What Is Systemic Lupus Erythematosus?
Systemic lupus erythematosus (SLE) is one of the most complex autoimmune diseases, characterised by multisystem involvement and considerable clinical variability.
The autoimmune process produces autoantibodies directed against structural components of the body’s own cells, primarily DNA, nucleosomes and phospholipids. This leads to the deposition of immune complexes in multiple organs.
Its clinical manifestations cover a broad spectrum and may include the characteristic butterfly-shaped facial rash, photosensitivity, arthritis, lupus nephritis, which is among the most serious manifestations, pleuritis, pericarditis, haematological abnormalities and neuropsychiatric involvement.
The condition follows a relapsing and remitting course, and its management is clinically challenging because disease control must be balanced against the adverse effects of treatment.
Characteristics
Vascular injury is a central feature of SLE. Immune complexes are deposited within vessel walls, causing inflammation, endothelial dysfunction and an increased risk of thrombosis, particularly in patients with antiphospholipid syndrome.
The resulting ischaemia in organs such as the kidneys, brain and skin represents an important mechanism of tissue injury in addition to inflammation itself.
Another characteristic feature is the high level of oxidative stress associated with SLE. Patients often have impaired antioxidant defences and increased markers of oxidative injury, findings linked to the progression of renal and vascular damage.
Strengthening antioxidant protection therefore represents an important unmet therapeutic objective.
Experimental Studies and Clinical Reports
Experimental studies in animal models of SLE have shown that hyperbaric oxygen therapy may reduce immune complex deposition in the kidneys, improve renal function and lower inflammatory markers.
Clinical reports involving patients with cutaneous or vascular manifestations of lupus have also described improved tissue healing and fewer ischaemic episodes.
The antioxidant effects of hyperbaric oxygen therapy, mediated through the activation of superoxide dismutase (SOD), catalase and glutathione, address one of the central mechanisms of tissue injury in SLE. At the same time, improved endothelial function through increased nitric oxide production may help reduce the risk of vascular complications.
The Role of Hyperbaric Oxygen Therapy
In SLE, hyperbaric oxygen therapy may be used as an adjunctive option in selected clinical situations, including cutaneous manifestations with ischaemic ulcers, vascular complications, complications of neuropsychiatric lupus or as broader biological support in patients with stable disease.
Close collaboration with rheumatologists and careful assessment of disease activity are always required before treatment begins.
Its principal therapeutic mechanisms include antioxidant activity, improved vascular function and a mild immunomodulatory effect through enhanced regulatory T-cell activity.
A typical treatment course consists of 20 to 40 sessions and is individualised according to the patient’s clinical manifestations.