What Is Multiple Sclerosis?
Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system in young adults. The autoimmune process, driven primarily by autoreactive T lymphocytes, targets myelin, the fatty sheath surrounding nerve fibres that enables the efficient transmission of nerve impulses. The breakdown of myelin disrupts nerve conduction and leads to a wide range of neurological symptoms.
Multiple sclerosis is approached primarily from the perspective of autoimmunity and inflammation, complementing the analysis of its neurological dimension.
The autoimmune inflammation present within active MS plaques is a direct target of the immunomodulatory effects of hyperbaric oxygen therapy.
Characteristics of Multiple Sclerosis
Within active demyelinating plaques, the autoimmune inflammatory infiltrate, including T lymphocytes, macrophages and neutrophils, produces cytokines and reactive oxygen species that actively damage myelin and axons.
Secondary ischaemia develops within the plaques as a result of inflammatory infiltration and vascular dysfunction, further aggravating tissue injury.
At the same time, demyelinated neurons require considerably more energy to conduct nerve signals without myelin. This increased demand creates a state of “functional ischaemia”, even within inactive plaques.
Improving energy efficiency through increased oxygenation may help address this functional deficit.
Scientific Studies
In addition to the evidence discussed in the neurological section, the autoimmune dimension of MS provides a rationale for the use of hyperbaric oxygen therapy through several immunomodulatory mechanisms. These include suppression of the Th1 and Th17 pathways, increased regulatory T-cell activity, reduced production of autoantibodies against myelin and decreased oxidative injury within nervous tissue.
Studies have reported improvements in clinical status, reductions in fatigue and better outcomes on neuropsychological assessment scales in patients with stable MS. These effects have been attributed in part to reduced neuroinflammation and improved energy metabolism within nervous tissue.
The Role of Hyperbaric Oxygen Therapy
From an autoimmune perspective, hyperbaric oxygen therapy in MS is used only outside periods of acute relapse and as an adjunct to neuroimmunological treatment.
It aims to reduce chronic neuroinflammation, improve energy metabolism in demyelinated neurons and strengthen the regulatory immune mechanisms that help limit the autoimmune response.
A typical treatment course consists of 20 to 40 sessions, always under neurological supervision.