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VGE arterialization, however,
will need a novel approach.
One promising direction is the
study of the innate immune
system and inflammation,
both of which are involved in
the human body’s response to
stress. Diving involves exposure
to environmental changes that
challenge the entire body and
elicit immune responses and
inflammation controlled by
genetic mechanisms. However,
measurable changes are rarely
present in asymptomatic
divers, making it difficult
to study the transition of
physiological adaptive stress
responses into maladaptive or
pathological reactions that lead
to impaired organ function.
GENETIC STUDIES
The idea that DCS, like breast
cancer, may be promoted by a
particular genetic or epigenetic
variation attracts more and
more researchers.
Genes are the basic physical
units of inheritance passed
from parents to offspring;
they contain the information
needed to specify traits.
Humans have approximately
20,000 genes, an impressive
collection that constitutes an
individual’s genotype. Genes
are grouped into 23 pairs
of chromosomes, each pair
containing approximately 3.1
billion distinct code elements.
The information encoded in
genes is expressed through
Below: Studies have identified changes in gene expression and transcription following breath-hold and compressed-gas dives.
Opposite, from top: Venous gas emboli (VGE) may enter arterial circulation through a right-to-left shunt such as a patent foramen ovale
(PFO). VGE do not occur after every dive, not all VGE enter the arterial circulation, and arterialized VGE do not always lead to DCS.
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