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Shaun S. Kunnavatana, BA; Susan Y. Quan, BS; R. James Koch, MD, MS

Arch Otolaryngol Head Neck Surg. 2005;131:809-814.

Objective  To examine the combined effect of hyperbaric oxygen and N-acetylcysteine, a well-studied antioxidant, on fibroblast proliferation and production of 3 specific growth factors: basic fibroblast growth factor, vascular endothelial growth factor, and transforming growth factor 1.

Design  In vitro study.

Subjects  None.

Interventions  Human dermal fibroblasts were propagated in serum-free medium and subjected to daily 90-minute 2-atm hyperbaric oxygen treatments with varying concentrations of N-acetylcysteine for 7 consecutive days. Cell proliferation and growth factor assays were performed on days 0, 1, 3, 5, and 7.

Results  Population doubling time decreased significantly with 40 µmol/L of N-acetylcysteine supplementation of 2-atm hyperbaric oxygen treatment. Higher levels of N-acetylcysteine increased population doubling time.

Conclusions  Supplementation of hyperbaric oxygen therapy with 40 µmol/L of N-acetylcysteine appears to increase fibroblast proliferation without producing an unfavorable growth factor profile for normal healing. This suggests that this level of N-acetylcysteine may foster an ideal redox environment for fibroblast proliferation in a hyperbaric oxygen environment.

Author Affiliations: Wound Healing and Tissue Engineering Laboratory, Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Stanford, Calif.