Acrolein is a toxic metabolite of
cyclophosphamide that causes
hemorrhagic cystitis in 2 to 40% of treated patients. Hyperbaric
oxygen (HBO) is used to treat poorly healing
wounds in conditions such as
Fournier's gangrene and radiation-induced
cystitis. The present study was designed to evaluate the effects of HBO on acute
acrolein-induced
hemorrhagic cystitis in a rat model. Rats were divided into 4 groups. Group I served as a control and received only HBO prior to sacrifice. Group II received
acrolein only, while groups III and IV received
acrolein as well as HBO
therapy. Hyperbaric
oxygen (100%
oxygen, 2.8 atmospheres, 90 minutes) was delivered twice a day for 4 days, with group III receiving a fifth HBO treatment just before
acrolein and group IV receiving the fifth HBO treatment just after
acrolein. After
therapy, the amount of urothelial injury was determined morphometrically. Group II untreated rat bladders had only 33% of the urothelium intact after
acrolein injury, whereas groups III and IV rat bladders had 93% (p < 0.01) and 55% (p < 0.01) intact urothelium, respectively,
after treatment with HBO. The timing of the HBO treatment appeared to be a critical factor, with less injury occurring if the fifth HBO treatment immediately preceded
acrolein. These results suggest that HBO may be useful as prophylaxis and treatment of
cyclophosphamide-induced
hemorrhagic cystitis.