| Sumario: | Diabetic patients undergoing hyperbaric oxygen therapies (HBOT) for refractory lower extremity neuropathic ulcers exhibit more than a twofold elevation ( p=0.004) in circulating stem cells after treatments and the post-HBOT CD34 cell population contains two- to threefold higher levels of hypoxia inducible factors-1, -2, and -3, as well as thioredoxin-1 ( p<0.003), than cells present in blood before HBOT. Skin margins obtained from 2-day-old abdominal wounds exhibit higher expression of CD133, CD34, hypoxia inducible factor-1, and Trx-1 vs. margins from refractory lower extremity wounds and expression of these proteins in all wounds is increased due to HBOT ( p<0.003). HBOT is known to mobilize bone marrow stem cells by stimulating nitric oxide synthase. We found that nitric oxide synthase activity is acutely increased in patients' platelets following HBOT and remains elevated for at least 20 hours. We conclude that HBOT stimulates vasculogenic stem cell mobilization from bone marrow of diabetics and more cells are recruited to skin wounds.
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