Medical Ozone Therapy Research Articles

From Lab to Clinic: The Potential of Nanobubble Ozone Stored in Liposome with Pantothenic Acid (NOSLIP) in Treating Vaginal Infections with Long-lasting Effectiveness

Every year, 5-10 million women apply to various centers for sexually transmitted diseases due to infectious vaginitis (1). The three most notable causes of infectious vaginitis are bacterial vaginosis (BV), trichomoniasis, and vulvovaginal candidiasis (VVC). BV and VVC, which are endogenous genital infections, are the agents most responsible for the etiology of vaginal discharge (2). The most common symptoms of infectious vaginitis are vaginal discharge, itching, and a burning sensation. However, some cases are asymptomatic and are untreated (3). Group B streptococci (Streptococcus agalactiae; GBS) are gram-positive encapsulated bacteria that can colonize the intestinal and vaginal flora in 10-30% of healthy adults (4). Streptococcus agalactiae causes serious infections such as meningitis, sepsis, skin and soft tissue infections, pneumonia, urinary tract infections, and postpartum endometritis in newborns, pregnant women and adults with underlying diseases (4-6). Ozone is a highly reactive form of oxygen composed of three oxygen atoms. It is generated through the interaction of UV light and high-pressure diatomic oxygen. Ozone is widely acknowledged for its potent antibacterial properties due to its strong oxidative nature. Ozone therapy has garnered growing interest in recent years and is widely recognized for its beneficial impact on infection, reperfusion injury, cancer, and dental caries (7-8). At present, ozone therapy is an emerging approach in the clinical management of vaginitis. The medical ozone therapy device utilizes an ozone generator to produce a specific concentration of ozone, which is subsequently combined with filtered tap water to create ozonated water. Ozone and reactive chemicals exist in a liquid state and have a significant impact on vaginal sterilization (9).

Effect of Medical Ozone Therapy in Preventing Compromised Nasal Skin in Revision Rhinoplasty.

Ozone is often used as an additive therapy for skin conditions like infectious diseases, wound healing, diabetic foot, and pressure ulcers. The viability of the nasal skin has crucial importance in revision rhinoplasty cases. The study investigates the potential benefits of medical ozone therapy in healing the nasal skin in multiple-operated cases. The study retrospectively examined 523 revision rhinoplasty patients operated by the first author from January 2017 to January 2024. Patients consenting to ozone therapy received 3 major autohemotherapy sessions post-surgery. Patients were divided into 2 groups: those with compromised nasal skin (infection, poor vascular supply) and those with normal healing. Age, gender, smoking, diabetes, previous surgeries, grafting materials, and techniques were considered. Of the 523 patients, 12 (2.3%) experienced major skin complications like infection and necrosis, while 511 (97.7%) had no or minor issues, such as discoloration. In total, 301 patients accepted and received ozone therapy. Of the patients without major complications, 299 (58.3%) received ozone therapy, while 212 (41.7%) did not. Among the 12 with major complications, two (16.7%) received ozone therapy, and the remaining 10 (83.3%) did not. Ozone therapy recipients showed statistically fewer skin problems (p<0.05). Costal cartilage as tip and septal extension graft was linked to skin issues (p<0.05). No major adverse effects from ozone therapy were noted. Our findings indicate that ozone therapy may be a safe and potentially effective option for patients undergoing revision rhinoplasty, especially those with compromised nasal skin. It appears to aid in skin healing and regeneration, possibly through enhancing oxygen delivery and modulation of the immune response. Ozone therapy is a promising adjunct treatment for managing skin complications in revision rhinoplasty patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Clinical effectiveness of medical ozone therapy in COVID-19: the evidence and gaps map.

Ozone therapy (OT), a medical procedure, has been showing good results during the coronavirus disease (COVID-19). We aimed to build an evidence and gaps map (EGM) of OT in the COVID-19 ranking the articles found according to levels of evidence and outcomes. The EGM brings bubbles of different sizes and different colors according to the articles. The OT intervention used was major or minor autohemotherapy, rectal insufflation and ozonized saline solution. EGM was based on 13 clinical studies using OT for COVID-19 involving a total of 271 patients. We found 30 outcomes related to OT in COVID-19. Our EGM divided the outcomes into six groups: 1-clinical improvement; 2-hospitalization; 3-inflammatory, thromboembolic, infectious, or metabolic markers; 4-radiological aspects, 5-viral infection and 6-adverse events. Major autohemotherapy was present in 19 outcomes, followed by rectal insufflation. Improvement in clinical symptoms of COVID-19, improvement of respiratory function, improvement of oxygen saturation, reduction in hospital internment, decrease in C-reactive protein, decrease in ferritin, decrease in lactate dehydrogenase, decrease in interleukin 6, decrease in D-dimer, radiological improvement of lung lesions and absence of reported adverse events were related in the papers. The most commonly used concentrations of OT in major autohemotherapy and in rectal insufflation were 40 μg/mL and 35 μg/mL, respectively. Here, we bring the first EGM showing the efficacy and safety of OT in the treatment of COVID-19. OT can be used as integrative medical therapy in COVID-19 at a low cost and improve the health conditions of the patients.

Effect of Ozone Therapy on Epidural Fibrosis in Rats

To demonstrate the effect of medical ozone therapy on the development of epidural fibrosis. A total of 25 Sprague-Dawley male rats were randomly divided into 3 groups: a control group (L3-L4 laminectomy only), a systemic ozone therapy (SOT) group (L3-L4 laminectomy only+ intraperitoneal 15 mL [30 μg/mL] ozone), and a local ozone therapy (LOT) group (L3-L4 laminectomy only+ subcutaneous 15 mL [30 μg/mL] ozone). Ozone therapy was administered 4 times on a 3-day interval during the wound-healing process, with the first dose immediately administered after surgery. The effects of ozone therapy on vascular endothelial growth factor, inflammation, and epidural fibrosis between groups were evaluated. Staining with vascular endothelial growth factor was significantly less in the group that received SOT compared with the control group (P= 0.021). When the groups were compared in terms of inflammation, it was found that inflammation was less common in the SOT and LOT groups compared with the control group (SOT vs. control: P= 0.004 and LOT vs. control: P= 0.024), whereas inflammation was found to be significantly less in the SOT group compared with the LOT group (P= 0.008). In the histopathologic evaluation of epidural fibrosis, there was no significant difference between the SOT and LOT groups but less epidural fibrosis was observed in both groups compared to the control group (LOT vs. control: P= 0.037; SOT vs. control: P= 0.018). Medical ozone therapy may be an alternative method that can be used effectively and safely in the prevention of epidural fibrosis after laminectomy.

Comparison of hyperbaric oxygen and ozone treatment for ischemia/re-perfusion injury in an experimental testicular torsion model.

This study aims to compare the effects of medical ozone (MO) therapy and hyperbaric oxygen (HBO) therapy in an experimental testicular torsion model by measuring the oxidant and antioxidant markers and examining the histopathological tissue damage findings. Thirty-two Wistar rats are used and are divided into four groups; (1) sham group (SG), (2) only ischemia/reperfusion (I/R) by testicular torsion, (3) HBO administered group, and (4) MO administered group. No torsion was conducted in the SG. In all other groups, rats underwent testicular torsion followed by detorsion to create an I/R model. After I/R, HBO was injected in the HBO group, and in the MO group, intraperitoneal ozone was applied. At the end of 1 week, testicular tissues were obtained for biochemical analyzes and histopathological examinations. Biochemically, malondialdehyde (MDA) levels were measured for oxidant activity, and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels were measured for antioxidant activity. Furthermore, the testicles were evaluated histopathologically. Both HBO and MO have significantly decreased MDA levels, compared with sham and I/R groups, resulting in decreased oxidation effects. The antioxidant GSH-Px levels in the HBO and MO groups were significantly higher than in the sham and I/R groups. In addition, the antioxidant SOD levels in the HBO group were significantly higher than sham, I/R, and MO groups. Therefore, the antioxidant effect of HBO was observed to be superior to MO, specifically considering SOD levels. Histopathologically, there was no significant difference between the groups (p>0.05). The study may extrapolate that both HBO and MO are antioxidant agents that can be used in testicular torsion. HBO treatment might improve the cellular antioxidant capacity due to increased antioxidant marker levels more than MO therapy. However, further studies are needed with a larger sample size.

The effect of medical ozone therapy in addition to ovarian detorsion in ischemia reperfusion model

This study aimed to investigate the protective effect of ozone therapy on ovarian reserve, number of ovarian follicles, ovarian morphology in a rat ischaemia reperfusion (IR) injury model. Twenty-four, Wistar Hannover rats were included. The rats were divided into three groups as control, detorsion-only, and ozone therapy + detorsion groups. There was a statistically significant difference in the follicular damage and inflammation scores between the study groups (p = .019, p = .002, respectively). The highest AMH decrease was observed in the detorsion-only group (p = .012). The total damage score was higher in the detorsion-only group than the ozone therapy + detorsion group. Preantral, small and large antral follicle numbers were less in the detorsion-only group than the ozone therapy + detorsion group. The highest postoperative day 7 TAS level was in the ozone therapy + detorsion group. TOS levels did not differ significantly between the study groups. The combination of the ozone therapy with ovarian detorsion is more effective in protecting the ovarian reserve than ovarian detorsion-only. Impact Statement What is already known on this subject? Adnexal torsion is a common gynecological emergency in reproductive-age women. The recommended management is the detorsion of the adnexal pedicle in patients with fertility desire. What do the results of this study add? The combination of the medical ozone therapy with conventional surgical ovarian detorsion is more effective in the protection of the ovarian reserve compared to surgical ovarian detorsion. What are the implications of these findings for clinical practice and/or further research? This study speculates that medical ozone therapy in addition to conventional surgical ovarian detorsion could preserve ovarian reserve and function if confirmed in further clinical studies.

Protective effect of rectal ozone therapy against oxidative stress in immunoglobulin A deficiency

The excess in the production of free radicals produces an imbalance between the prooxidants and antioxidants in favor of the former; which causes loss of redox control signaling and damage to biomolecules such as proteins, lipids and deoxyribonucleic acid. When homeostasis is altered in the redox metabolism of cells that participate in the immune response, they usually evolve into a situation of oxidative stress that facilitates cell dysfunction and death. The objective of our work was to study the effect of ozone on the regulation of redox status, necessary to maintain normal immune function in patients with immunoglobulin A deficiency. Patients and methods: The Research Ethics Committee conducted and approved a clinical trial and whose patients gave informed consent for inclusion. Sixty patients were randomly assigned to two groups: one receiving ozone rectal insufflation (study group-SG) and the second using Hebertrans® (control-GC group), subcutaneously. Pro-oxidant parameters (malondialdehyde-MDA and advanced oxidation protein products-AOPP) and antioxidant parameters (superoxide dismutase1-SOD1, catalase-CAT, glutathione peroxidase-GPx and total antioxidant capacity of serum) were measured. They were measured at the beginning and one month after treatment. Results: In the SG the MDA and the APOP of patients ?15 years, decreased significantly (p = 0.000) with respect to the control group. SOD1 in the SG increased in patients ?15 years (p = 0.006) and from 16 to 30 years of age (p = 0.040) with respect to GC. CAT in patients ?15 years of the SG increased significantly (p=0.001) with respect to initial values. The final result of the total antioxidant capacity in the SG was significantly (p=0.000) higher in patients ? 15 years, similar results were obtained in GPx (p=0.013). Conclusions: With ozone therapy, beneficial effects on the oxidation reduction balance were achieved. Medical ozone therapy may be an additional treatment option, for immunoglobulin A deficient patients with oxidative stress.

Intravenous ozonized saline therapy as prophylaxis for healthcare workers (HCWs) in a dedicated COVID-19 hospital in India - A retrospective study.

In the current pandemic, Health Care Workers (HCWs) are at a high risk of developing COVID-19. Preventive methods like the use of personal protective equipment, isolation, social distancing, and chemoprophylaxis show limited benefit. Despite standard prophylaxis, many of the HCWs develop COVID-19. Medical ozone therapy has immunomodulatory, antioxidant and antiviral effect, and, therefore, it can be explored as prophylaxis for COVID-19. We conducted a retrospective controlled cohort study. IV ozonized saline was administered once a day for a total of 4 days in one month in addition to standard prophylaxis for COVID-19 to HCWs in a dedicated COVID hospital. Fresh ozonized saline was prepared for every administration and was given over 1 hour. There were 235 HCWs, 64 received the ozone prophylaxis and 171 did not. The incidence of COVID-19 was significantly (p=0.04) lesser in HCWs that received ozone prophylaxis (4.6%) as compared to those who did not (14.03%). The benefit was seen irrespective of the risk of exposure. In the red zone, 8.69% of the HCWs who received ozone prophylaxis tested positive as opposed to 15.3% of those who did not. In the orange zone, 4.34% of the HCWs who received ozone prophylaxis tested positive, remarkably lesser than those who did not (20%). In the green zone, none of the HCWs who received ozone prophylaxis tested positive; however, 3.4% of the HCWs who did not receive ozone prophylaxis tested positive. No major adverse events were noted. IV ozonized saline can be used in addition to the standard prophylactic regimen for the prevention of COVID-19 in HCWs. Prospective larger studies are required to establish the potency of IV ozonized saline as prophylaxis.

Medical ozone therapy in facet joint syndrome: an overview of sonoanatomy, ultrasound-guided injection techniques and potential mechanism of action.

Facet joint osteoarthritis is the most prevalent source of facet joint pain and represents a significant cause of low back pain. Oxygen-ozone therapy has been shown to have positive results in acute and chronic spinal degeneration diseases and it could be a safe and efficacious alternative to traditional facet joint conservative treatments. This review article explains the interventional facet joint management with ultrasound-guided oxygen-ozone therapy, providing an anatomy/sonoanatomy overview of lumbar facet joints and summarizing the potential mechanism of action of oxygen-ozone in the treatment of facet joint osteoarthritis, not yet fully understood.

The preventive role of medical ozone therapy on remote organ injury induced by hepatic ischemia reperfusion

Aim: This study explores the effects of ozone therapy on the prevention of remote organ injury in rats with induced hepatic ischemia reperfusion injury.Materials and Methods: Twenty-one male Sprague Dawley rats were sorted randomly into three groups: (a) A control group in which the rats’ abdomens were operated on by laparotomy, and their livers then viewed and closed with a suture; (b) Rats with induced hepatic ischemia-reperfusion injuries; and (c) Rats induced with the same injuries that were administered ozone therapy before reperfusion. The rats’ hepatic arteries, portal veins, and bile ducts were clamped, and ischemia was induced for 45 min. Reperfusion was provided for 90 min in the second and third groups. The third group was administered 0.5 mg/kg ozone intraperitoneally before reperfusion. Liver, lung, and kidney tissues were taken for biochemical and histopathological examinations.Results: In the second group, malondialdehyde levels in the lung and kidney tissues were higher than in the control group, while catalase and superoxide dismutase enzyme levels were lower. The third group had lower malondialdehyde levels and higher catalase and superoxide dismutase enzyme levels than the group that did not receive the therapy. In histopathological evaluations, the damage to both kidney and lung tissues in the third group was higher than in the control group; however, this damage was significantly lower than in the second group.Conclusions: The findings indicated that the administration of ozone therapy attenuated lung and kidney injuries caused by hepatic ischemia, since partial protection was demonstrated in many instances.

Deneysel Yanık Modelinde Hiperbarik Oksijen ve Medikal Ozon Tedavisinin Yara İyileşmesi Üzerine Etkilerinin Karşılaştırılması

Objective: Burn injury is a type of injury which is the disruptin of skin and organs by the effects of heat, electrical current, chemical caustic or burning agents. The purposes of daily burn care are removing of necrotic tissue, prevention of bacterial contamination, control of travma, stimulation of epithelization and protection of systemic complications. In this study, the effects of hyperbaric oxygen and ozone therapy were investigated, and used as adjuvant therapy in burn management, on burned areas utilizing experimental burn model. Material and Methods: In this study, 28 Wistar albino rats weighing 200-220 gr were used and divided into four groups. 10% burn defect areas were occured in all experiments. In the first group, rats were treated with hyperbaric oxygen. Medical ozone therapy was applied to the second group. In the third group, only debridement was used as treatment. Any treatment options were not used to rats in the fourth group. Results: The analysis revealed no statistically significant difference of burns surface areas between Groups 1 and 2, while a significant reduction were noted in Groups 1 and 2 when compared to the other groups. On histopathologic examination of the Groups 1 and 2 we observed a significant decrease in the inflammation and fibrosis rates when compared with other groups. Conclusion: As a result, we observed the affirmative effects of hyperbaric oxygen and ozone therapy on burn management. We suggest that these treatment modalities can be added to standart treatment options as adjuvant therapy. We also think that large researches are needed to support this issue.

The Role of Medical Ozone in Improving Antioxidant Status in Multiple Drug-Resistant Tuberculosis Patients: A Quasi-experimental Study

Background: Multiple drug-resistant tuberculosis (MDR-TB) is a growing public health threat. Oxidative stress is reckoned as one of the rate-limiting steps in the progression of TB. Oxidative stress increases the level of tissue injury and organ damage. The use of medical ozone therapy is gaining popularity due to its anti-microbial property and its homeostatic potential. Objectives: The present study investigates the role of ozone therapy in boosting the antioxidant status of MDR-TB patients. Methods: Medical Ozone therapy was given through rectal insufflations for 21 days in seven MDR-TB patients (five males and two females) who were under anti-Koch Treatment-4 were enrolled after obtaining written consent. The sessions were spaced out at a rate of three sessions per week. Blood serum and plasma samples were collected from the patients at the baseline and at the end of the 21st session to assess the antioxidant status of superoxide dismutase (SOD) and glutathione reductase (GR) and other biochemical parameters. Results: Statistically significant rise was observed in SOD (P = 0.028), but not in GR (P = 0.058). No other biochemical profiles showed any statistically significant change except for a reduction in serum glutamic-pyruvic transaminase (P = 0.026). Participants also expressed subjective improvement in their mental status. However, we have not used any validated scales to record their mental status. Conclusions: The present study suggests that ozone can be a promising medium in tackling the oxidative stress and enhancing the positive mental attitude in ailing MDR-TB patients. Therefore, it can be considered as adjuvant therapy in treating MDR-TB. However, there are major limitations like smaller sample size and lack of control group. Large scale randomized trials are warranted.

Development of ozone reactor for medicine base on Dielectric Barrier Discharge (DBD) plasma

The development of the reactor for a lower concentration of ozone need to be done. The tipe of reactor can be used for the application of medical ozone therapy. Medical ozone therapy can be produced by using double DBD plasma reactor with oxygen as source and variation of voltage. The influence of flowrate to ozone capacity was investigated using double DBD plasma reactor with cylinder-cylinder configuration. The high AC voltage was applied in the range of 0-2000 Volts and the frequency of 50 Hz. The pure oxygen inserted into the reactor with several variations in flow rate, i.e. 2 to 10 L/min. The results showed that the ozone concentration decreased with increasing gas flow rate. I-V characteristic shows that reactor has two regime current as function of voltage. This characteristic is difference with single dielectric DBD Plasma reactor. The suitable dose of ozone therapy for medical other than useful in numerous pathological conditions could be a powerful therapeutic resource to prevent the damages of aging and to improve many functions in human bodies without deleterious effects.

Ozone Therapy in a Patient with Diabetic Foot Ulcerations and a Decision for Amputation

Background: Diabetic foot together with open wounds in distal type peripheral arterial disease constitutes a challenge in therapeutic planning. Ozone therapy may unveil new horizons in management. Case Report: A 67-year-old woman with diabetes mellitus was applied with open wounds at the bottom of her foot with purulent discharge, with a decision for above ankle amputation. She had had numerous interventions for her wounds including metatarsal amputations due to osteomyelitis and had been on an intense treatment including antibiotics, insulin, antihypertensives and antiaggregants. Angiogram revealed diffuse peripheral arterial disease in lower extremities. All medication but antihypertensives was stopped. She received major medical ozone application as 2000 gamma/session i.v. for 2 weeks, external ozone sac application starting from 60 and dropping to 30 gamma/session for 3 weeks and ozone insuflation 40 gamma/session for 10 sessions. Her purulent discharge ceased after the third session and the atonic debris of the wounds exfoliated, the wounds healed from the base towards the surface of the skin. She was then put on cilostazol and clopidogrel therapy. Conclusion: By being one of the known strongest bactericide, virucide, and fungicide elements, medical ozone therapy stimulates and upregulates the antioxidant system of the body with its hormesis effects. After the cessation of all circulatory system supporting medication (as their interaction with ozone is not clear yet), appropriate ozone therapy may bring new horizons for patients when all classically known methods of treatment have been completed, before assigning the patients for amputation.

EFFICACY AND SAFETY OF OZONE THERAPY FOR PATIENTS WITH CHRONIC HEPATITIS B: A MULTICENTER, RANDOMIZED CLINICAL TRIAL

Background: Ozone therapy has a long history. Some studies proved that ozone therapy was useful in treatment of virus hepatitis.Objective: To evaluate the efficacy and safety of new medical ozone therapy system for the treatment of chronic hepatitis B.Method One hundred eighty-nine patients with chronic hepatitis B were included in this open-label, phase 3 study, and randomly assigned to receive ozone autohemotherapy with experimental ozone generator TianYi (group 1) or with ozone generator Humares (group 2) or oral diammonium glycyrrhizinate capsules (group 3) in a 1:1:1 ratio for 12 weeks. The primary efficacy end point was sera HBV DNA level of less than 1×103 IU/ml or having a more than 2 log10 reduction in HBV DNA level at the end of 12 weeks treatment as compared to baseline HBV DNA level. Secondary end points included HBeAg seroconversion, biochemical response, and combined response.Results At the end of 12 weeks treatment, the proportion of patients reached the primary end point of virologic response in group 1, group 2, and group 3 were 22.4% (13/58, 95% CI, 12.5 to 35.3), 14.7 (9/61, 95% CI, 7.0 to 26.2) and 3.9% (2/51, 95% CI, 0.5 to 13.5), respectively (p=0.021) in the pre-protocol population. Virologic response occurred in more patients receiving ozone therapy with experimental device than patients receiving oral diammonium glycyrrhizinate capsules (mean difference 18.5%, 95% CI 6.3 to 31.5, p=0.005). However, there was no statistical difference in VR12 rates between the treatment of medical ozone therapy system with experimental device (group 1) and with Humares (group 2) (mean difference 7.7%, 95% CI -6.5 to 22.0, p=0.282). More HBeAg seroconversion in patients treated by Tianyi ozone therapy system than those treated by Humares ozone therapy device and oral diammonium glycyrrhizinate capsules (14.8%, 5.1% and 7.3%, respectively, P = 0.272). Higher biochemical response rate was observes in patients receiving ozone therapy than oral diammonium glycyrrhizinate capsules (31.6%, 36.7% and 24.0%, respectively, p = 0.359). The safety profile was similar for the three treatment groups and adverse events were .scare infrequent and mild.Conclusions: Ozone therapy had superior antiviral efficacy with a similar safety profile as compared with oral diammonium glycyrrhizinate capsules through week 12 treatment. Ozone therapy is also associated with normalized ALT and AST levels, demonstrating that ozone therapy could benefit the patients with chronic hepatitis B.

Medical ozone therapy reduces oxidative stress and testicular damage in an experimental model of testicular torsion in rats.

ABSTRACTObjective:Testicular torsion (TT) refers to rotation of the testis and twisting of the spermatic cord. TT results in ischemia-reperfusion (I/R) injury involving increased oxidative stress, inflammation and apoptosis, and can even lead to infertility. The aim of this study was to investigate the effect of ozone therapy on testicular damage due to I/R injury in an experimental torsion model.Materials and Methods:24 male Sprague-Dawley rats were divided into 3 groups; shamoperated, torsion/detorsion (T/D), and T/D+ozone. Ozone (1mg/kg) was injected intraperitoneally 120 minutes before detorsion and for the following 24h. Blood and tissue samples were collected at the end of 24h. Johnsen score, ischemia modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were determined.Results:Levels of IMA, TOS, OSI, and histopathological scores increased in the serum/tissue of the rats in the experimental T/D group. Serum IMA, TOS, and OSI levels and tissue histopathological scores were lower in the rats treated with ozone compared with the T/D group.Conclusion:Our study results suggest that ozone therapy may exhibit beneficial effects on both biochemical and histopathological findings. Clinical trials are now necessary to confirm this.

The beneficial effects of ozone therapy in acetaminophen-induced hepatotoxicity in mice.

The aim of the present study was to determine the therapeutic effects of medical ozone therapy on acute acetaminophen (APAP)-induced hepatotoxicity which were not clearly demonstrated in prior studies. Twenty-four mice were randomly assigned into three equal groups: Group 1 (control), Group 2 (APAP) and Group 3 (APAP +ozone). Hepatotoxicity was induced by APAP given as a single dose of 300mg/kg intraperitoneally in Groups 2 and 3. Additionally, Group 3 received 20mcg/0.5mL ozone intraperitoneal twice a day for the remaining of the study. Other groups received saline injections. On the fourth day of the study, biochemical variables (AST, ALT, ALP) and liver histopathology was assessed. Intraperitoneal administration of a single dose of APAP induced hepatocellular damage that was shown by both liver enzymes and histopathological changes (p<0.001). AST, ALT, ALP levels were elevated in both groups 2 and 3 and the difference from group 1 was statistically significant (p<0.01).Mean ALT and AST levels of group 2 were statistically significantly higher versus group 3 (p<0.01). In histopathological examinations; necrosis and inflammation were more prominent in Group 2 compared to Group 3 (p<0.01). Ozone showed beneficial effects on APAP hepatotoxicity at a statistically significant level. It is known that ozone has therapeutic effects in various diseases owing to its antioxidant effects. The present study suggests that ozone may be utilized as a routine supplementary therapy in acute APAP hepatotoxicity.

Medical ozone therapy reduces shock wave therapy-induced renal injury

Objectives: Extracorporeal shock wave (ESW) lithotripsy is the preferred treatment modality for uncomplicated kidney stones. More recently free oxygen radical production following ESW application has been considered to be crucial in shock wave-induced renal damage. It has been shown that ozone therapy (OT) has ameliorative and preventive effects against various pathological conditions due to increased nitro-oxidative stress. In current study, we aimed to evaluate the efficacy of OT against ESW-induced renal injury. Methods: Twenty-four male Sprague–Dawley rats were divided into three groups: sham-operated, ESW, and ESW + OT groups. All groups except sham-operated group were subjected to ESW procedure. ESW + OT group received 1 mg/kg/day of oxygen/ozone mixture intraperitoneally at 2 h before ESW, and OT was continued once a day for consecutive three days. The animals were killed at the 4th day, and kidney tissue and blood samples were harvested for biochemical and histopathologic analysis. Results: Serum ALT and AST levels, serum neopterin, tissue nitrite/nitrate levels, and tissue oxidative stress parameters were increased in the ESW group and almost came close to control values in the treatment group (p < 0.05, ESW vs. ESW + OT). Histopathological injury scores were significantly lower in treatment group than the ESW group (p < 0.05, ESW vs. ESW + OT). Immunohistochemical iNOS staining scores in ESW group were higher than those of sham-operated group (p < 0.05, ESW vs. sham-operated), iNOS staining scores in OT group were significantly lower than the ESW group (p < 0.05, ESW + OT vs. ESW). Conclusion: OT ameliorates nitro-oxidative stress and reduces the severity of pathological changes in the experimental ESW-induced renal injury of rat model.

Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis.

Osteoarthritis (OA) is the most common degenerative joint disease and a growing health problem affecting more than half of the population over the age of 65. It is characterized by inflammation in the cartilage and synovium, resulting in the loss of joint structure and progressive damage to the cartilage. Many pro-inflammatory mediators are elevated in OA, including reactive oxygen species (ROS) such as nitric oxide (NO) and hydrogen peroxide (H2O2). Damaged articular cartilage remains a challenge to treat due to the limited self-healing capacity of the tissue and unsuccessful biological interventions. This highlights the need for better therapeutic strategies to heal damaged articular cartilage. Ozone (O3) therapy has been shown to have positive results in the treatment of OA; however the use of O3 therapy as a therapeutic agent is controversial. There is a perception that O3 is always toxic, whereas evidence indicates that when it is applied following a specified method, O3 can be effective in the treatment of degenerative diseases. The mechanism of action of O3 therapy in OA is not fully understood and this review summarizes the use of O3 therapy in the treatment of damaged articular cartilage in OA.

Medical ozone therapy for the inner ear acoustic trauma

ObjectivesThe goal of the study was to look at the potential protective effect of ozone therapy by studying its antioxidant and vasodilatation effects against hearing loss caused by acoustic trauma. MethodsThirty-two male Wistar Albino rats were divided into four groups of eight. The 1st group was exposed to acoustic trauma, the 2nd group was treated with ozone initially, and was exposed to acoustic trauma 24h later, the 3rd group received ozone without trauma, while the 4th group was the control group. The 1st and 2nd groups were exposed to acoustic trauma with 105dB SPL white band noise for 4h. DPOAE and ABR tests were conducted in all groups on the 1st, 5th, and 10th days after trauma. ResultsIn the 1st group, the effects of acoustic trauma continued on days 1, 5 and 10. The 2nd group's DPOAE and ABR results on days 5 and 10 showed significant improvement at all frequencies compared to deterioration on day 1, and the readings were comparable to baseline measurements. ConclusionAcoustic trauma is a pathology that is experienced frequently and leads to many problems in terms of health and cost. Ozone was demonstrated to be a reparative substance against acoustic trauma and, in addition, it can be supplied and applied easily.