Hyperbaric Oxygen Therapy Increases Brain-Derived Neurotrophic Factor as well as Decreases Systemic Immune-Inflammatory Index and Systemic Inflammatory Response Index in Autism Spectrum Disorder

Verna Biutifasari (Clinical Pathology Sub-Specialist Doctor Education Program, Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Jl. Prof. Dr. Moestopo No.47, Surabaya 60132)
Ni Komang Sri Dewi Untari (Department of Hyperbaric, Naval Health Institute (LAKESLA) Drs. Med. R. Rijadi Sastropanoelar, Phys, Jl. Sarwajala No.2, Surabaya 60155)
Pramita Anindya Nugraheni (Departement of Pediatric, Faculty of Medicine, Universitas Hang Tuah, Komplek Barat RSAL Dr. Ramelan, Jl. Gadung No. 1, Surabaya 60244)
Ronald Pratama Adiwinoto (Department of Community Medicine. Faculty of Medicine, Universitas Hang Tuah, Komplek Barat RSAL Dr. Ramelan, Jl. Gadung No. 1, Surabaya 60244)
Djatiwidodo Edi Pratiknya (Department of Marine Health, Faculty of Medicine, Universitas Hang Tuah, Komplek Barat RSAL Dr. Ramelan, Jl. Gadung No. 1, Surabaya 60244)
Vendra Setiawan (Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Surabaya, Jl. Raya Kalirungkut, Surabaya 60293)
Hartono Kahar (Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Jl. Prof. Dr. Moestopo No.47, Surabaya 60132)
Betty Agustina Tambunan (Department of Clinical Pathology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Jl. Prof. Dr. Moestopo No.47, Surabaya 60132)

The Indonesian Biomedical Journal
Vol 16, No 6 (2024)

BACKGROUND: Neuroinflammation and immune dysregulation are frequently viewed as contributing factors of autism spectrum disorder (ASD). Brain-derived neurotrophic factor (BDNF) is involved in the maintenance of neuron viability, as well as in neuron differentiation. Meanwhile, Systemic Immune-Inflammatory Index (SII) and Systemic Inflammatory Response Index (SIRI) are basic hematological indices used to assess inflammation and immune status. Hyperbaric oxygen (HBO) is known to enhance cerebral blood flow and reduce inflammation, however, not many studies have observed the its effect on BDNF level, SII, and SIRI in ASD subjects; therefore, this study was performed.METHODS: Fifteen ASD subjects were involved in this study and received HBO therapy 10 times within a 2-week period. The HBO therapy was performed by letting the subjects got into an isolated chamber filled with 100% oxygen and 1.3 ATA pressure for 60 minutes. Pre- and post-therapy blood samples were taken from subjects. BDNF level was measured with Enzyme Linked Immunosorbent Assay (ELISA), while neutrophils, monocytes, lymphocytes and platelets were measured by hematology analyzer for the calculation of SII and SIRI.RESULTS: Post-therapy BDNF level was higher than pre-therapy (1.84 ng/mL vs. 1.46 ng/mL; p=0.039). The increased in BDNF suggested reduced neuroinflammation and enhanced connections between neurons. Both post-therapy SII (672.4 vs. 359.4; p=0.005) and SIRI (1.3 vs. 0.7; p=0.009) were significantly lower than pre-therapy indexes. Decreased in SII and SIRI signified a reduction in neuroinflammation.CONCLUSION: HBO therapy increases BDNF level, also decreases SII and SIRI in ASD subjects. These results suggest that HBO has an effect on neuroinflammation, specifically in ameliorating inflammation.KEYWORDS: autism spectrum disorder, BDNF, SII, SIRI, hyperbaric oxygen therapy