence is assumed to be chronic intermittent hypoxia (IH) inducing alterations at the molecular level, oxidative stress, persistent systemic inflammation, oxygen sensor activation, and increase of sympathetic activity. Overall, these mechanisms have an effect on vessel permeability and are considered to be important factors for explaining vascular, metabolic, and cognitive OSA-related consequences. The present review attempts to examine together the research paradigms and clinical studies on the effect of acute and chronic IH and the potential link with OSA. We firstly describe the literature data on the mechanisms activated by acute and chronic IH at the experimental level, which are very helpful and beneficial to explaining OSA consequences. Then, we describe in detail the effect of IH in patients with OSA that we can consider “the human model” of chronic IH. In this way, we can better understand the specific pathophysiological mechanisms proposed to explain the consequences of IH in OSA.

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Section: Experimental Studies On Ihmentioning

confidence: 99%

Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

Sforza¹,

Roche²

2016

110

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“…Hypoxic conditioning (HC) sessions (either sustained or intermittent) can be repeated over several days or weeks to extend the neuroprotection period. 2 The HC stimulus can be either normobaric (by inhaling a gas mixture with reduced dioxygen fraction, i.e. reduced FiO 2 ) or hypobaric (by reducing the atmospheric pressure within specific hypobaric chamber, i.e.…”

Section: Introductionmentioning

confidence: 99%

Hypoxic conditioning and the central nervous system: A new therapeutic opportunity for brain and spinal cord injuries?

Baillieul

Chacaroun

Doutreleau

et al. 2017

Exp Biol Med (Maywood)

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Neuroprotection and brain recovery from either acute or chronic neurodegeneration still represent a challenge in neurology and neurorehabilitation. Hypoxic conditioning may represent a harmless and efficient non-pharmacological new therapeutic modality in the field of neuroprotection and neuroplasticity, as supported by many preclinical data. Animal studies provide clear evidence for neuroprotection and neuroplasticity induced by hypoxic conditioning in several models of neurological disorders. These studies show improved functional outcomes when hypoxic conditioning is applied and provides important information to translate this intervention to clinical practice. Some studies in humans provide encouraging data regarding the tolerance and therapeutic effects of hypoxic conditioning strategies. The main issues to address in future research include the definition of the appropriate hypoxic dose and pattern of exposure, the determination of relevant physiological biomarkers to assess the effects of the treatment and the evaluation of combined strategies involving hypoxic conditioning and other pharmacological or non-pharmacological treatments. AbstractCentral nervous system diseases are among the most disabling in the world. Neuroprotection and brain recovery from either acute or chronic neurodegeneration still represent a challenge in neurology and neurorehabilitation as pharmacology treatments are often insufficiently effective. Conditioning the central nervous system has been proposed as a potential non-pharmacological neuro-therapeutic. Conditioning refers to a procedure by which a potentially deleterious stimulus is applied near to but below the threshold of damage to the organism to increase resistance to the same or even different noxious stimuli given above the threshold of damage. Hypoxic conditioning has been investigated in several cellular and preclinical models and is now recognized as inducing endogenous mechanisms of neuroprotection. Ischemic, traumatic, or chronic neurodegenerative diseases can benefit from hypoxic conditioning strategies aiming at preventing the deleterious consequences or reducing the severity of the pathological condition (preconditioning) or aiming at inducing neuroplasticity and recovery (postconditioning) following central nervous system injury. Hypoxic conditioning can consist in single (sustained) or cyclical (intermittent, interspersed by short period of normoxia) hypoxia stimuli which duration range from few minutes to several hours and that can be repeated over several days or weeks. This mini-review addresses the existing evidence regarding the use of hypoxic conditioning as a potential innovating neuro-therapeutic modality to induce neuroprotection, neuroplasticity and brain recovery. This mini-review also emphasizes issues which remain to be clarified and future researches to be performed in the field.

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“…Although chronic hypoxia is known to be an aggravating factor in several cardiovascular and respiratory diseases, hypoxic exposure may also be of significant benefits to one's cardiorespiratory status as demonstrated in animal models (e.g., Béguin et al, 2005) and as reviewed recently by our group (Verges et al, 2015) and others (Almendros et al, 2014; Navarrete-Opazo and Mitchell, 2014; Mateika et al, 2015). Hypoxic exposure as a potential therapeutic aid is a promising rehabilitation method for many clinical populations, including hypertensive (Serebrovskaya et al, 2008) and overweight (Kayser and Verges, 2013) patients.…”

Section: Introductionmentioning

confidence: 69%

Physiological Responses to Two Hypoxic Conditioning Strategies in Healthy Subjects

et al. 2017

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Objective: Hypoxic exposure can be used as a therapeutic tool by inducing various cardiovascular, neuromuscular, and metabolic adaptations. Hypoxic conditioning strategies have been evaluated in patients with chronic diseases using either sustained (SH) or intermittent (IH) hypoxic sessions. Whether hypoxic conditioning via SH or IH may induce different physiological responses remains to be elucidated.Methods: Fourteen healthy active subjects (7 females, age 25 ± 8 years, body mass index 21.5 ± 2.5 kg·m−2) performed two interventions in a single blind, randomized cross-over design, starting with either 3 x SH (48 h apart), or 3 x IH (48 h apart), separated by a 2 week washout period. SH sessions consisted of breathing a gas mixture with reduced inspiratory oxygen fraction (FiO2), continuously adjusted to reach arterial oxygen saturations (SpO2) of 70–80% for 1 h. IH sessions consisted of 5 min with reduced FiO2 (SpO2 = 70–80%), followed by 3-min normoxia, repeated seven times. During the first (S1) and third (S3) sessions of each hypoxic intervention, cardiorespiratory parameters, and muscle and pre-frontal cortex oxygenation (near infrared spectroscopy) were assessed continuously.Results: Minute ventilation increased significantly during IH sessions (+2 ± 2 L·min−1) while heart rate increased during both SH (+11 ± 4 bpm) and IH (+13 ± 5 bpm) sessions. Arterial blood pressure increased during all hypoxic sessions, although baseline normoxic systolic blood pressure was reduced from S1 to S3 in IH only (−8 ± 11 mmHg). Muscle oxygenation decreased significantly during S3 but not S1, for both hypoxic interventions (S3: SH −6 ± 5%, IH −3 ± 4%); pre-frontal oxygenation decreased in S1 and S3, and to a greater extent in SH vs. IH (−13 ± 3% vs. −6 ± 6%). Heart rate variability indices indicated a significantly larger increase in sympathetic activity in SH vs. IH (lower SDNN, PNN50, and RMSSD values in SH). From S1 to S3, further reduction in heart rate variability was observed in SH (SDNN, PNN50, and RMSSD reduction) while heart rate variability increased in IH (SDNN and RMSSD increase).Conclusions: These results showed significant differences in heart rate variability, blood pressure, and tissue oxygenation changes during short-term SH vs. IH conditioning interventions. Heart rate variability may provide useful information about the early adaptations induced by such intervention.

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Hypoxic Conditioning as a New Therapeutic Modality

Cited by 103 publications

References 122 publications

Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

Chronic intermittent hypoxia and obstructive sleep apnea: an experimental and clinical approach

Hypoxic conditioning and the central nervous system: A new therapeutic opportunity for brain and spinal cord injuries?

Physiological Responses to Two Hypoxic Conditioning Strategies in Healthy Subjects

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