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Wu H, Wang J, Lin Y, He W, Hou J, Deng M, Chen Y, Liu Q, Lu A, Cui Z, Guan D, Yu B. Injectable Ozone-Rich Nanocomposite Hydrogel Loaded with D-Mannose for Anti-Inflammatory and Cartilage Protection in Osteoarthritis Treatment. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2309597. [PMID: 38279613 DOI: 10.1002/smll.202309597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/27/2023] [Indexed: 01/28/2024]
Abstract
Osteoarthritis (OA) is a dynamic condition characterized by cartilage damage and synovial inflammation. Ozone (O3) shows potential therapeutic effects owing to its anti-inflammatory properties; however, its high reactivity and short half-life substantially limit its effectiveness in OA treatment. In this study, an ozone-rich thermosensitive nanocomposite hydrogel loaded with D-mannose is developed for OA treatment. Briefly, O3 is encapsulated in nanoparticles (NPs) composed of perfluorotributylamine and fluorinated hyaluronic acid to improve its stability. Next, D-mannose is conjugated with α-amino of the hydroxypropyl chitin (HPCH) via Schiff base to prepare MHPCH. These nanoparticles are encapsulated in MHPCH to produce O3 NPs@MHPCH. In vitro cell experiments demonstrate that the O3 NPs@MHPCH treatment significantly reduced VEGF and inflammation levels, accompanied by a decrease in inflammatory factors such as IL-1β, IL-6, TNF-α, and iNOS. Furthermore, O3 NPs@MHPCH promotes the expression of collagen II and aggrecan and stimulates chondrocyte proliferation. Additionally, in vivo studies show that O3 NPs@MHPCH significantly alleviated OA by reducing synovial inflammation, cartilage destruction, and subchondral bone remodeling. O3 NPs@MHPCH offers a promising option for improving the efficacy of O3 therapy and reducing the risk of synovial inflammation and cartilage degeneration in OA.
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Affiliation(s)
- Hangtian Wu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Jun Wang
- School of Medicine, Foshan University, Foshan, Guangdong, 528000, P. R. China
| | - Yanpeng Lin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Wanling He
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Jiahui Hou
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Mingye Deng
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Yupeng Chen
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Qinwen Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Aiping Lu
- Institute of Integrated Bioinformedicine and Translational Science, Hong Kong Baptist University, Hong Kong, 999077, P. R. China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, 510515, P. R. China
| | - Zhuang Cui
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
| | - Daogang Guan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, 510515, P. R. China
- Guangdong Provincial Key Laboratory of Single Cell Technology and Application, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Bin Yu
- Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, P. R. China
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Valdenassi L, Chierchia M, Pandolfi S, Bellardi D, Chirumbolo S, Franzini M. Adjunct treatment with ozone to enhance therapy of knee osteoarthritis: preliminary results. Clin Rheumatol 2024; 43:2093-2101. [PMID: 38671261 DOI: 10.1007/s10067-024-06972-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Knee osteoarthritis (knee OA), commonly known as gonarthrosis, is a chronic pathology involving knee at the joint level causing progressive pain, stiffness and difficulty in ambulation and leg movements. So far in situ infiltration therapies such as platelet rich plasma, conditioned autologous serum or hyaluronic acid, provided some encouraging though limited hopes for a routinely recommended therapy for knee OA. Recent clinical successful observations about the use of whole autologous blood ozonated with a calibrated mixture of oxygen and ozone, has promoted the present research study, in order to treat knee OA. A number of 250 patients suffering with knee OA of different Ahlback scores, were treated with infiltration of ozonated blood and evaluated for their WOMAC and Lequesne indexes, pre- and post-treatment, to evaluate pain, disability and stiffness. Patients recovered about 50% of their health status, reducing pain, stiffness and disability by only 5 sessions, one/week, with 20 μg/ml O3 ozonated autologous blood knee infiltrations. The evidence asks for further supporting results yet encourages our efforts to go ahead in this research issue. Key Points •The oxygen-ozone therapy via ozonated blood infiltration was used in this study. •Ozone reduced pain, disability, and stiffness in both female and male patients. •The treatment with ozone improved WOMAC both in type I and type II Ahlback knee OA. •The oxygen-ozone therapy via ozonated blood ameliorated Lequesne functional index.
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Affiliation(s)
- Luigi Valdenassi
- Magenta Medical Center, Genoa, Italy
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
| | - Marianna Chierchia
- Department of Orthopedics and Traumatology, University of Caserta "Luigi Vanvitelli", Caserta, Italy
| | - Sergio Pandolfi
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
| | | | - Salvatore Chirumbolo
- Department of Engineering and Innovation Medicine (DIMI), University of Verona, Strada Le Grazie 8, 37134, Verona, Italy.
| | - Marianno Franzini
- Italian Scientific Society of Oxygen Ozone Therapy (SIOOT) and Master School of Oxygen Ozone Therapy, University of Pavia, Pavia, Italy
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Song X, Liu Y, Chen S, Zhang L, Zhang H, Shen X, Du H, Sun R. Knee osteoarthritis: A review of animal models and intervention of traditional Chinese medicine. Animal Model Exp Med 2024; 7:114-126. [PMID: 38409942 PMCID: PMC11079151 DOI: 10.1002/ame2.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/10/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults. The pathophysiology of KOA remains poorly understood, as it involves complex mechanisms that result in the same outcome. Consequently, researchers are interested in studying KOA and require appropriate animal models for basic research. Chinese herbal compounds, which consist of multiple herbs with diverse pharmacological properties, possess characteristics such as multicomponent, multipathway, and multitarget effects. The potential benefits in the treatment of KOA continue to attract attention. PURPOSE This study aims to provide a comprehensive overview of the advantages, limitations, and specific considerations in selecting different species and methods for KOA animal models. This will help researchers make informed decisions when choosing an animal model. METHODS Online academic databases (e.g., PubMed, Google Scholar, Web of Science, and CNKI) were searched using the search terms "knee osteoarthritis," "animal models," "traditional Chinese medicine," and their combinations, primarily including KOA studies published from 2010 to 2023. RESULTS Based on literature retrieval, this review provides a comprehensive overview of the methods of establishing KOA animal models; introduces the current status of advantages and disadvantages of various animal models, including mice, rats, rabbits, dogs, and sheep/goats; and presents the current status of methods used to establish KOA animal models. CONCLUSION This study provides a review of the animal models used in recent KOA research, discusses the common modeling methods, and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.
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Affiliation(s)
- Xuyu Song
- Orthopaedic trauma surgeryThe Second Hospital of Shandong UniversityJinanShandongChina
| | - Ying Liu
- Academy of Traditional Chinese MedicineTianjin University of Traditional Chinese MedicineTianjinChina
| | - Siyi Chen
- Academy of Traditional Chinese MedicineTianjin University of Traditional Chinese MedicineTianjinChina
| | - Lei Zhang
- Department of Traditional Chinese MedicineThe Second Hospital of Shandong UniversityJinanShandongChina
| | - Huijie Zhang
- College of pharmacyShandong University of Traditional Chinese MedicineJinanShandongChina
| | - Xianhui Shen
- The Second Clinical College of Shandong UniversityShandong UniversityJinanShandongChina
| | - Hang Du
- The Second Clinical College of Shandong UniversityShandong UniversityJinanShandongChina
| | - Rong Sun
- Advanced Medical Research InstituteShandong UniversityJinanShandongChina
- The Second Hospital of Shandong UniversityJinanShandongChina
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Arias-Vázquez PI, Guzzardo MN, Guzzardo DR, Castillo-Avila RG, Tovilla-Zárate CA, Ake Montiel MAN. Efficacy of ozone injections for reducing musculoskeletal pain in comparison with corticosteroid injections: A systematic review and meta-analysis. J Back Musculoskelet Rehabil 2024; 37:821-838. [PMID: 38277280 DOI: 10.3233/bmr-230173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Corticosteroid injections are frequently used in the short-term treatment of musculoskeletal pain, but their use is controversial as repeated exposures to corticosteroids can lead to deleterious effects on musculoskeletal tissue. Ozone injections have been proposed as a possible treatment for musculoskeletal pain; however, their effectiveness has not been compared with corticosteroids. OBJECTIVE To evaluate the effectiveness of ozone injections for reducing pain in individuals with musculoskeletal pain in comparison with corticosteroid injections through a meta-analysis. METHODS An online systematic search was performed using electronic databases up to September 2023. We searched for studies that compared corticosteroid injections with ozone injections in the treatment of musculoskeletal pain of diverse origins. RESULTS Eleven studies were included comprising a total of 534 individuals. In the overall pooled analysis, a pain reduction in favor of corticosteroid injections was found in the short term (d= 0.31, 95% CI 0.01 to 0.60, p (z) 0.04, I2 = 32%). In the medium term, no significant differences were found in reducing pain between groups (d=-0.17, 95% CI -0.42 to 0.07, p (z) 0.15, I2 = 0%). CONCLUSIONS Our results suggest that corticosteroids injections are more effective in reducing musculoskeletal pain in the short term, but equally effective in the medium term when compared with ozone injections. Nonetheless, better-quality clinical trials are necessary to corroborate these results.
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Affiliation(s)
| | - Mauro Nicolás Guzzardo
- Team of Formation and Research in Pain (EFID in Spanish), National University of Rosario, Rosario, Argentina
| | - Duilio Román Guzzardo
- Team of Formation and Research in Pain (EFID in Spanish), National University of Rosario, Rosario, Argentina
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Chirumbolo S, Valdenassi L, Tirelli U, Ricevuti G, Pandolfi S, Vaiano F, Galoforo A, Loprete F, Simonetti V, Chierchia M, Bellardi D, Richelmi T, Franzini M. The Oxygen-Ozone Adjunct Medical Treatment According to the Protocols from the Italian Scientific Society of Oxygen-Ozone Therapy: How Ozone Applications in the Blood Can Influence Clinical Therapy Success via the Modulation of Cell Biology and Immunity. BIOLOGY 2023; 12:1512. [PMID: 38132338 PMCID: PMC10740843 DOI: 10.3390/biology12121512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Ozone is an allotrope of oxygen whose use in medicine has rapidly grown in recent years. Ozonated blood allows for the use of ozone in a safe modality, as plasma and blood cells are endowed with an antioxidant system able to quench ozone's pro-oxidant property and to elicit the Nrf2/Kwap1/ARE pathway. METHODS We present two clinical studies, a case-series (six patients) observational study adopting ozone as a major autohemotherapy and topical ozone to address infected post-surgical wounds with multi-drug resistant bacteria and an observational study (250 patients) using ozonated blood for treating knee osteoarthritis. RESULTS Ozonated blood via major autohemotherapy reduced the extent of infections in wounds, reduced the inflammatory biomarkers by more than 75% and improved patients' QoL, whereas ozonated blood via minor autohemotherapy improved significantly (p < 0.001) WOMAC and Lequesne's parameters in knee osteoarthritis. CONCLUSIONS The models described, i.e., ozone autohemotherapy in wound antimicrobial treatment and ozonated blood in knee osteoarthrosis, following our protocols, share the outstanding ability of ozone to modulate the innate immune response and address bacterial clearance as well as inflammation and pain.
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Affiliation(s)
- Salvatore Chirumbolo
- Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy
| | - Luigi Valdenassi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | | | - Giovanni Ricevuti
- Department of Drug Science, University of Pavia, 27100 Pavia, Italy;
| | - Sergio Pandolfi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Francesco Vaiano
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Antonio Galoforo
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Fortunato Loprete
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Vincenzo Simonetti
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Marianna Chierchia
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | | | - Tommaso Richelmi
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
| | - Marianno Franzini
- Italian Scientific Society of Oxygen–Ozone Therapy (SIOOT), High Master School of Oxygen-Ozone Therapy, University of Pavia, 27100 Pavia, Italy; (L.V.); (S.P.); (F.V.); (A.G.); (F.L.); (V.S.); (M.C.); or (T.R.); (M.F.)
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