How Is Crohn’s Disease Treated?
From an autoimmune perspective, Crohn’s disease is treated as a disorder of the intestinal immune response. Instead of tolerating the normal bacteria of the gut, the immune system develops an abnormal inflammatory response against them, resulting in chronic transmural inflammation.
This autoimmune component shapes the therapeutic approach. Treatment may include biologic agents, such as anti-TNF and anti-IL-12/23 therapies, as well as immunomodulatory medication.
From an immunological perspective, the imbalance between inflammation-promoting Th1 and Th17 cells and regulatory T lymphocytes, which help suppress excessive immune activity, represents a central pathological mechanism.
Restoring this balance is therefore a biologically rational therapeutic objective, both for pharmacological treatment and for adjunctive interventions such as hyperbaric oxygen therapy.
Characteristics of Autoimmune Inflammation in Crohn’s Disease
Autoimmune inflammation in Crohn’s disease has a distinctive characteristic: it develops within an environment of persistent local hypoxia.
The inflamed intestinal mucosa is exposed to reduced oxygen levels because of the increased metabolic demands of inflammation and impaired microcirculation.
This hypoxia activates hypoxia-inducible factor 1-alpha (HIF-1α), which intensifies inflammatory signalling rather than suppressing it, creating a self-perpetuating cycle.
Addressing local hypoxia through hyperbaric oxygen therapy may help interrupt this cycle. At the same time, its immunomodulatory effects may support restoration of the Th17/Treg balance that is disrupted in Crohn’s disease.
Scientific Studies and Clinical Evidence
In addition to clinical evidence concerning healing of the intestinal wall, studies have specifically evaluated the immunomodulatory effects of hyperbaric oxygen therapy in patients with Crohn’s disease.
The findings have included increased regulatory T-cell activity, reductions in Th17 cells and lower levels of cytokines associated with Crohn’s disease, including IL-17 and IL-23. These results suggest an immune-directed effect extending beyond a general anti-inflammatory action.
This immunomodulatory mechanism may help explain why some patients with Crohn’s disease who received hyperbaric oxygen therapy experienced longer periods of remission after completing treatment.
The Role of Hyperbaric Oxygen Therapy
When used within an autoimmune treatment framework for Crohn’s disease, hyperbaric oxygen therapy focuses on immunomodulation: restoring the Th17/Treg balance, reducing pathological intestinal immune activation and creating more favourable biological conditions for prolonged remission.
It is always used alongside and in support of biologic or immunomodulatory treatment.
A typical treatment course consists of 20 to 40 sessions, planned in collaboration with the gastroenterologist.