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The Hyperoxic-Hypoxic Paradox
Abstract
Effective metabolism is highly dependent on a narrow therapeutic range of oxygen. Accordingly, low levels of oxygen, or hypoxia, are one of the most powerful inducers of gene expression, metabolic changes, and regenerative processes, including angiogenesis and stimulation of stem cell proliferation, migration, and differentiation. The sensing of decreased oxygen levels (hypoxia) or increased oxygen levels (hyperoxia), occurs through specialized chemoreceptor cells and metabolic changes at the cellular level, which regulate the response. Interestingly, fluctuations in the free oxygen concentration rather than the absolute level of oxygen can be interpreted at the cellular level as a lack of oxygen. Thus, repeated intermittent hyperoxia can induce many of the mediators and cellular mechanisms that are usually induced during hypoxia. This is called the hyperoxic-hypoxic paradox (HHP). This article reviews oxygen physiology, the main cellular processes triggered by hypoxia, and the cascade of events triggered by the HHP.
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“The observed improvements may be attributed to the underlying biological mechanisms of HBOT. By dedicated protocols of pressure and oxygen fluctuations, HBOT enhances tissue oxygenation and triggers regenerative pathways through oxygen and pressure sensitive gene expression, a phenomenon known as the Hyperoxic-Hypoxic Paradox (HHP) (13).”
From Hyperbaric oxygen therapy improves post-concussion symptoms in adults with childhood traumatic brain injury: a retrospective cohort study (2025) · cites this paper as [13]
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“By increasing oxygen delivery under elevated pressure, dedicated protocols of HBOT may induce neuroplasticity and recovery of dysfunctional brain regions even at the late chronic phase (13, 14).”
From Hyperbaric oxygen therapy improves post-concussion symptoms in adults with childhood traumatic brain injury: a retrospective cohort study (2025) · cites this paper as [13]
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Metadata
- Authors
- Hadanny, A., & Efrati, S.
- Affiliations
- The Sagol Center for Hyperbaric Medicine and Research, Shamir (Assaf-Harofeh) Medical Center, Zerifin 70300, Israel
- ORCID
- Efrati, Shai
- Venue
- Biomolecules
- Publisher
- MDPI AG
- Published
- 2020-06-25
- Volume
- 10
- Issue
- 6
- Pages
- 958
- ISSN
- 2218-273X
- Cited by
- 204
- References
- 16
- Language
- en
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: The Hyperoxic-Hypoxic Paradox. https://app.cochat.ai/papers/10.3390/biom10060958
- The paper
- Hadanny, A., & Efrati, S. (2020). The Hyperoxic-Hypoxic Paradox. Biomolecules. https://doi.org/10.3390/biom10060958
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.