{
  "abstract": "Background: Hyperbaric oxygen therapy (HBOT) remains limited by insufficient individualization, a lack of biomarker-guided dosing, and heterogeneous clinical outcomes across indications and patient populations. We propose a translational, biomarker-driven framework for treating HBOT as a measurable and titratable intervention. This narrative review presents a conceptual framework rather than a formal systematic review or a clinically validated dosing algorithm.\n\nMethods: Dosing is quantified using pressure–time integral (PTI) and cumulative oxygen exposure. A three-tier biomarker architecture supports decision-making: proximal sensors (redox balance, mitochondrial function, endothelial and microcirculatory responses), mechanistic mediators (inflammation–immunity and senescence), and integrative endpoints (epigenetic clocks, multi-omics, functional outcomes, and patient-reported measures). These signals are proposed for integration into a Composite Response Index (CRI) to support prospective evaluation of real-time monitoring and adaptive titration across treatment cycles and clinical scenarios. Evidence is synthesized narratively across HBOT indications, oxygen-biology mechanisms, safety literature, trial-methodology guidance, and biomarker-practicality considerations.\n\nResults: The framework proposes candidate, prospectively testable rules for dose adjustment, phenotype-based stratification, and biologically aligned monitoring schedules. It supports dual-channel stratification by indication and phenotype, enabling hypothesis-driven “right patient, right dose” strategies, and integrates evidence generation across randomized trials, platform studies, and real-world data using causal inference and Bayesian approaches. These operational rules are intended as framework-level proposals and require prospective validation before routine clinical implementation.\n\nConclusions: This biomarker-driven strategy operationalizes HBOT as a quantifiable intervention, enabling personalized dosing, improved reproducibility, and more consistent clinical responses, with translational potential across neurorehabilitation, cardiometabolic health, wound care, and healthy ageing. The CRI, PTI-based dose mapping, biomarker thresholds, and titration rules should therefore be interpreted as a de novo implementation framework and prospective validation target, not as clinically validated decision limits.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12967-026-08722-w.",
  "abstract_shown": true,
  "affiliations": [
    "South China Hospital, Medical School, Shenzhen University, Shenzhen, P.R. China",
    "Yiyuan Longevity Technology (Shenzhen) Co., Ltd, Shenzhen, P.R. China",
    "Department of Hyperbaric Oxygen, Shenzhen People’s Hospital, Shenzhen, P.R. China"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
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        0,
        1
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      "name": "Halimureti Simayijiang",
      "orcid": "0009-0000-1786-4049"
    },
    {
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        1
      ],
      "name": "Yueling Lin"
    },
    {
      "affs": [
        1
      ],
      "name": "Tingting Zhong"
    },
    {
      "affs": [
        2
      ],
      "name": "Zhuo Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Kun Zhang"
    },
    {
      "affs": [
        2
      ],
      "name": "Ying Long"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1ksvgcve0zgg4.bib",
  "cited_by": 0,
  "doi": "10.1186/s12967-026-08722-w",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711866/",
  "id": "1ksvgcve0zgg4",
  "issns": [
    "1479-5876"
  ],
  "landing_url": "https://doi.org/10.1186/s12967-026-08722-w",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
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  "pdf_url": null,
  "pmcid": "PMC13711866",
  "pmid": "42947214",
  "published": "2026-07-30",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/1ksvgcve0zgg4.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:34Z",
      "native_id": "PMC13711866",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12967-026-08722-w"
    }
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  "subjects": [
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      "field": "medicine",
      "origin": "openalex:2712|Diabetic Foot Ulcer Assessment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Precision hyperbaric oxygen therapy: a biomarker-driven framework",
  "title_text": "Precision hyperbaric oxygen therapy: a biomarker-driven framework",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:34Z",
  "url": "https://research.draconitic.com/paper/1ksvgcve0zgg4",
  "venue": "Journal of Translational Medicine",
  "versions": []
}