Diving and hyperbaric medicine are relatively young and rapidly evolving specialties. Several pathologies dealt with regularly in this discipline remain incompletely understood.

Decompression sickness (DCS) is a potentially fatal condition usually observed after scuba diving. It involves bubble formation in blood and tissues from dissolved inert gas secondary to decreases in ambient pressure (decompression). Its manifestations range from a mild illness to a rapidly life-threatening one. The standard treatment for DCS involves oxygen delivered at an elevated ambient pressure - hyperbaric oxygen (HBO).

To date, limited gene expression studies in humans have focused on cohorts of divers completing uneventful freediving or scuba diving, and showed that diving is a powerful physiologic stressor that affects the expression of several genes.

A team of researchers from the Faculty of Medicine and Surgery and Centre of Molecular Medicine and Biobanking, in collaboration with Norwegian University for Science and Technology, Trondheim and the Diving and Hyperbaric unit, Mater Dei Hospital have performed the first RNA-sequencing study of human DCS.

This research has shown that DCS induces the enrichment of transcripts involved in inflammation, activation of the innate and adaptive immune system as well as a shift in white blood cell subtypes that was reversed in response to HBO. The observed changes highlight a continuum between the responses elicited by uneventful diving and diving complicated by DCS. This research has provided the first genomic signature of DCS and will help secure Malta’s current reputation of being an excellent centre for hyperbaric medicine.

This study was led by Dr Nikolai P. Pace and Dr Ingrid Eftedal. The co-authors are Dr Kurt Magri, Dr Vanessa Petroni Magri, Dr Lyubisa Matity, Dr Charles Azzopardi and Dr Stephen Muscat.

A paper describing these findings will be published in Frontiers in Physiology. You can find the abstract online.