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1 Institute of Undersea and Hyperbaric Medicine, National Defense Medical Center, Taipei 114, Taiwan; and 2 Division of Pulmonary Medicine, Department of Internal Medicine, Tri-Service General Hospital, Taipei 114, Taiwan, Republic of China; and 3 Department of Physiology, University of Hawaii at Manoa, Manoa, Hawaii 96822
Diving acclimatization
refers to a reduced susceptibility to acute decompression sickness
(DCS) in individuals undergoing repeated compression-decompression
cycles. We postulated that mechanisms responsible for the
acclimatization are similar to that of a stress preconditioning. In
this study, we investigated the protective effect of prior heat shock
treatment on air embolism-induced lung injury and on the incidence of
DCS in rats. We exposed rats (n = 31) to a pressure
cycle that induced signs of severe DCS in 48% of the rats, greater
wet-to-dry ratio (W/D) of lung weight compared with the control group
(5.48 ± 0.69 vs. 4.70 ± 0.17), and higher protein
concentration in bronchoalveolar lavage (BAL) fluid (362 ± 184 vs. 209 ± 78 mg/l) compared with the control group. Rats with DCS
expressed more heat shock protein 70 (HSP70) in the lungs than those
without signs of disease. Prior heat shock (n = 12)
increased the expression of HSP70 in the lung and attenuated the
elevation of W/D of lung weight (5.03 ± 0.17) after the identical decompression protocol. Prior heat shock reduced the incidence of
severe DCS by 23%, but this failed to reach statistical significant (
2 = 1.94, P = 0.163). Venous air
infusion (1.0 ml/40 min) caused profound hypoxemia (54.5 ± 3.8 vs. 83.8 ± 3.2 Torr at baseline; n = 6), greater
W/D of lung weight (5.98 ± 0.45), and high protein concentration
in BAL fluid (595 ± 129 mg/l). Prior heat shock (n = 6) did not alter the level of hypoxemia caused by
air embolism, but it accelerated the recovery to normoxemia after air
infusion was stopped. Prior heat shock also attenuated the elevation of W/D of lung weight (5.19 ± 0.40) and the increase in BAL protein (371 ± 69 mg/l) in air embolism group. Our results showed that the occurrence of DCS after rapid decompression is associated with
increased expression of a stress protein (HSP70) and that prior heat
shock exposure attenuates the air bubble-induced lung injury. These
results suggest that bubble formation in tissues activates a stress
response and that stress preconditioning attenuates lung injury on
subsequent stress, which may be the mechanism responsible for diving acclimatization.
diving acclimatization; decompression sickness; air embolism; heat shock protein
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