Aviv Scientific Package
Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) involves inhaling 100% oxygen at pressures greater than one atmosphere absolute (1 ATA) to increase the oxygen dissolved in the body's tissues. During HBOT treatment, arterial O2 tension typically surpasses 2000 mmHg, with tissue levels between 200-400 mmHg. Traditionally, HBOT has been used worldwide primarily for chronic non-healing wounds.
The combined impact of hyperoxia and hyperbaric pressure significantly improves tissue oxygenation while targeting oxygen and pressure-sensitive genes, enhancing mitochondrial metabolism and providing anti-apoptotic and anti-inflammatory effects.
Recently, there is increasing evidence that HBOT can also promote neuronal regeneration and neuroplasticity. The intermittent elevation of oxygen concentration triggers various mediators and cellular mechanisms typically induced during hypoxia but without the harmful effects of hypoxia itself - a phenomenon known as the Hyperoxic-Hypoxic Paradox.
Hyperoxic-HyGO poxic Paradox
  • HIf-1 α: 
Intermittent hyperoxic exposure during HBOT can induce hypoxia-inducible factor-1 alpha (HIF-1α), a transcriptional regulator of genes involved in angiogenesis, energy metabolism, and cell proliferation. Additionally, HIF-1α modulates immune responses, such as the helper T-cell differentiation towards a regulatory (Treg) or Th17 phenotype. 
  • Stem cells: 
The HBOT protocol promotes stem cell proliferation, mobilization, and differentiation. During treatment, circulating hematopoietic stem cell numbers increase 3-8 times compared to pre-treatment levels. The mobilized stem cells target damaged tissues in need of regeneration.
Our group demonstrated increased mesenchymal stem cell proliferation in humans for the first time (Figure-1). Unlike traditional agents that increase stem cell proliferation, HBOT does not elevate circulating leukocyte count. Furthermore, HBOT induces tissue-specific stem cell differentiation; for example, in the brain, it promotes neural stem cell proliferation and differentiation.
  • Mitochondrial function
HBOT improves mitochondrial function and increases the number of mitochondria per cell through biogenesis. This has been demonstrated by other researchers, as well as in our athlete study involving muscle biopsies.    
  • Angiogenesis: 
HBOT stimulates hematopoietic stem cells leading to angiogenesis, or the development of new blood vessels. This has been evident in treatment of non-healing peripheral wounds and recently by our group in both the brain, heart and male genitalia using novel MRI perfusion techniques.  
Figure 1. 
Circulating mesenchymal stem cells in a healthy population before and along the HBOT.

Aviv’s affiliated center, The Sagol Center for Hyperbaric Medicine & Research in the Shamir (previously Assaf-Harofeh) Medical Center in Israel is currently the largest center of its kind in the world, treating more than 300 patients per day.
The professional staff includes a multi-disciplinary team of physicians, neuropsychologists, psychologists, neurobiologists, physicists, technology engineers, biologists, physiologists, nutritionist, nurses, and physiotherapists. This unique multidisciplinary collaboration allows the team to conduct its ground-breaking research program focusing on the effects of Hyperbaric Oxygen Therapy (HBOT) on several types of brain injuries and age-related cognitive decline.
The Research Program
The research program conducted at our the Sagol Center indicates that HBOT can induce neuroplasticity and regeneration of damaged brain tissue even years after an acute insult. Moreover, by using new comprehensive brain imaging, the potential recoverable brain tissue can be characterized and identified prior to the treatment.
As a result, the range of therapeutic indications for HBOT was expanded to include:
  • Stroke
  • Post-concussion syndrome
  • Traumatic brain injury
  • Fibromyalgia - chronic pain syndrome
  • Age-related cognitive and functional decline
  • Post-Traumatic Stress Disorder – PTSD      
  • Post-COVID Syndrome      
  • Post viral
Additional areas of research:
  • Athletic performance

To Scientific References - Click Here
Age-Related Decline
A significant portion of our ongoing research focuses on addressing the imminent issue affecting the Western world: age-related cognitive and functional decline. The first, most comprehensive randomized study conducted on a healthy aging population revealed that a specific HBOT protocol can significantly improve this so-called "normal" age-related decline. Published in the journal Aging in 2020, the results demonstrated that HBOT can enhance brain activity, as indicated by perfusion MRI, and boost cognitive functions in the normal aging population.
Another peer-reviewed study in Aging (2020) confirmed that Aviv's unique HBOT protocols can significantly increase telomere length and reduce the number of senescent cells – marking the first time a therapeutic intervention has been proven to reverse these two hallmarks of aging biology in humans.
Improved cellular performance applies to other tissues and organs in the aging body. Skin biopsies have shown that HBOT can significantly modulate the pathophysiology of skin aging in a healthy aging population by inducing skin angiogenesis, reducing senescent cell count, and increasing collagen density and elastic fiber length. Cardiac echocardiography has also proven that HBOT can enhance cardiac function in the normal aging population. Angiogenesis has been documented in the male genitalia using unique perfusion MRI, which correlated with improvements in erectile and sexual function.
In a recent translational study, the unique HBOT protocol's therapeutic effects were assessed in an Alzheimer's disease mouse model. The treatment reduced amyloid plaque burden, increased cerebral blood flow, and enhanced both cognitive function and behavior in the animals. The study also evaluated six human subjects with pathological memory loss, who showed significant improvement alongside increased cerebral blood flow.
Long COVID
In October 2021, the World Health Organization established an official definition for Long COVID, encompassing a range of new, recurring, or ongoing symptoms persisting more than 3 months after an initial COVID-19 infection. This definition includes cognitive dysfunction as a common symptom.
Since December 2021, our team at the Sagol Center started one of the most comprehensive studies on post-COVID patients. The team designed a prospective, randomized, double-blind, placebo-controlled clinical trial focusing on HBOT as the therapeutic intervention. The findings revealed that patients treated with HBOT experienced significant improvements in their overall cognitive function and within specific brain regions responsible for attention and executive function. They also showed enhancements in energy levels, sleep patterns, psychiatric symptoms, and pain management. Conversely, control group participants who received the placebo (sham) treatment did not see significant improvements in their long COVID symptoms. The positive effects of this unique treatment protocol are attributed to neuroplasticity and increased brain perfusion in areas related to cognitive and emotional functions.
The second study employed a novel functional MRI technique and identified significant changes in brain connectivity and functional networks in the HBOT group compared to the placebo group.
A third study demonstrated that HBOT could improve cardiac functions in post-COVID patients as well.
The fourth study was a longitudinal follow-up of the original randomized controlled trial original cohort (see above, first study). It demonstrated that the clinical improvements in both quality of life, quality of sleep, psychiatric and pain symptoms of patients suffering from long COVID are maintained long term and persistent even 1 year after the last HBOT session.  
Athletic Performance
Enhanced mitochondrial function and regenerative capacity can also boost athletic performance. A randomized controlled study demonstrated that HBOT can improve mitochondrial function at the cellular level, stimulate mitochondrial proliferation, and increase the cardio-pulmonary exercise maximal capacity of athletes (resulting in higher VO2 max, anaerobic threshold, and power generation).
Scientific References
The following list includes references to our studies carried out by the team at the Shamir Medical Center in Israel.
Performance and Aging
In addition to reviewing the references below, you may also wish to view the following short TEDx talk and Exponential Medicine Conference lecture delivered by Prof. Shai Efrati, MD:

Data and Studies

Post-COVID 19
  • Amir Hadanny, Shachar Finci, Merav Catalogna, Ramzia Abu Hamed, Calanit Korin, Levi Gabriella, Katia Adler-Vallach, Natalia Tarasula, Mahgna Hamad, Zemer Wang, Erez Lang, Yonatan Zemel, Yair Bechor, Noami Rahimi-Levene, Yonatan Shapira, Oleg Gorelik, Irma Tzur, Eduard Ilgiyaev, Avi Mizrachi, Eli Shiloah, Yasmin Maor, Osnat Lev-Zion Korach, Shai Efrati. Hyperbaric Oxygen Therapy for COVID-19 Patients: A Prospective, Randomized Controlled Trial 9 Apr 2021

Traumatic Brain Injury & Post Concussion

Post Stroke

Chronic Pain Syndrome - Fibromyalgia

Physical Performance & Sport

Post Traumatic Stress Disorder - PTSD

Erectile Dysfunction

Safety of our Treatment Protocols

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