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Pelinsari SM, Sarandy MM, Vilela EF, Novaes RD, Schlamb J, Gonçalves RV. Ozone Exposure Controls Oxidative Stress and the Inflammatory Process of Hepatocytes in Murine Models. Antioxidants (Basel) 2024; 13:212. [PMID: 38397810 PMCID: PMC10886373 DOI: 10.3390/antiox13020212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Ozone exposure is a promising tool for treating liver damage since it is known to control the release of free radicals and increase the expression of antioxidant enzymes. The objective is to investigate the main intracellular pathways activated after exposure to ozone, considering the dosage of antioxidant enzymes and markers of oxidative stress. (2) Methods: This systematic review was performed based on the PRISMA guidelines and using a structured search in MEDLINE (PubMed), Scopus, and Web of Science. Bias analysis and methodological quality assessments were examined using the SYRCLE Risk of Bias tool. (3) Results: Nineteen studies were selected. The results showed that the exposure to ozone has a protective effect on liver tissue, promoting a decrease in inflammatory markers and a reduction in oxidative stress in liver tissue. In addition, ozone exposure also promoted an increase in antioxidant enzymes. The morphological consequences of controlling these intracellular pathways were reducing the tissue inflammatory process and reducing areas of degeneration and necrosis. (4) Conclusions: Ozone exposure has a beneficial effect on models of liver injury through the decrease in oxidative stress in tissue and inflammatory markers. In addition, it regulates the Nrf2/ARE antioxidant pathway and blocks the NF-κB inflammatory pathway.
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Affiliation(s)
- Silvania Mol Pelinsari
- Departament of General Biology, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (S.M.P.)
| | - Mariáurea Matias Sarandy
- Departament of General Biology, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (S.M.P.)
- Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, NC 28081, USA
| | - Emerson Ferreira Vilela
- Agriculture and Livestock Research Enterprise of Minas Gerais (EPAMIG-Sudeste), Viçosa 36570-000, MG, Brazil
| | - Rômulo Dias Novaes
- Departament of Structural Biology, Federal University of Alfenas, Alfenas 37130-001, MG, Brazil;
- Departament of Animal Biology, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil
| | - Jade Schlamb
- Plants for Human Health Institute, North Carolina Research Campus, North Carolina State University, Kannapolis, NC 28081, USA
| | - Reggiani Vilela Gonçalves
- Departament of General Biology, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil; (S.M.P.)
- Departament of Animal Biology, Federal University of Viçosa, Viçosa 36570-900, MG, Brazil
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Dong J, Zhang L, Jia H, Zhu Y, Xiang R, Li P. Effects of adjuvant application of corticosteroid and ozone after ultrasound-guided puncture and lavage for the treatment of rotator cuff calcific tendinitis: study protocol for a non-inferiority randomized controlled trial. Trials 2023; 24:375. [PMID: 37277813 DOI: 10.1186/s13063-023-07401-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 05/22/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Steroid injection after percutaneous irrigation of calcific deposits is a common method for the treatment of rotator cuff calcific tendinitis (RCCT). However, steroids may prevent calcification resorption and cause potentially irreversible damage to tendons. Recent studies have confirmed the positive effects of ozone injection in shoulder tendinopathies, but no RCCTs have been reported. Thus, our study aims to evaluate the non-inferiority of ozone versus steroid injection. METHODS This is a prospective, randomized, parallel control and non-inferiority trial. A total of 100 patients with unilateral symptomatic RCCT will be enrolled and randomized in a 1:1 ratio to two groups: ultrasound-guided injection with ozone or corticosteroid. The primary outcome is the numeric rating scale for pain (NRS) at 1 week and 3 months following the procedure. Secondary outcomes include a multi-dimensional evaluation of shoulder disability and quality of life improvement, the degree of calcification absorption after treatment, and the number of multiple treatments. DISCUSSION The results of this study will provide short-term and long-term evidence for the effectiveness of ozone treatment in RCCT in relieving pain or improving shoulder function. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2200063469. Registered on 7 September 2022.
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Affiliation(s)
- Jing Dong
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China
| | - Lan Zhang
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China
| | - Haibin Jia
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China
| | - Yuanjiang Zhu
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China
| | - Rui Xiang
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China
| | - Peiyu Li
- Department of Anesthesiology, Sichuan Provincial Orthopedic Hospital, No. 132 West First Section First Ring Road, Chengdu, China.
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Ogut E, Armagan K. Evaluation of the Potential Impact of Medical Ozone Therapy on Covid-19: A Review Study. OZONE: SCIENCE & ENGINEERING 2023; 45:213-231. [DOI: 10.1080/01919512.2022.2065242] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/07/2022] [Indexed: 07/22/2023]
Affiliation(s)
- Eren Ogut
- Department of Anatomy, School of Medicine, Bahçeşehir University, İstanbul, 34715, Turkey
| | - Kutay Armagan
- Medical Faculty Student, School of Medicine, Bahcesehir University, Istanbul, Turkey
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Ogut E, Armagan K. Evaluation of the Potential Impact of Medical Ozone Therapy on Covid-19: A Review Study. OZONE: SCIENCE & ENGINEERING 2023; 45:213-231. [DOI: https:/doi.org/10.1080/01919512.2022.2065242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/07/2022] [Indexed: 07/22/2023]
Affiliation(s)
- Eren Ogut
- Department of Anatomy, School of Medicine, Bahçeşehir University, İstanbul, 34715, Turkey
| | - Kutay Armagan
- Medical Faculty Student, School of Medicine, Bahcesehir University, Istanbul, Turkey
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Shang W, Wang Y, Wang G, Han D. Benefits of ozone on mortality in patients with COVID-19: A systematic review and meta-analysis. Complement Ther Med 2023; 72:102907. [PMID: 36513208 PMCID: PMC9737514 DOI: 10.1016/j.ctim.2022.102907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. Ozone therapy has long been used in the treatment of a variety of infectious diseases, probably through its antioxidant properties and the supply of oxygen to hypoxic tissues. This systematic review and meta-analysis aimed to determine the efficacy of ozone on mortality in patients with COVID-19. METHODS A systematic search was made of PubMed, Embase, Cochrane Library, and clinicaltrials.gov, without language restrictions. Prospective controlled trials on treatment of COVID-19 with ozone, compared with placebo or blank, were reviewed. Studies were pooled to risk ratios (RRs) and weighted mean differences (WMDs), with 95% confidence intervals (CIs). RESULTS Eight trials (enrolling 371 participants) met the inclusion criteria. Ozone therapy showed significant effects on mortality (RR 0.38, 95% CI 0.17-0.85; P = 0.02), length of hospital stay (WMD -1.63 days, 95% CI -3.05 to -0.22 days; P = 0.02), and polymerase chain reaction (PCR) positivity (RR 0.07, 95% CI 0.01-0.34; P = 0.001). CONCLUSIONS Ozone therapy significantly reduced mortality, PCR positivity, and length of stay in hospitalized patients with COVID-19. Ozone therapy should be considered for COVID-19 patients.
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Affiliation(s)
- Wenli Shang
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi 710061, China
| | - Guizuo Wang
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China
| | - Dong Han
- Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi 710068, China,Correspondence to: Department of Respiratory and Critical Care Medicine, Shaanxi Provincial People’s Hospital, No. 256, West Youyi Road, Xi’an, Shaanxi 710068, China
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Jafari-Oori M, Vahedian-azimi A, Ghorbanzadeh K, Sepahvand E, Dehi M, Ebadi A, Izadi M. Efficacy of ozone adjuvant therapy in COVID-19 patients: A meta-analysis study. Front Med (Lausanne) 2022; 9:1037749. [PMID: 36438064 PMCID: PMC9685165 DOI: 10.3389/fmed.2022.1037749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/19/2022] [Indexed: 10/14/2023] Open
Abstract
Introduction Using ozone therapy to manage COVID-19 patients has been accompanied by conflicting results in prior studies. Therefore, we aimed to widely assess the effects of ozone as adjuvant therapy in COVID-19 patients. Methods PubMed, Scopus, Web of Science, Cochrane, ProQuest, Springer, and Sage journals were searched systematically until April 2022. Mortality rate, ICU admission, hospital-length stay, negative PCR, pulmonary, renal, and hepatic functions, as well as inflammatory and blood systems were pooled to compare the efficacy of ozone as adjacent therapy (OZ) and standard treatment (ST). Analyses were run with the random/fixed models, sub-group analysis, funnel plot, and sensitivity analysis using comprehensive meta-analysis (CMA) software version 2.0. Results The results of four randomized clinical trials (RCTs) and four case-control studies with a total of 371 COVID-19 positive patients were analyzed. The OZ group patients had a shorter length of hospital stay (P > 0.05), lower ICU admissions (P > 0.05), and lower mortality rates (P < 0.05) than the ST group cases. After treatment, 41% more COVID-19 patients had negative PCR tests than the ST group (P < 0.05). Serum creatinine and urea levels were not modified in either group (P > 0.05). Moreover, except for albumin serum levels, which decreased significantly in the OZ group, serum bilirubin, ALT, and AST were not modified in either group (P > 0.05). Both arms did not show a decrease in C-reactive protein blood levels (P > 0.05), but the OZ group showed a significant modification in LDH serum levels (P < 0.05). Unlike the d-dimer and WBC serum levels (P > 0.05), platelet levels were increased in the OZ group (P < 0.05). No negative side effects were demonstrated in either group. Conclusion Ozone therapy was effective significantly on PCR test and LDH serum levels, as well as mortality based on overall estimation. Concerning the length of hospital stay and ICU admissions, although the results were insignificant, their effect sizes were notable clinically. More RCT studies are needed to show the efficacy of ozone therapy on other studied variables.
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Affiliation(s)
- Mehdi Jafari-Oori
- Atherosclerosis Research Center, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Kobra Ghorbanzadeh
- Department of Nursing, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Elham Sepahvand
- Social Determinants of Health Research Center, Poledokhtar School of Nursing, Lorestan University of Medical Sciences, Lorestan, Iran
| | - Manijeh Dehi
- Department of Nursing, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Abbas Ebadi
- Faculty of Nursing, Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mortaza Izadi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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The Mito-Hormetic Mechanisms of Ozone in the Clearance of SARS-CoV2 and in the COVID-19 Therapy. Biomedicines 2022; 10:biomedicines10092258. [PMID: 36140358 PMCID: PMC9496465 DOI: 10.3390/biomedicines10092258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
An increasing body of evidence in the literature is reporting the feasibility of using medical ozone as a possible alternative and adjuvant treatment for COVID-19 patients, significantly reducing hospitalization time, pro-inflammatory indicators, and coagulation markers and improving blood oxygenation parameters. In addition to the well-described ability of medical ozone in counteracting oxidative stress through the upregulation of the main anti-oxidant and scavenging enzymes, oxygen–ozone (O2–O3) therapy has also proved effective in reducing chronic inflammation and the occurrence of immune thrombosis, two key players involved in COVID-19 exacerbation and severity. As chronic inflammation and oxidative stress are also reported to be among the main drivers of the long sequelae of SARS-CoV2 infection, a rising number of studies is investigating the potential of O2–O3 therapy to reduce and/or prevent the wide range of post-COVID (or PASC)-related disorders. This narrative review aims to describe the molecular mechanisms through which medical ozone acts, to summarize the clinical evidence on the use of O2–O3 therapy as an alternative and adjuvant COVID-19 treatment, and to discuss the emerging potential of this approach in the context of PASC symptoms, thus offering new insights into effective and safe nonantiviral therapies for the fighting of this devastating pandemic.
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Setyo Budi D, Fahmi Rofananda I, Reza Pratama N, Sutanto H, Sukma Hariftyani A, Ratna Desita S, Zinedinita Rahmasari A, Pudy Asmarawati T, Agung Waskito L, Dyah Kencono Wungu C. Ozone as an adjuvant therapy for COVID-19: A systematic review and meta-analysis. Int Immunopharmacol 2022; 110:109014. [PMID: 35803132 PMCID: PMC9250927 DOI: 10.1016/j.intimp.2022.109014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/31/2022] [Accepted: 06/28/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Ozone adjuvant in COVID-19 management showed conflicting results in prior studies. Here, we aimed to comprehensively evaluate benefits and side effects of ozone as adjuvant therapy in COVID-19 patients. METHODS Systematic searches were conducted in MEDLINE, ScienceDirect, Cochrane Library, Springer, medRxiv, and ProQuest for articles investigating ozone as adjuvant therapy in COVID-19. Clinical and laboratory outcomes, mortality, length of hospital stay, intensive care unit (ICU) admission, and adverse events were assessed. RESULTS Thirteen studies were included in this review. Case-control studies, but not randomized controlled trials (RCTs), showed a decrease in mortality following ozone therapy (OR = 0.24 (95% CI [0.07-0.76]), p = 0.02, I2 = 0%, fixed-effect). However, ozone therapy did not improve the length of hospital stay (SMD = -0.99 (95 %CI -2.44 to 0.45), p = 0.18, I2 = 84%, random-effects) and ICU admission (RR = 0.57 (95 %CI [0.05-6.71]), I2 = 73%, p = 0.65, random-effects). Consecutive case control studies suggested that ozone therapy significantly improved levels of D-dimer (p = 0.0060), lactate dehydrogenase (LDH; p = 0.0209), C-reactive protein (CRP; p = 0.0040) and interleukin (IL)-6 (p = 0.0048) as compared to standard therapy alone. CONCLUSIONS The beneficial effect of ozone in COVID-19 management seems to be limited to the improvements of laboratory parameters among severe patients, including the reduction of IL-6, LDH, CRP, and D-dimer levels. Meanwhile, other study endpoints, such as mortality, length of stay and ICU admission, were not improved following ozone therapy, although it may partly be due to a shorter duration of viral clearance. Furthermore, no serious adverse event was reported following ozone therapy, suggesting its high safety profile. (PROSPERO ID: CRD42021278018).
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Affiliation(s)
| | | | | | - Henry Sutanto
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, the Netherlands,Department of Physiology and Pharmacology, State University of New York (SUNY) Downstate Health Sciences University, NY, USA
| | | | | | | | - Tri Pudy Asmarawati
- Department of Internal medicine, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Langgeng Agung Waskito
- Department of Internal medicine, Faculty of Medicine, Universitas Airlangga, Indonesia,Institute of Tropical Disease, Universitas Airlangga, Indonesia,Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Institute of Tropical Disease, Universitas Airlangga, Indonesia; Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Indonesia.
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Cenci A, Macchia I, La Sorsa V, Sbarigia C, Di Donna V, Pietraforte D. Mechanisms of Action of Ozone Therapy in Emerging Viral Diseases: Immunomodulatory Effects and Therapeutic Advantages With Reference to SARS-CoV-2. Front Microbiol 2022; 13:871645. [PMID: 35531273 PMCID: PMC9069003 DOI: 10.3389/fmicb.2022.871645] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/07/2022] [Indexed: 12/24/2022] Open
Abstract
Medical oxygen-ozone (O2-O3) is a successful therapeutic approach accounting on the assessed beneficial action of ozone in the range 30–45 μg/ml (expanded range 10–80 μg/ml according to different protocols), as in this dosage range ozone is able to trigger a cellular hormetic response via the modulating activity of reactive oxygen species (ROS), as signaling molecules. The ozone-dependent ROS-mediated fatty acid oxidation leads to the formation of lipid ozonization products (LOPs), which act as signal transducers by triggering ROS signaling and therefore mitohormetic processes. These processes ultimately activate survival mechanisms at a cellular level, such as the Nrf2/Keap1/ARE system activation, the AMPK/FOXO/mTOR/Sir1 pathway and the Nrf2/NF-kB cross talk. Furthermore, indirectly, via these pathways, LOPs trigger the HIF-1α pathway, the HO-1 signaling and the NO/iNOS biochemical machinery. Ozone-driven shift of cytokine activation pathways, from pro-inflammatory to anti-inflammatory immediately afterwards, also exert direct immunoregulatory effects on regulatory T lymphocytes as well as on the intestinal microbiota, which in turn can affect immune response thus influencing the progression of the disease. In this review, we will describe the biological and biochemical mechanisms of action of ozone therapy with the aim of evaluating both positive and critical aspects of ozone use as a therapeutic adjuvant in the light of emerging viral infections, such as SARS-CoV-2 and microbiome-associated disorders related to SARS-CoV-2.
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Affiliation(s)
- Alessandra Cenci
- Core Facilities, Italian National Institute of Health, Rome, Italy
- *Correspondence: Alessandra Cenci,
| | - Iole Macchia
- Department of Oncology and Molecular Medicine, Italian National Institute of Health, Rome, Italy
| | - Valentina La Sorsa
- Research Coordination and Support Service, Italian National Institute of Health, Rome, Italy
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Sabancı AU, Erkan Alkan P, Mujde C, Polat HU, Ornek Erguzeloglu C, Bisgin A, Ozakin C, Temel SG. Nanobubble Ozone Stored in Hyaluronic Acid Decorated Liposomes: Antibacterial, Anti-SARS-CoV-2 Effect and Biocompatibility Tests. Int J Nanomedicine 2022; 17:351-379. [PMID: 35115773 PMCID: PMC8801396 DOI: 10.2147/ijn.s328090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Ahmet Umit Sabancı
- Bursa Çekirge State Hospital, Orthopedics and Traumatology Clinic, Bursa, Turkey
| | - Perihan Erkan Alkan
- Bursa Uludağ University, Vocational School of Health Services, Medical Laboratory Technician Department, Bursa, Turkey
| | - Cem Mujde
- Çukurova University AGENTEM (Adana Genetic Diseases and Treatment Center), Adana, Turkey
| | - Hivda Ulbeği Polat
- TUBITAK, Marmara Research Center, Genetic Engineering and Biotechnology Institute, Gebze, Kocaeli, Turkey
| | - Cemre Ornek Erguzeloglu
- Bursa Uludag University, Institute of Health Sciences, Department of Translational Medicine, Bursa, Turkey
| | - Atil Bisgin
- Çukurova University AGENTEM (Adana Genetic Diseases and Treatment Center), Adana, Turkey
- Çukurova University, Faculty of Medicine, Department of Medical Genetics, Adana, Turkey
| | - Cuneyt Ozakin
- Bursa Uludağ University, Faculty of Medicine, Department of Infectious Diseases and Microbiology, Bursa, Turkey
- Correspondence: Cuneyt Ozakin Bursa Uludağ University, Faculty of Medicine, Department of Infectious Diseases and Microbiology, Bursa, Turkey Email
| | - Sehime G Temel
- Bursa Uludag University, Institute of Health Sciences, Department of Translational Medicine, Bursa, Turkey
- Bursa Uludağ University, Faculty of Medicine, Department of Medical Genetics, Bursa, Turkey
- Bursa Uludag University, Health Sciences Institute, Department of Translational Medicine, Bursa, Turkey
- Sehime G Temel Bursa Uludağ University, Faculty of Medicine, Department of Medical Genetics, Bursa, Turkey Email
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Niño-Sandoval TC, Rocha NS, Sarinho FW, Vasconcelos CFDM, Vasconcelos AFDM, Vasconcelos BC. Effect of autohemotherapy in the treatment of viral infections - a systematic review. Public Health 2021; 201:78-88. [PMID: 34798327 DOI: 10.1016/j.puhe.2021.09.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 08/19/2021] [Accepted: 09/23/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To analyze the literature to determine whether autohemotherapy has any effect either clinically or on the immune system on viral diseases on the last ten years. STUDY DESIGN Systematic review. METHODS Searches from the year 2010, with at least 5 patients were conducted in PubMed/MEDLINE, Embase, Scopus, Cochrane, LILACS, SciELO, and Web of Science databases. Hand searches were performed in systematic reviews and literature reviews related to autohemotherapy. Unpublished manuscripts were hand-searched in specialized journals. RESULTS Eight articles were included. Hepatitis B virus, hepatitis C virus, and Coronavirus were evaluated. Autohemotherapy had good results in hepatitis C, hepatitis B, and Coronavirus. CONCLUSION Autohemotherapy is a safe practice that improves symptoms in the treatment of hepatitis B virus, hepatitis C virus, and Coronavirus. It is necessary to perform more prospective comparative studies with homogeneous protocols.
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Affiliation(s)
- T C Niño-Sandoval
- Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco - School of Dentistry (UPE/FOP), University Hospital Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife PE, CEP: 50.100-130, Brazil.
| | - N S Rocha
- Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco - School of Dentistry (UPE/FOP), University Hospital Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife PE, CEP: 50.100-130, Brazil.
| | - F W Sarinho
- Master Program of Graduate Studies in Child and Adolescent Center of Health Sciences, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife PE: 50670-901, Brazil.
| | - C F de M Vasconcelos
- Doctorate Program in Surgery, Faculty of Medicine, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife PE: 50670-901, Brazil.
| | - A F de M Vasconcelos
- Faculty of Dentistry, Federal University of Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife PE: 50670-901, Brazil.
| | - B C Vasconcelos
- Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco - School of Dentistry (UPE/FOP), University Hospital Oswaldo Cruz, Rua Arnóbio Marquês, 310 - Santo Amaro, Recife PE, CEP: 50.100-130, Brazil.
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12
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Dengiz E, Özcan Ç, Güven Yİ, Uçar S, Ener BK, Sözen S, Yağcı B, Güzel İA, Yiğit B, Andaç A, Güneş B, Bor E, Karabudak U, Kaya A. Ozone gas applied through nebulization as adjuvant treatment for lung respiratory diseases due to COVID-19 infections: a prospective randomized trial. Med Gas Res 2021; 12:55-59. [PMID: 34677153 PMCID: PMC8562398 DOI: 10.4103/2045-9912.326001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
The objective of this study was to provide lung disinfection by nebulizing ozone gas with distilled water and olive oil for patients who have clinical symptoms due to coronavirus disease 2019 (COVID-19). The study attempted to reduce the viral load of COVID-19 in the lungs of patients, to provide a faster response to medical treatment. Between August 2020 and September 2020, 30 patients who met the study criteria were prospectively evaluated. There were 2 groups with 15 patients in each group: patients in control group were not treated with ozone and only received standard COVID-19 treatment; patients in ozone group received lung disinfection technique with ozone and standard COVID-19 treatment. A statistically significant difference was found in the length of stay in hospital, change in C-reactive protein, polymerase chain reaction results after 5 days, and computed tomography scores between two groups. There was no statistically significant difference in D-dimer, urea, lactate dehydrogenase, lymphocyte, leukocyte, and platelet between two groups. According to the data, we think that the lung disinfection technique applied with ozone inhalation reduces the rate of pneumonia in COVID-19 patients and makes the patients respond faster to the treatment and become negative according to the polymerase chain reaction tests. The study was approved by the Ethical Committee of the İstanbul Medipol University Clinical Trials (approval No. 0011) on July 2, 2020.
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Affiliation(s)
- Erhan Dengiz
- Edis Pharma Pharmaceutical Industry, Istanbul, Turkey
| | - Çağrı Özcan
- Health Science Univercity, Umraniye Training and Research Hospital, Istanbul, Turkey
| | | | - Selcen Uçar
- Dr. Feriha Öz Emergency Hospital, İstanbul, Turkey
| | - Behçet Kemal Ener
- Health Science Univercity, Umraniye Training and Research Hospital, Istanbul, Turkey
| | | | - Buket Yağcı
- Health Science Univercity, Haydarpasa Training and Research Hospital, İstanbul, Turkey
| | | | - Betül Yiğit
- Dr. Feriha Öz Emergency Hospital, İstanbul, Turkey
| | | | | | - Emire Bor
- Edis Pharma Pharmaceutical Industry, Istanbul, Turkey
| | | | - Ali Kaya
- Edis Pharma Pharmaceutical Industry, Istanbul, Turkey
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Sozio E, De Monte A, Sermann G, Bassi F, Sacchet D, Sbrana F, Ripoli A, Curcio F, Fabris M, Marengo S, Italiani D, Luciana Boccalatte-Rosa D, Tascini C. CORonavirus-19 mild to moderate pneumonia Management with blood Ozonization in patients with Respiratory failure (CORMOR) multicentric prospective randomized clinical trial. Int Immunopharmacol 2021; 98:107874. [PMID: 34186281 PMCID: PMC8196321 DOI: 10.1016/j.intimp.2021.107874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Following positive experience on the use of blood ozonation in SARS-CoV-2, the CORMOR randomized trial was designed to evaluate the adjuvant role of oxygen/ozone therapy in mild to moderate SARS-CoV-2 pneumonia. METHODS The trial (ClinicalTrial.gov NCT04388514) was conducted in four different Italian centers (April-October 2020). Patients were treated according to best available standard of care (SoC) therapy, with or without O3-autohemotherapy (O3-AHT). RESULTS A total of 92 patients were enrolled: SoC + O3-AHT (48 patients) were compared to the SoC treatment (44 patients). The two groups differed in steroids therapy administration (72.7% in SoC arm vs. 50.0% in O3-AHT arm; p = 0.044). Steroid therapy was routinely started when it was subsequently deemed as effective for the treatment of COVID-19 disease. No significant differences in mortality rates, length of hospital stay, mechanical ventilation requirement and ICU admission were observed. Clinical improvement in patients with pneumonia was assessed according to a specifically designed score (decrease in SIMEU class, improvement in radiology imaging, improvement in PaO2/FiO2, reduction in LDH and requirement of oxygen therapy ≤ 5 days). Score assessment was performed on day-3 (T3) and day-7 (TEnd) of O3-AHT treatment. A significant increase in the score was reported at TEnd, in the O3-AHT treatment arm (0 [0-1] in the SoC arm vs. 2 [1-3] the O3-AHT arm; p = 0.018). No adverse events related O3-AHT treatment was observed. CONCLUSION In mild-to-moderate pneumonia due to SARS-CoV-2, adjuvant oxygen/ozone therapy did not show any effect on mortality, or mechanical intubation but show a clinical improvement a day 7 from randomization in a composite clinical endpoint. Larger Randomized prospective studies alone or in combination with steroids are needed to confirm our results.
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Affiliation(s)
- Emanuela Sozio
- U.O. Malattie Infettive, Dipartimento di Medicina dell'Università di Udine, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - Amato De Monte
- SOC Anestesia e Rianimazione 1, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - Giovanni Sermann
- SOC Anestesia e Rianimazione 1, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - Flavio Bassi
- SOC Anestesia e Rianimazione 2, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - Davide Sacchet
- U.O. Malattie Infettive, Dipartimento di Medicina dell'Università di Udine, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
| | - Francesco Sbrana
- U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monastrio, Via Moruzzi1, Pisa, Italy.
| | - Andrea Ripoli
- Deep Health Unit, Fondazione Toscana "Gabriele Monasterio", Pisa, Italy.
| | - Francesco Curcio
- Istituto di Patologia Clinica, Azienda Sanitaria Universitaria Integrata di Udine (ASUID), Udine, Italy.
| | - Martina Fabris
- Istituto di Patologia Clinica, Azienda Sanitaria Universitaria Integrata di Udine (ASUID), Udine, Italy.
| | - Stefania Marengo
- SC di Medicina Interna e Unità di Terapia Semi Intensiva Internistica, Ordine Mauriziano di Torino, Torino, Italy.
| | | | | | - Carlo Tascini
- U.O. Malattie Infettive, Dipartimento di Medicina dell'Università di Udine, Università di Udine e Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
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Abstract
CoVID-19 is a multi-symptomatic disease which has made a global impact due to its ability to spread rapidly, and its relatively high mortality rate. Beyond the heroic efforts to develop vaccines, which we do not discuss herein, the response of scientists and clinicians to this complex problem has reflected the need to detect CoVID-19 rapidly, to diagnose patients likely to show adverse symptoms, and to treat severe and critical CoVID-19. Here we aim to encapsulate these varied and sometimes conflicting approaches and the resulting data in terms of chemistry and biology. In the process we highlight emerging concepts, and potential future applications that may arise out of this immense effort.
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Affiliation(s)
| | - Yimon Aye
- Swiss Federal Institute of Technology in Lausanne (EPFL)1015LausanneSwitzerland
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15
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Chirumbolo S, Valdenassi L, Simonetti V, Bertossi D, Ricevuti G, Franzini M, Pandolfi S. Insights on the mechanisms of action of ozone in the medical therapy against COVID-19. Int Immunopharmacol 2021; 96:107777. [PMID: 34020394 PMCID: PMC8112288 DOI: 10.1016/j.intimp.2021.107777] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/28/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023]
Abstract
An increasing amount of reports in the literature is showing that medical ozone (O3) is used, with encouraging results, in treating COVID-19 patients, optimizing pain and symptoms relief, respiratory parameters, inflammatory and coagulation markers and the overall health status, so reducing significantly how much time patients underwent hospitalization and intensive care. To date, aside from mechanisms taking into account the ability of O3 to activate a rapid oxidative stress response, by up-regulating antioxidant and scavenging enzymes, no sound hypothesis was addressed to attempt a synopsis of how O3 should act on COVID-19. The knowledge on how O3 works on inflammation and thrombosis mechanisms is of the utmost importance to make physicians endowed with new guns against SARS-CoV2 pandemic. This review tries to address this issue, so to expand the debate in the scientific community.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Luigi Valdenassi
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Vincenzo Simonetti
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Dario Bertossi
- Department of Surgery, Dentistry, Paediatrics and Gynaecology Unit of Maxillo-Facial Surgery University of Verona, Verona, Italy
| | | | - Marianno Franzini
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy
| | - Sergio Pandolfi
- SIOOT, High School in Oxygen Ozone Therapy, University of Pavia, Italy; SIOOT INTERNATIONAL, Communian Clinic, Gorle Bergamo, Italy; Villa Mafalda Clinics via Monte delle Gioie, Rome, Italy
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16
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De Monte A, Sermann G, Sozio E, Sbrana F, Tascini C. Blood ozonization in patients with mild to moderate COVID-19 pneumonia: a single centre experience: reply. Intern Emerg Med 2021; 16:795-796. [PMID: 33534080 PMCID: PMC7854869 DOI: 10.1007/s11739-021-02630-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 01/15/2023]
Affiliation(s)
- Amato De Monte
- SOC Anestesia e Rianimazione Uno, Università di Udine e Azienda Sanitaria Universitaria Integrata Di Udine, Udine, Italia
| | - Giovanni Sermann
- SOC Anestesia e Rianimazione Uno, Università di Udine e Azienda Sanitaria Universitaria Integrata Di Udine, Udine, Italia
| | - Emanuela Sozio
- U.O. Malattie Infettive, Dipartimento di Medicina dell'Università di Udine, Università di Udine e Azienda Sanitaria Universitaria Integrata Di Udine, Udine, Italia
| | - Francesco Sbrana
- U.O. Lipoapheresis and Center for Inherited Dyslipidemias, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Carlo Tascini
- U.O. Malattie Infettive, Dipartimento di Medicina dell'Università di Udine, Università di Udine e Azienda Sanitaria Universitaria Integrata Di Udine, Udine, Italia.
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17
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Fernández-Cuadros ME, Albaladejo-Florín MJ, Álava-Rabasa S, Gallego-Galiana J, Pérez-Cruz GF, Usandizaga-Elio I, Pacios E, Torres-García DE, Peña-Lora D, Casique-Bocanegra L, López-Muñoz MJ, Rodríguez-de-Cía J, Pérez-Moro OS. Compassionate Use of Rectal Ozone (O 3) in Severe COVID-19 Pneumonia: a Case-Control Study. ACTA ACUST UNITED AC 2021; 3:1185-1199. [PMID: 33778374 PMCID: PMC7984736 DOI: 10.1007/s42399-021-00849-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/11/2022]
Abstract
Objectives To evaluate effect of rectal ozone in severe COVID-19 pneumonia and to compare it to standard of care (SOC). Material and Methods In a case-control study, 14 patients with severe bilateral COVID-19 pneumonia (positive RT-PCR), treated with SOC and rectal ozone, were evaluated before-and-after treatment and compared with SOC (14 patients) in a 10-day follow-up period. Ozone protocol consisted of 8 sessions (1 session/day) of intra-rectal ozone (150 mL volume, 35 μg/mL concentration [5.25mg total dose]). The SOC protocol included O2 supply, antivirals (Remdesivir), corticosteroids (Dexamethasone/Metilprednisolone), monoclonal antibodies (Anakinra/Tocilizumab), antibiotics (Azytromicine), and anticoagulants (Enoxaparine). Primary outcome variables were the following: (a) clinical (O2 saturation and O2 supply); (b) biochemical (lymphocyte count, fibrinogen, D-dimer, urea, ferritin, LDH, IL-6, and CRP); (c) radiological Taylor’s scale. Secondary outcome variables were the following: (a) hospitalization length of stay, (b) mortality rate. Results At baseline, ozone/SOC groups were not different on age, comorbidities, O2 saturation, and O2 supply. Patients in the ozone group improved O2 saturation and decrease O2 supply. SOC maintained O2 saturation and required more O2 supply. Lymphocyte count improved only in the ozone group and with statistical difference (p<0.05). Biomarkers of inflammation (fibrinogen, D-dimer, urea, LDH, CRP, and IL-6) decreased in both groups, but only significantly in favor of the ozone group (p<0.05). Ferritin showed a significant decrease in the ozone group but an increase on the SOC group. Radiological pneumonitis decreased on both groups but the decrease was only significant in the ozone group (p<0.0001). Mortality and length of stay, although not significant, were inferior in the ozone group. Conclusion Compassionate use of rectal ozone improved O2 saturation, reduced O2 supply, decreased inflammation biomarkers, and improved Taylor’s radiological scale significantly when compared to the SOC group. Mortality and length of stay were inferior in the ozone group, but this difference was not significant.
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Affiliation(s)
- Marcos Edgar Fernández-Cuadros
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Santa Cristina, Calle del Maestro Vives 2 y 3, 28009 Madrid, Spain
| | - María Jesús Albaladejo-Florín
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Santa Cristina, Calle del Maestro Vives 2 y 3, 28009 Madrid, Spain
| | - Sandra Álava-Rabasa
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Santa Cristina, Calle del Maestro Vives 2 y 3, 28009 Madrid, Spain
| | - Juan Gallego-Galiana
- Servicio de Medicina Interna, Hospital Universitario Santa Cristina, Madrid, Spain
| | | | | | - Enrique Pacios
- Servicio de Medicina Interna, Hospital Universitario Santa Cristina, Madrid, Spain
| | | | - Daiana Peña-Lora
- Unidad de Geriatría, Hospital Universitario Santa Cristina, Madrid, Spain
| | | | | | | | - Olga Susana Pérez-Moro
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Santa Cristina, Calle del Maestro Vives 2 y 3, 28009 Madrid, Spain
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de Sire A, Agostini F, Lippi L, Mangone M, Marchese S, Cisari C, Bernetti A, Invernizzi M. Oxygen-Ozone Therapy in the Rehabilitation Field: State of the Art on Mechanisms of Action, Safety and Effectiveness in Patients with Musculoskeletal Disorders. Biomolecules 2021; 11:biom11030356. [PMID: 33652804 PMCID: PMC7996934 DOI: 10.3390/biom11030356] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/11/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
In recent years, the interest in oxygen–ozone (O2O3) therapy application has considerably increased in the field of rehabilitation. Despite its widespread use in common clinical practice, the biochemical effects of O2O3 are still far from being understood, although its chemical properties seem to play a pivotal role in exerting its positive effects on different pathological conditions. Indeed, the effectiveness of O2O3 therapy might be partly due to the moderate oxidative stress produced by O3 interactions with biological components. O2O3 therapy is widely used as an adjuvant therapeutic option in several pathological conditions characterized by chronic inflammatory processes and immune over-activation, and most musculoskeletal disorders share these pathophysiological processes. The present comprehensive review depicts the state-of-the-art on the mechanisms of action, safety and effectiveness of O2O3 therapy in the complex scenario of the management of musculoskeletal disorders. Taken together, our findings suggest that O2O3 therapy seems to reduce pain and improve functioning in patients affected by low back pain and knee osteoarthritis, as reported by several studies in the literature. However, to date, further studies are warranted to clearly investigate the therapeutic effects of this promising therapy on other musculoskeletal disorders in the field of rehabilitation.
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Affiliation(s)
- Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
- Correspondence: ; Tel.: +39-096-136-9768
| | - Francesco Agostini
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Massimiliano Mangone
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Simone Marchese
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Carlo Cisari
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
| | - Andrea Bernetti
- Department of Anatomy, Histology, Forensic Medicine and Orthopedics, Sapienza University, 00185 Rome, Italy; (F.A.); (M.M.); (S.M.); (A.B.)
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont, 28100 Novara, Italy; (L.L.); (C.C.); (M.I.)
- Infrastruttura Ricerca Formazione Innovazione (IRFI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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