Effects of hyperbaric oxygen on the level of plasma HMGB1/NF-kB level in patients with acute spinal cord injury

Objective To investigate the effect of hyperbaric oxygen (HBO) on the expression level of plasma HMGB1/NF-κB in patients with acute spinal cord injury. Methods With the knowledge and consent of the patients, 82 cases of acute spinal cord injury were divided into the control group (or the routine treatment group) (n= 40) and the treatment group (or the routine treatment + HBO therapy group) (n= 42). Plasma levels of HMGB1/NF-kappa B (kB) were detected by ELISA, both before treatment and at the same time points of day 3, 7, 10 and 30 after treatment. Total effective rate was evaluated by using ASIA scores of spinal cord injury. Results The plasma HMGB1 levels of the patients with acute spinal cord injury in the control group were elevated, and the peak value was at day 3 after treatment. The plasma HMGB1 levels of the patients in the HBO group were decreased after HBO treatment. Statistical differences in the plasma HMGB1 levels could be seen at day 3, 7, 10 and 30 after treatment, as compared with those of the control group (P< 0.01). However, the plasma HMGB1 level at day 30 following HBO therapy was still higher than that of the baseline at the time of injury. The plasma NF-kB levels for the patients of the control group were decreased, with the peak level at day 1 after treatment. As compared with those of the control group, the levels of plasma NF-kB for the patients of the HBO group were also decreased, and statistical significance could be noted in its levels at day 3, 7 and 30 after treatment (P< 0.01). The level of NF-kB at day 30 after HBO was significantly lower than that of the baseline at the time of injury. Total effective rate for the HBO group was 85.7%, as compared with that of the control group(70.0%), and statistical significance could be noticed, when comparisons were made between them (P< 0.05). Conclusions HBO therapy could decrease inflammatory reaction of secondary injury by decreasing HMGB1/ NF-kappa B levels in peripheral blood, and promote recovery of neurological function in patients with acute spinal cord injury. Key words: Acute spinal cord injury; Hyperbaric oxygen; Plasma HMGB1; Plasma NF-κB