Hyperbaric oxygen suppressed tumor progression through the improvement of tumor hypoxia and induction of tumor apoptosis in A549-cell-transferred lung cancer

Sci Rep. 2021 Jun 8;11(1):12033. doi: 10.1038/s41598-021-91454-2.


Tumor cells have long been recognized as a relative contraindication to hyperbaric oxygen treatment (HBOT) since HBOT might enhance progressive cancer growth. However, in an oxygen deficit condition, tumor cells are more progressive and can be metastatic. HBOT increasing in oxygen partial pressure may benefit tumor suppression. In this study, we investigated the effects of HBOT on solid tumors, such as lung cancer. Non-small cell human lung carcinoma A549-cell-transferred severe combined immunodeficiency mice (SCID) mice were selected as an in vivo model to detect the potential mechanism of HBOT in lung tumors. HBOT not only improved tumor hypoxia but also suppressed tumor growth in murine xenograft tumor models. Platelet endothelial cell adhesion molecule (PECAM-1/CD31) was significantly increased after HBOT. Immunostaining of cleaved caspase-3 was demonstrated and apoptotic tumor cells with nuclear debris were aggregated starting on the 14th-day after HBOT. In vitro, HBOT suppressed the growth of A549 cells in a time-dependent manner and immediately downregulated the expression of p53 protein after HBOT in A549 cells. Furthermore, HBOT-reduced p53 protein could be rescued by a proteasome degradation inhibitor, but not an autophagy inhibitor in A549 cells. Our results demonstrated that HBOT improved tissue angiogenesis, tumor hypoxia and increased tumor apoptosis to lung cancer cells in murine xenograft tumor models, through modifying the tumor hypoxic microenvironment. HBOT will merit further cancer therapy as an adjuvant treatment for solid tumors, such as lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • A549 Cells
  • Animals
  • Apoptosis*
  • Carcinoma, Non-Small-Cell Lung / therapy
  • Caspase 3 / metabolism
  • Cell Line, Tumor
  • Disease Progression
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Hypoxia
  • Immunohistochemistry
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / therapy*
  • Mice
  • Mice, SCID
  • Neoplasm Transplantation
  • Neoplasms / therapy*
  • Platelet Endothelial Cell Adhesion Molecule-1 / metabolism
  • Proteasome Endopeptidase Complex / metabolism
  • Tumor Hypoxia*
  • Tumor Microenvironment


  • PECAM1 protein, human
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Caspase 3
  • Proteasome Endopeptidase Complex