The Effect of Hyperbaric Oxygen Therapy on Human Adipose-Derived Stem Cells

Plast Reconstr Surg. 2020 Aug;146(2):309-320. doi: 10.1097/PRS.0000000000007029.


Background: Adipose-derived stem cells are considered as candidate cells for regenerative plastic surgery. Measures to influence cellular properties and thereby direct their regenerative potential remain elusive. Hyperbaric oxygen therapy-the exposure to 100% oxygen at an increased atmospheric pressure-has been propagated as a noninvasive treatment for a multitude of indications and presents a potential option to condition cells for tissue-engineering purposes. The present study evaluates the effect of hyperbaric oxygen therapy on human adipose-derived stem cells.

Methods: Human adipose-derived stem cells from healthy donors were treated with hyperbaric oxygen therapy at 2 and 3 atm. Viability before and after each hyperbaric oxygen therapy, proliferation, expression of surface markers and protein contents of transforming growth factor (TGF)-β, tumor necrosis factor-α, hepatocyte growth factor, and epithelial growth factor in the supernatants of treated adipose-derived stem cells were measured. Lastly, adipogenic, osteogenic, and chondrogenic differentiation with and without use of differentiation-inducing media (i.e., autodifferentiation) was examined.

Results: Hyperbaric oxygen therapy with 3 atm increased viability, proliferation, and CD34 expression and reduced the CD31/CD34/CD45 adipose-derived stem cell subset and endothelial progenitor cell population. TGF-β levels were significantly decreased after two hyperbaric oxygen therapy sessions in the 2-atm group and decreased after three hyperbaric oxygen therapy sessions in the 3-atm group. Hepatocyte growth factor secretion remained unaltered in all groups. Although the osteogenic and chondrogenic differentiation were not influenced, adipogenic differentiation and autodifferentiation were significantly enhanced, with osteogenic autodifferentiation significantly alleviated by hyperbaric oxygen therapy with 3 atm.

Conclusion: Hyperbaric oxygen therapy with 3 atm increases viability and proliferation of adipose-derived stem cells, alters marker expression and subpopulations, decreases TGF-β secretion, and skews adipose-derived stem cells toward adipogenic differentiation.

Clinical question/level of evidence: Therapeutic, V.

MeSH terms

  • Adipogenesis / drug effects*
  • Adipose Tissue / cytology
  • Adult
  • Biomarkers / metabolism
  • Cell Differentiation / drug effects*
  • Cell Engineering / methods*
  • Cell Proliferation / drug effects
  • Cell Survival / drug effects
  • Cells, Cultured
  • Cytokines / metabolism
  • Female
  • Humans
  • Intercellular Signaling Peptides and Proteins / metabolism
  • Male
  • Mesenchymal Stem Cells / drug effects*
  • Mesenchymal Stem Cells / physiology
  • Middle Aged
  • Oxygen / administration & dosage*
  • Pressure
  • Primary Cell Culture / methods


  • Biomarkers
  • Cytokines
  • Intercellular Signaling Peptides and Proteins
  • Oxygen