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Hyperbaric Oxygen Treatment for Alzheimer's (nih.gov)
133 points by taf2 on Oct 7, 2021 | hide | past | favorite | 61 comments


This might happen after a few months along with much hilarity among all concerned:

https://www.liebertpub.com/doi/10.1089/cbr.2019.3535.retract

"Cancer Biotherapy and Radiopharmaceuticals officially retracts the paper entitled, “LncRNA SNHG16 Promotes Proliferation, Migration, and Invasion of Glioma Cells Through Regulating the miR-490/PCBP2 Axis,” by Fangen Kong, Yang Yan, Jinfeng Deng, Yaoli Zhu, Yingqin Li, Huiqing Li, and Yiping Wang (Cancer Biother Radiopharm. E-pub ahead of print 23 Jul 2020; doi: 10.1089/cbr.2019.3535) at the authors' request:

“We apologized that we have found a serious problem in our paper. In fact, the Western blot experiment in our study was commissioned a third-party company for testing. In present, some peers have found that the company has forged experimental reports. After contacting the company, they were unable to provide the original images. We have checked and confirmed that the authenticity of the data provided by the company is problematic. In view of the problems in this paper, all the authors have discussed and agreed to withdraw the paper.”

The journal publisher requested the name of the “third-party company,” to which the authors replied:

“We apologize for our mistakes. Our so-called "the third party company", after further investigation, is actually not a company but an individual person. Due to the personal reasons, the previous experimental data were lost and the original raw data could not be provided. So we can not guarantee the authenticity of those data provided by that person. Some members are considering to repeat the experiment again, but we have no way to raise enough fund to repeat it. Hence after serious discussion, we decided to withdraw the manuscript.

Again we apologize sincerely for your inconvenience."


The sheer number of fraudulent papers being produced in China, sadly, is affecting the trust in research coming from there[1]:

> “The effect is devastating,” says Li, about the impacts on Chinese science. “The literature environment published in Chinese is already ruined, since hardly anyone believes them or references studies from them.”

“Now this plague has eroded into the international medical journals,” he adds. The fact that people use paper mills also affects China’s reputation globally, says Futao Huang, a Chinese researcher working at Hiroshima University in Japan.

Reputation and trust do matter, even in (what should be) objective disciplines with (what should be) reproducible experiments.

[1] https://www.nature.com/articles/d41586-021-00733-5?error=coo...


It's an interesting story but there seems to be no connection to the OP. It's a different field, different researchers, from a different institution.

What's the connection?


It drives me crazy how socially acceptable racism against Chinese people is on hacker news. In another thread I saw a top comment say about a paper “I won’t believe it until westerners reproduce it”. This despite several authors being based at US universities (but having Chinese names!)


Calling out a common problem with Chinese research is not racism. There is a real problem here, and it needs to be called out and fixed. That won't happen if it gets ignored by everyone.


Calling out a problem with Chinese research in general is fine. Asserting that an individual piece of research should be dismissed due to broader trends related to one’s race instead of evaluating it on its own merit is racist. And it’s even worse in this article where the comment refers to an unrelated article which has flaws that clearly don’t exist in this paper’s case (as such a study could not be a product of a paper mill). This fact should be obvious to anyone who has thought critically about the fundamental reason why racism is wrong for more than five minutes.


I think this is more like branding. When University of Phoenix was around, it had a bad brand. I wouldn’t spend much time thinking about papers written by UoP people because so many were trash. It’s possible some were good.

When it comes to academic research, China is the University of Phoenix.

That’s not racism, it’s bad brand reputation.


You just defined racism.


Countries aren’t races. This is a problem unique to China, not Chinese people.

Other countries in East and South Asia don’t have this problem.

ABC is the US don’t have this problem.

Non-Chinese at Chinese institutions share this problem.

I don’t think the issue is based on race at all, but based on bad decisions made by the CCP and the cultural impact of those decisions.

Is it racist to say the University of Phoenix doesn’t produce reputable papers?


Name any authors from China but of non-Chinese ethnicity you believe are problematic.

We went from one scientific study, to another totally unrelated scientific study, to the CCP. What does the CCP have to do with the study in question?


"The people of this country can't be trusted".

Totally not racism...


It is perfectly acceptable to call out flaws in US culture, why should it be different for China? What does race have to do with it? Do you see anyone claiming that Han people are genetically predisposed to forging research papers?


When discussing US "culture", one usually has at least enough nuance to discern left from right ("us" vs "those idiots") in a population of 300 million.

When discussing China, there is no distinction. All 1.4 billion people are the same.


That's partly racist to assume name implies location.

But being skeptical based on location and the academic culture in that combination of location and field is not racist.


> Chinese people

John Cena?


Seriously. I was looking for one myself. The only thing I can think of is that he noticed they both have Chinese names. Nice


I don't think they're referring to the nationality of the people involved, but rather the nationality of the institutions.


I wonder why there were "hilarity" :

> Some members are considering to repeat the experiment again, but we have no way to raise enough fund to repeat it.

That's really a sad situation...


Oh boy, how I hate that weasel word “problematic”. Every time I see it I know a load of bullshit is coming.


The more one thinks about that damn word the worse it gets. If something is problematic, the implication is that there is a “right” way, which we must all follow, and that way is determined by the speaker. It’s so childish.


No placebo control, and not even mention of limitations of the study. Of course getting into a hyperbaric chamber with even normal pressure in itself will have a cognitive effect.


Hyperbaric treatment has been pushed for so many chronic conditions and I've never really seen it pan out. I wouldn't be too hopeful about this.


"This paper brought to you by the Hyperbaric Chamber Makers Association."


Many will brush it off as a bad paper, but there's always the risk of someone using this as evidence to give people false hope.

Which is a pretty shitty thing to do in my opinion.


I didn't see a Bonferroni adjustment either, would would suggest actively fishing for statistically significant differences


It seems like it would be impossible to have a true double blind study with something like hyperbaric oxygen. Once the chamber reaches pressure, it is very obvious to the patient.


> Each treatment included 20‐minute pure oxygen inhalation (O2 = 99.9%, oxygen supply pressure 0.4 to 0.7 MPa, oxygen flow 10 to 15 L/h), 15 minutes interval, and then another 20‐minute pure oxygen inhalation (O2 = 99.9%, oxygen supply pressure 0.4 to 0.7 MPa, oxygen flow 10 to 15 L/h) under the pressure of 0.22 MPa (0.12 MPa on pressure gauge) in hyperbaric oxygen chamber (Medical Oxygen Chamber, SY3200‐8500, Yantai Hongyuan Oxygen Industrial Inc., Shandong, China).

Controls that spring to mind would be to have the chamber pressurised to a lower pressure (if you're not already familiar with hyperbaric chambers, you won't know it's at a lower pressure), or to replace the pure oxygen with normal air. Showing a dose-response relationship to pressure or oxygen concentration would go a long way towards making up for the lack of a true negative control.


IIRC from SCUBA diving, breathing pressurized normal air can result in nitrogen narcosis, at least while you're still under pressure.

Not sure if there's a lingering effect afterwards, which IIUC is what we're talking about here.


OTOH, if there is, using that as a control would give you a nice big signal!


Bring the chamber pressure down slowly enough to decompress.


I wonder if one could compensate by having a control group with high-pressure but low-concentration oxygen


Would that be safe for the patients?


I speak under correction but I think that's how diving works - high pressure air, with extra nitrogen. So the concentration of oxygen is less but the total amount is the same


I too speak under correction, but usually the nitrogen gas is actually at a lower percentage or eliminated altogether. Pressurized nitrogen causes nitrogen narcosis, so the filler gas instead is commonly helium.


What about a global somatic benefit ? Improving oxygen delivery, to an extent, should improve all cells function right ?


Sure, it might help, and we can imagine reasons for it to work, but the point was that this experiment might not be good evidence for it working.


Why would you need placebo control for such study? You need placebo studies to isolate the effect, not for measuring the effect.


Oh man, if Edward Jenner, the father of vaccinology, was alive today, he would get crucified over his discovery of the smallpox vaccine.

"What? Did you just scrape some cow's tits and inject fluid into a boy? No control? Where the ethics approval?"

And that's probably in the Top 10 of largest advancements in medicine of all time. Luckily he did it all before the existence of armchair keyboard warriors.


Edward Jenner was hardly the father of Vaccinology. This method was long known in Indian sources.

The best source concerning the Indian method of treatment of smallpox is a report by Dr. John Z. Holwell in 1767 for the College of Physicians in London. This report is an excellent source for understanding the mind of the Ayurvedic doctors of the eighteenth century. [1]

[1] https://swarajyamag.com/books/smallpox


It sounds like he wasn't even the first among his contemporaries.

But it is known for certain that in the years following 1770, at least six people in England and Germany (Sevel, Jensen, Jesty 1774, Rendall, Plett 1791) tested successfully the possibility of using the cowpox vaccine as an immunization for smallpox in humans.

https://en.wikipedia.org/wiki/Smallpox_vaccine#Early_vaccina...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2279376/


Evidence of variolation goes back to the 15th century

https://en.m.wikipedia.org/wiki/Variolation#China


Probably not, since most people against it would be dead or never born.


I'm always happy to read about any kind of progress on AD amelioration but N = 42 is unfortunately a very small sample size to justify any potential encouraging results.


Due to the time and expense involved in hyperbaric therapy it's really tough to study large numbers of subjects.


Seems very similar to [1] from a few weeks ago. Iirc the prevailing conclusion back then was that the sample set was way too small, and was absent a control group. And seems like the same is true here.

[1] https://news.ycombinator.com/item?id=28508070


In a pilot study like this, the effect size is only thing that matters.

In this study the effect size is so small that it would not make this treatment very effective even if it was real.


I didn't see any comparison with ambient pressure O2 treatment. Wearing a nasal cannula with 6 LPM O2 from a bottle or concentrator is easy to do at home. But nobody has a hyperbaric chamber at home. Is the hyperbaric treatment absolutely necessary and if so why?


There are two ways to increase the partial pressure of oxygen: either raise the overall pressure, or increase the concentration of oxygen (at the expense of nitrogen concentration, surely). Assuming a change in nitrogen partial pressure isn't going to interfere with things, I'd have to agree, there's not an obvious difference between the two. Maybe the researchers used a hyperbaric chamber just because they had access to a hyperbaric chamber.


A hyperbaric chamber treatment generally does both, so raises the partial pressure more than you could without it. And indeed that is what they did here.


>Assuming a change in nitrogen partial pressure isn't going to interfere with things

That may not be safe to assume! https://pubmed.ncbi.nlm.nih.gov/1130736/

>The anesthetic effect of air at atmospheric pressure

>Nitrogen has recognized narcotic potential at hyperbaric pressures. No narcotic effect of helium has been demonstrated at any pressure. We evaluated the effect of nitrogen in air at one atmosphere on human performance by comparing it with helium-oxygen using a four-alternative divided-attention task that requires rapid response to auditory and visual signal changes. There was a 9.3 per cent decrease in response time when subjects breathed helium-oxygen, a significant change (P less than 0.001). This change could not be ascribed to practice since the order of presentation of gases did not have a significant effect. It concluded that the nitrogen in ambient air slightly but measurable impairs human performance compared with a non-anesthetic gas such as helium.


I'm curious, doesn't Hyperbaric Oxygen Treatment contribute to oxidative stress? What happens if someone does it regularly?


What happened with the lsd microdosing treatment of Alzheimer? Did it do any good? Are there any follow ups on that one? There are some articles from august of last year that mention the idea, but I don't know if the trials were successful.

https://www.frontiersin.org/articles/10.3389/fnsyn.2020.0003...

https://pubmed.ncbi.nlm.nih.gov/32973482/


Oxygen is known to be toxic at high pressure. Most healthy young army recruits can withstand a pure oxygen atmosphere (at normal atmospheric pressure) for up to 24 hours before they begin to suffer adverse effects.

Astronauts could withstand the pure oxygen atmospheres in the space program because the pressure of the capsules was significantly less than 1atm.

NASA wrote a report on the toxic properties of oxygen while working on the Apollo program: Space-cabin Atmospheres: Oxygen toxicity (1964) - https://news.ycombinator.com/item?id=25883728

Any benefit of high pressure oxygen treatment is short lived. People lose their metabolisms as they age. Alzheimer's is one possible result.


>> People lose their metabolisms as they age. Alzheimer's is one possible result.

Except for those with early-onset alzheimer's. And some old people never get it. So it isn't as simple as saying that old people get old. There is a specific disease at play, one that likely can be treated or even cured once we better understand the underlying causes.

>> Most healthy young army recruits can withstand a pure oxygen atmosphere

Who is still doing this? Those were phenomenally dangerous studies that I haven't heard about in decades. Outside of space suits, nobody is puts people in pure oxygen atmospheres anymore. Even hyperbaric oxygen therapy doesn't use pure O2. At most, subjects breath pure O2 in a mask.


And of course it's not just toxic; the fire risk is the other reason you don't want to fill a room with pure O2. As NASA sadly learned in Apollo 1.


Nasa did worse than that. To simulate space they pressurized Apollo 1 to one atmosphere above external pressure. So they were at two atmospheres of pressure, which is ironically about the same pressure as the hyperbaric oxygen therapy used in the OP. The patients in the OP were using masks.


NASA originally spec'd a mixed gas atmosphere for Apollo, it just got too heavy. After the fire in Apollo 1, they switched to mixed-gas at launch, with this gradually bleeding out to pure O2 as the mission progressed.

This was discussed in my comment in my linked submission.


Even if it fades it could be used as a periodic booster.


> Conclusion

> Based on previous studies and our recent findings, we propose that hyperbaric oxygen treatment may be a promising alternative therapy for AD and aMCI.

> Keywords: Alzheimer's disease, hyperbaric oxygen treatment, hypoxia, mild cognitive impairment



The effect size and it's duration is not that high. They found small effect that lasted a month and faded away quickly afterwards.




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