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Viebahn-Haensler R, León Fernández OS. Mitochondrial Dysfunction, Its Oxidative Stress-Induced Pathologies and Redox Bioregulation through Low-Dose Medical Ozone: A Systematic Review. Molecules 2024; 29:2738. [PMID: 38930804 PMCID: PMC11207058 DOI: 10.3390/molecules29122738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/27/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
Our hypothesis that controlled ozone applications interfere with the redox balance of a biological organism (first published in 1998 with a preclinical trial on protecting the liver from CCl4 intoxication) has been verified over the past two decades in reactive oxygen species (ROS)-induced mitochondrial pathologies, such as rheumatoid arthritis, osteoarthritis, aging processes and type 2 diabetes, and in the prevention of intoxications. Low-dose ozone acts as a redox bioregulator: the restoration of the disturbed redox balance is comprehensible in a number of preclinical and clinical studies by a remarkable increase in the antioxidant repair markers, here mainly shown as a glutathione increase and a reduction in oxidative stress markers, mainly malondialdehyde. The mechanism of action is shown, and relevant data are displayed, evaluated and comprehensively discussed: the repair side of the equilibrium increases by 21% up to 140% compared to the non-ozone-treated groups and depending on the indication, the stress markers are simultaneously reduced, and the redox system regains its balance.
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Silva LP, Portela RW, Machado MC, Canuto GAB, Costa-Neto JM, de Carvalho VDMP, de Sá HC, Damasceno KA, de Souza VRC, Coelho CS, Estrela-Lima A. Ozone Therapy in the Integrated Treatment of Female Dogs with Mammary Cancer: Oxidative Profile and Quality of Life. Antioxidants (Basel) 2024; 13:673. [PMID: 38929112 PMCID: PMC11200475 DOI: 10.3390/antiox13060673] [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: 05/05/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
Considering the high frequency of malignant breast tumors, there is a growing search for new therapeutic strategies that control neoplastic growth and dissemination, combined with fewer adverse reactions. Therefore, this study evaluated the effects of ozone therapy in female dogs with mammary cancer undergoing chemotherapy treatment. Twenty-five canines diagnosed with malignant mammary neoplasia were divided into two groups: one treated with carboplatin alone (n = 11) and the other with carboplatin associated with ozone therapy (n = 14). Clinical and laboratory evaluations, mastectomy, analysis of the oxidative profile based on total antioxidant capacity (TAC) and serum concentrations of malondialdehyde (MDA), survival rate, and quality of life were performed. Animals in the ozone therapy group had higher concentrations of red blood cells and platelets, significantly improving the survival rate and quality of life. Furthermore, adverse reactions were less intense and frequent in this group, which was associated with an increase in TAC and a reduction in MDA. These results indicate that the combination of carboplatin and ozone therapy represents a promising complementary treatment for female dogs with mammary cancer, as it was associated with fewer adverse reactions and a better oxidative profile.
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Affiliation(s)
- Laís Pereira Silva
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
| | - Ricardo Wagner Portela
- Laboratory of Immunology and Molecular Biology (LABIMUNO), Institute of Health Sciences, Federal University of Bahia, Salvador 40110-100, Brazil
| | - Marília Carneiro Machado
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
- Center for Agricultural, Environmental and Biological Sciences, Federal University of Reconcavo of Bahia, Cruz das Almas 44380-000, Brazil
| | - Gisele André Baptista Canuto
- Department of Analytical Chemistry, Institute of Chemistry, Federal University of Bahia, Salvador 40170-110, Brazil; (G.A.B.C.); (H.C.d.S.)
| | - João Moreira Costa-Neto
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
- Department of Anatomy, Pathology and Veterinary Clinics, Federal University of Bahia, Salvador 40170-110, Brazil
| | - Vitor de Moraes Pina de Carvalho
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
| | - Hanna Carvalho de Sá
- Department of Analytical Chemistry, Institute of Chemistry, Federal University of Bahia, Salvador 40170-110, Brazil; (G.A.B.C.); (H.C.d.S.)
| | - Karine Araújo Damasceno
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
- Experimental Pathology Laboratory (LAPEX), Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador 40296-710, Brazil
| | | | - Clarisse Simões Coelho
- Faculty of Veterinary Medicine, Lusofona University, 1749-024 Lisbon, Portugal; (V.R.C.d.S.); (C.S.C.)
- Veterinary and Animal Research Centre (CECAV), Faculty of Veterinary Medicine, Lusofona University, 1749-024 Lisbon, Portugal
- Mediterranean Institute for Agriculture, Environment and Development, Universidade de Évora, 7004-516 Évora, Portugal
| | - Alessandra Estrela-Lima
- Research Center on Mammary Oncology (NPqOM), Federal University of Bahia, Salvador 40170-110, Brazil; (L.P.S.); (M.C.M.); (J.M.C.-N.); (V.d.M.P.d.C.); (K.A.D.)
- Department of Anatomy, Pathology and Veterinary Clinics, Federal University of Bahia, Salvador 40170-110, Brazil
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Clavo B, Cánovas-Molina A, Díaz-Garrido JA, Cañas S, Ramallo-Fariña Y, Laffite H, Federico M, Rodríguez-Abreu D, Galván S, García-Lourve C, González-Beltrán D, Caramés MA, Hernández-Fleta JL, Serrano-Aguilar P, Rodríguez-Esparragón F. Effects of ozone therapy on anxiety and depression in patients with refractory symptoms of severe diseases: a pilot study. Front Psychol 2023; 14:1176204. [PMID: 37599784 PMCID: PMC10437070 DOI: 10.3389/fpsyg.2023.1176204] [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: 02/28/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Background Patients with refractory symptoms of severe diseases frequently experience anxiety, depression, and an altered health-related quality of life (HRQOL). Some publications have described the beneficial effect of ozone therapy on several symptoms of this kind of patient. The aim of this study was to preliminarily evaluate, in patients treated because of refractory symptoms of cancer treatment and advanced nononcologic diseases, if ozone therapy has an additional impact on self-reported anxiety and depression. Methods Before and after ozone treatment, we assessed (i) anxiety and depression according to the Hospital Anxiety and Depression Scale (HADS); (ii) the HRQOL (according to the EQ-5D-5L questionnaire), which includes a dimension on anxiety and depression and a visual analog scale (VAS) measuring self-perceived general health. Results Before ozone therapy, 56% of patients were on anxiolytic and/or antidepressant treatment. Before and after ozone therapy, the anxiety and depression HADS subscales (i) significantly correlated with the anxiety/depression dimension of the EQ-5D-5L questionnaire and (ii) inversely correlated with the health status as measured by the VAS. After ozone therapy, we found a significant improvement in anxiety and depression measured by both the (i) HADS subscales and (ii) EQ-5D-5L questionnaire. Conclusion The addition of ozone therapy for patients with refractory symptoms of cancer treatment and advanced chronic nononcologic diseases can decrease anxiety and depression severity levels. Additional, more focused studies are ongoing to provide the needed explanatory information for this finding.
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Universitary Institute for Research in Biomedicine and Health (iUIBS), Molecular and Translational Pharmacology Group, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Spanish Group of Clinical Research in Radiation Oncology (GICOR), Madrid, Spain
| | - Angeles Cánovas-Molina
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Juan A. Díaz-Garrido
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Silvia Cañas
- Psychiatry Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Santa Cruz de Tenerife, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), Santa Cruz de Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Horus Laffite
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Delvys Rodríguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Saray Galván
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Carla García-Lourve
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
| | - Damián González-Beltrán
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Miguel A. Caramés
- Chronic Pain Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose L. Hernández-Fleta
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Pedro Serrano-Aguilar
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, Santa Cruz de Tenerife, Spain
| | - Francisco Rodríguez-Esparragón
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria/Tenerife, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Santa Cruz de Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
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Ozone in Chemotherapy-Induced Peripheral Neuropathy—Current State of Art, Possibilities, and Perspectives. Int J Mol Sci 2023; 24:ijms24065279. [PMID: 36982352 PMCID: PMC10049472 DOI: 10.3390/ijms24065279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most detrimental toxicity to a patient’s quality of life. Pathophysiological mechanisms involved in CIPN pathogenesis are complex, multifactorial, and only partially examined. They are suspected to be associated with oxidative stress (OS), mitochondrial dysfunction, ROS-induced apoptosis, myelin sheath and DNA damage, and immunological and inflammatory processes. Unfortunately, medications commonly used for the management of other neuropathic pain syndromes, including gabapentinoids, opioids, and tricyclic antidepressants (such as desipramine and nortriptyline), do not bring satisfactory results in CIPN. The aim of this review is to evaluate the existing literature on the potential use of medical ozone as a treatment for CIPN. This paper would explore the potential therapeutic benefits of medical ozone. The review would evaluate the existing literature on the use of medical ozone in other contexts, as well as its potential application in treating CIPN. The review would also suggest possible research methods, such as randomized controlled trials, to evaluate the efficacy of medical ozone as a treatment for CIPN. Medical ozone has been used to disinfect and treat diseases for over 150 years. The effectiveness of ozone in treating infections, wounds, and a variety of diseases has been well documented. Ozone therapy is also documented to inhibit the growth of human cancer cells and has antioxidative and anti-inflammatory effects. Due to its ability to modulate oxidative stress, inflammation, and ischemia/hypoxia, ozone may have a potentially valuable effect on CIPN.
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Clavo B, Cánovas-Molina A, Ramallo-Fariña Y, Federico M, Rodríguez-Abreu D, Galván S, Ribeiro I, Marques da Silva SC, Navarro M, González-Beltrán D, Díaz-Garrido JA, Cazorla-Rivero S, Rodríguez-Esparragón F, Serrano-Aguilar P. Effects of Ozone Treatment on Health-Related Quality of Life and Toxicity Induced by Radiotherapy and Chemotherapy in Symptomatic Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1479. [PMID: 36674232 PMCID: PMC9859304 DOI: 10.3390/ijerph20021479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
(1) Background: The continuous improvement in cancer treatment has led to improvement in patients’ survival and a subsequent increase in the number of cancer survivors living with adverse side effects of cancer treatments, sometimes with a high and adverse impact on their health-related quality of life (HRQOL). Side effects of cancer treatments are frequently associated with chronic status of oxidative stress, inflammation, and/or ischemia. The potential for ozone treatment to modulate those processes and improve some of those adverse effects has previously been described. The aim of this study was to evaluate the effect of ozone treatment on the HRQOL and grade of toxicity in symptomatic cancer survivors. (2) Methods: Before and after ozone treatment, we assessed (i) the HRQOL (according to the EQ-5D-5L questionnaire) and (ii) the grade of toxicity (according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute of EEUU (CTCAE v.5.0)) in 26 cancer survivors with chronic side effects of radiotherapy and chemotherapy. (3) Results: There was a significant (p < 0.001) improvement in the EQ-5D-5L index as per the self-reported outcome evaluation of patients’ health status. All the dimensions of the EQ-5D-5L questionnaire (mobility, self-care, activities, pain/discomfort, and anxiety/depression) and the self-evaluation of the health status using the visual analog scale were significantly improved (p < 0.05). The grade of toxicity was also significantly decreased (p < 0.001). (4) Conclusions: In cancer survivors with chronic side effects of cancer treatment, ozone treatment can improve the grade of toxicity and the HRQOL. These results merit additional research. Further studies are ongoing.
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain
- Universitary Institute for Research in Biomedicine and Health (iUIBS), Molecular and Translational Pharmacology Group, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Spanish Group of Clinical Research in Radiation Oncology (GICOR), 28290 Madrid, Spain
| | - Angeles Cánovas-Molina
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain
| | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), 38109 Santa Cruz de Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, 38296 La Laguna, Spain
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
| | - Delvys Rodríguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain
| | - Saray Galván
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
| | - Ivone Ribeiro
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
| | - Susana C. Marques da Silva
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain
| | - Minerva Navarro
- Chronic Pain Unit, Dr. Negrín University Hospital, 35019 Las Palmas de Gran Canaria, Spain
| | - Damián González-Beltrán
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
| | - Juan A. Díaz-Garrido
- Psychiatry Department, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
| | - Sara Cazorla-Rivero
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Universidad de La Laguna, 38296 La Laguna, Spain
| | - Francisco Rodríguez-Esparragón
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, 35019 Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), 35019 Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias, Universidad de La Laguna, 38296 La Laguna, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro Serrano-Aguilar
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), 38109 Santa Cruz de Tenerife, Spain
- Instituto de Tecnologías Biomédicas (ITB), Universidad de la Laguna, 38296 La Laguna, Spain
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Clavo B, Rodríguez-Abreu D, Galván S, Federico M, Martínez-Sánchez G, Ramallo-Fariña Y, Antonelli C, Benítez G, Rey-Baltar D, Jorge IJ, Rodríguez-Esparragón F, Serrano-Aguilar P. Long-term improvement by ozone treatment in chronic pain secondary to chemotherapy-induced peripheral neuropathy: A preliminary report. Front Physiol 2022; 13:935269. [PMID: 36111149 PMCID: PMC9468657 DOI: 10.3389/fphys.2022.935269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Pain secondary to chemotherapy-induced peripheral neuropathy (CIPN) can limit the administration of chemotherapy, cancer-treatment outcomes, and the quality of life of patients. Oxidative stress and inflammation are some of the key mechanisms involved in CIPN. Successful treatments for CIPN are limited. This report shows our preliminary experience using ozone treatment as a modulator of oxidative stress in chronic pain secondary to CIPN. Methods: Ozone treatment, by rectal insufflation, was administered in seven patients suffering from pain secondary to grade II or III CIPN. Pain was assessed by the visual analog scale (VAS). Results: All patients, except one, showed clinically relevant pain improvement. Median pain score according to the VAS was 7 (range: 5–8) before ozone treatment, 4 (range: 2–6) at the end of ozone treatment (p = 0.004), 5.5 (range: 1.8–6.3) 3 months after the end of ozone treatment (p = 0.008), and 6 (range: 2.6–6.6) 6 months after the end of ozone treatment (p = 0.008). The toxicity grade, according to the Common Terminology Criteria for Adverse Events (CTCAE v.5.0), improved in half of the patients. Conclusion: This report shows that most patients obtained clinically relevant and long-lasting improvement in chronic pain secondary to CIPN after treatment with ozone. These observed effects merit further research and support our ongoing randomized clinical trial (NCT04299893).
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Chronic Pain Unit, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Spain
- Molecular and Translational Pharmacology Group, Universitary Institute for Research in Biomedicine and Health (iUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Tenerife, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- Spanish Group of Clinical Research in Radiation Oncology (GICOR), Madrid, Spain
- *Correspondence: Bernardino Clavo, ; Francisco Rodríguez-Esparragón,
| | - Delvys Rodríguez-Abreu
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Saray Galván
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Federico
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Yolanda Ramallo-Fariña
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Carla Antonelli
- Medical Oncology Department, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Gretel Benítez
- Medical Oncology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Dolores Rey-Baltar
- Radiation Oncology Department, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Ignacio J Jorge
- Chronic Pain Unit, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Francisco Rodríguez-Esparragón
- Research Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
- Fundación Canaria Instituto de Investigación Sanitaria de Canarias (FIISC), Las Palmas de Gran Canaria, Spain
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias de la Universidad de La Laguna, Tenerife, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
- *Correspondence: Bernardino Clavo, ; Francisco Rodríguez-Esparragón,
| | - Pedro Serrano-Aguilar
- Research Network on Health Services in Chronic Diseases (REDISSEC), Instituto de Salud Carlos III, Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Servicio de Evaluación y Planificación del Servicio Canario de Salud (SESCS), Santa Cruz de Tenerife, Spain
- Red de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del Sistema Nacional de Salud (RedETS), Madrid, Spain
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Effect of Ozonated Water on Oral Mucositis and Pain Induced by Head and Neck Radiotherapy: A Cross-sectional Study. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.118914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Oral mucositis and local pain are the negative effects of the treatment of head and neck cancer with radiotherapy. Objectives: The study aimed to investigate the effect of ozonated water on the severity of mucositis and pain in (1) patients who were treated with ozonated water and (2) patients who were not treated with ozonated water. Methods: We randomly divided 93 patients with head and neck malignancy (aged 18 to 80) into three groups. Ozone-treated group 1 rinsed their mouth with 15 mL of ozonated water with a concentration of 20 - 50 ppm from the first session of radiotherapy for one minute before and after each session. Ozone-treated group 2 rinsed their mouth with 15 mL of ozonated water with a concentration of 20 - 50 ppm for three minutes and then swallowed it before and after each session. Ozone-treated groups 1 and 2 and the non-ozone-treated group received standard treatment if mucositis symptoms appeared in each patient. The minimum number of radiotherapy sessions was 30, and the minimum planned dose for each patient was 50 Gray. Anamnesis and the following clinical parameters were taken: the degree of mucositis, the use of corticosteroids, radiotherapy method, radiation dose, and Pain Visual Analog Scale. Multi-level and subgroup analyses were performed on the ozone-treated and non-ozone-treated levels. Results: The mean degrees of oral mucositis and pain were lower in the ozone-treated group 2 than in the ozone-treated group 1 and non-ozone-treated group (P < 0.05). The non-ozone-treated group had the highest degrees of oral mucositis and pain severity (P < 0.05). The Kruskal-Wallis H test showed that there was a statistically significant difference in the Visual Analog Scale of sessions 5, 10, 15, 20, 25, and 30 between different groups. However, there was no statistically significant difference in the Visual Analog Scale of session 1 (χ2 (2) = 1.022, P = 0.6). This study revealed that ozonated water can be used for preemptive pain control and mucositis. This finding aligned with previous studies. Also, former research proved the safety and efficacy of ozonated water in dentistry and medical uses. Conclusions: The use of ozonated water in patients with head and neck malignancy can reduce the pain severity and oral mucositis induced by radiotherapy. It seems that ozonated water can be used as a preemptive agent in patients who receive head and neck radiotherapy.
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Modulation by Ozone Therapy of Oxidative Stress in Chemotherapy-Induced Peripheral Neuropathy: The Background for a Randomized Clinical Trial. Int J Mol Sci 2021; 22:ijms22062802. [PMID: 33802143 PMCID: PMC7998838 DOI: 10.3390/ijms22062802] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Chemotherapy-induced peripheral neuropathy (CIPN) decreases the quality of life of patients and can lead to a dose reduction and/or the interruption of chemotherapy treatment, limiting its effectiveness. Potential pathophysiological mechanisms involved in the pathogenesis of CIPN include chronic oxidative stress and subsequent increase in free radicals and proinflammatory cytokines. Approaches for the treatment of CIPN are highly limited in their number and efficacy, although several antioxidant-based therapies have been tried. On the other hand, ozone therapy can induce an adaptive antioxidant and anti-inflammatory response, which could be potentially useful in the management of CIPN. (2) Methods: The aims of this works are: (a) to summarize the potential mechanisms that could induce CIPN by the most relevant drugs (platinum, taxanes, vinca alkaloids, and bortezomib), with particular focus on the role of oxidative stress; (b) to summarize the current situation of prophylactic and treatment approaches; (c) to describe the action mechanisms of ozone therapy to modify oxidative stress and inflammation with its potential repercussions for CIPN; (d) to describe related experimental and clinical reports with ozone therapy in chemo-induced neurologic symptoms and CIPN; and (e) to show the main details about an ongoing focused clinical trial. (3) Results: A wide background relating to the mechanisms of action and a small number of experimental and clinical reports suggest that ozone therapy could be useful to prevent or improve CIPN. (4) Conclusions: Currently, there are no clinically relevant approaches for the prevention and treatment of stablished CIPN. The potential role of ozone therapy in this syndrome merits further research. Randomized controlled trials are ongoing.
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Clavo B, Navarro M, Federico M, Borrelli E, Jorge IJ, Ribeiro I, Rodríguez-Melcon JI, Caramés MA, Santana-Rodríguez N, Rodríguez-Esparragón F. Ozone Therapy in Refractory Pelvic Pain Syndromes Secondary to Cancer Treatment: A New Approach Warranting Exploration. J Palliat Med 2020; 24:97-102. [PMID: 32379556 DOI: 10.1089/jpm.2019.0597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Chronic pain secondary to treatment in cancer survivors without tumor evidence is not unusual. Its management often requires specific approaches that are different from those applied for cancer patients with advanced disease and short life expectancy. Some studies have described clinical benefit with ozone therapy (O3T) in the management of pain and side effects secondary to cancer treatment. Objective: We present our preliminary experience with O3T in the management of refractory pelvic pain syndromes secondary to cancer treatment. Design: Case series. Subjects and Methods: Six cancer patients (without tumor evidence) who had been treated previously with radiotherapy, chemotherapy, or endoscopic procedures and were suffering persistent or severe pelvic pain (median 14 months) received O3T using ozone-oxygen gas mixture insufflation as a complementary therapy in addition to their scheduled conventional treatment. Results: All cases, except one, showed clinically relevant pain improvement. Visual analog scale score with the standard treatment was 7.8 ± 2.1 before O3T, 4.3 ± 3.4 (p = 0.049) after one month, 3.3 ± 3.7 (p = 0.024) after two months, and 2.8 ± 3.8 (p = 0.020) after three months of O3T. The median value of "pain symptom" according to the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events v. 5.0 showed a decrease from 3 (range: 2-3) to 1 (range: 0-3) (p = 0.046). Conclusions: Following unsuccessful conventional treatments, O3T provided significant benefit in our patients with refractory pelvic pain secondary to cancer treatment. These results merit further evaluation in blinded, randomized clinical trials.
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Affiliation(s)
- Bernardino Clavo
- Research Unit, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain.,Chronic Pain Unit, and Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain.,Radiation Oncology, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain.,BioPharm Group, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Grupo de Investigación Clínica en Oncología Radioterápica (GICOR), Madrid, Spain
| | - Minerva Navarro
- Chronic Pain Unit, and Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Mario Federico
- Radiation Oncology, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Emma Borrelli
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Ignacio J Jorge
- Chronic Pain Unit, and Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Ivone Ribeiro
- Radiation Oncology, Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | | | - Miguel A Caramés
- Chronic Pain Unit, and Dr. Negrín University Hospital, Las Palmas de Gran Canaria, Spain
| | - Norberto Santana-Rodríguez
- BioPharm Group, Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS), Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Section of Thoracic Surgery, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.,Department of Surgery, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
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Costanzo M, Romeo A, Cisterna B, Calderan L, Bernardi P, Covi V, Tabaracci G, Malatesta M. Ozone at low concentrations does not affect motility and proliferation of cancer cells in vitro. Eur J Histochem 2020; 64. [PMID: 32241095 PMCID: PMC7137928 DOI: 10.4081/ejh.2020.3119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 03/19/2020] [Indexed: 02/08/2023] Open
Abstract
Exposure to low ozone concentrations is used in medicine as an adjuvant/complementary treatment for a variety of diseases. The therapeutic potential of low ozone concentrations relies on their capability to increase the nuclear translocation of the Nuclear factor erythroid 2-related factor 2 (Nrf2), thus inducing the transcription of Antioxidant Response Elements (ARE)-driven genes and, through a cascade of events, a general cytoprotective response. However, based on the controversial role of Nrf2 in cancer initiation, progression and resistance to therapies, possible negative effects of ozone therapy may be hypothesised in oncological patients. With the aim to elucidate the possible changes in morphology, migration capability and proliferation of cancer cells following mild ozone exposure, we performed wound healing experiments in vitro on HeLa cells treated with low ozone concentrations currently used in the clinical practice. By combining a multimodal microscopy approach (light and fluorescence microscopy, scanning electron microscopy, atomic force microscopy) with morphometric analyses, we demonstrated that, under our experimental conditions, exposure to low ozone concentrations does not alter cytomorphology, motility and proliferation features, thus supporting the notion that ozone therapy should not positively affect tumour cell growth and metastasis.
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Affiliation(s)
- Manuela Costanzo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona.
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Modulation of Oxidative Stress by Ozone Therapy in the Prevention and Treatment of Chemotherapy-Induced Toxicity: Review and Prospects. Antioxidants (Basel) 2019; 8:antiox8120588. [PMID: 31779159 PMCID: PMC6943601 DOI: 10.3390/antiox8120588] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/15/2022] Open
Abstract
(1) Background: Cancer is one of the leading causes of mortality worldwide. Radiotherapy and chemotherapy attempt to kill tumor cells by different mechanisms mediated by an intracellular increase of free radicals. However, free radicals can also increase in healthy cells and lead to oxidative stress, resulting in further damage to healthy tissues. Approaches to prevent or treat many of these side effects are limited. Ozone therapy can induce a controlled oxidative stress able to stimulate an adaptive antioxidant response in healthy tissue. This review describes the studies using ozone therapy to prevent and/or treat chemotherapy-induced toxicity, and how its effect is linked to a modification of free radicals and antioxidants. (2) Methods: This review encompasses a total of 13 peer-reviewed original articles (most of them with assessment of oxidative stress parameters) and some related works. It is mainly focused on four drugs: Cisplatin, Methotrexate, Doxorubicin, and Bleomycin. (3) Results: In experimental models and the few existing clinical studies, modulation of free radicals and antioxidants by ozone therapy was associated with decreased chemotherapy-induced toxicity. (4) Conclusions: The potential role of ozone therapy in the management of chemotherapy-induced toxicity merits further research. Randomized controlled trials are ongoing.
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Galiè M, Covi V, Tabaracci G, Malatesta M. The Role of Nrf2 in the Antioxidant Cellular Response to Medical Ozone Exposure. Int J Mol Sci 2019; 20:E4009. [PMID: 31426459 PMCID: PMC6720777 DOI: 10.3390/ijms20164009] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 08/15/2019] [Accepted: 08/15/2019] [Indexed: 02/07/2023] Open
Abstract
Ozone (O3) is a natural, highly unstable atmospheric gas that rapidly decomposes to oxygen. Although not being a radical molecule, O3 is a very strong oxidant and therefore it is potentially toxic for living organisms. However, scientific evidence proved that the effects of O3 exposure are dose-dependent: high dosages stimulate severe oxidative stress resulting in inflammatory response and tissue injury, whereas low O3 concentrations induce a moderate oxidative eustress activating antioxidant pathways. These properties make O3 a powerful medical tool, which can be used as either a disinfectant or an adjuvant agent in the therapy of numerous diseases. In this paper, the cellular mechanisms involved in the antioxidant response to O3 exposure will be reviewed with special reference to the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) and its role in the efficacy of ozone therapy.
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Affiliation(s)
- Mirco Galiè
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie 8, I-37134 Verona, Italy
| | - Viviana Covi
- San Rocco Clinic, Via Monsignor G. V. Moreni 95, I-25018 Montichiari (BS), Italy
| | - Gabriele Tabaracci
- San Rocco Clinic, Via Monsignor G. V. Moreni 95, I-25018 Montichiari (BS), Italy
| | - Manuela Malatesta
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie 8, I-37134 Verona, Italy.
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Santana-Rodríguez N, Llontop P, Clavo B, Fiuza-Pérez MD, Zerecero K, Ayub A, Alshehri K, Yordi NA, Re L, Raad W, Fernández-Pérez L, García-Herrera R, Huang CYJ, Bhora FY. Ozone Therapy Protects Against Rejection in a Lung Transplantation Model: A New Treatment? Ann Thorac Surg 2017; 104:458-464. [PMID: 28549673 DOI: 10.1016/j.athoracsur.2017.02.054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 01/29/2017] [Accepted: 02/14/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND No satisfactory treatment exists for chronic rejection (CR) after lung transplantation (LT). Our objective was to assess whether ozone (O3) treatment could ameliorate CR. METHODS Male Sprague-Dawley inbred rats (n = 36) were randomly assigned into four groups: (1) control (n = 6), (2) sham (n = 6), (3) LT (n = 12), and (4) O3-LT (n = 12). Animals underwent left LT. O3 was rectally administered daily for 2 weeks before LT (from 20 to 50 μg) and 3 times/wk (50 μg/dose) up to 3 months. CR; acute rejection; and Hspb27, Prdx, Epas1, Gpx3, Vegfa, Sftpa1, Sftpb, Plvap, Klf2, Cldn5, Thbd, Dsip, Fmo2, and Sepp1 mRNA gene expression were determined. RESULTS Severe CR was observed in all animals of LT group, but none of the O3-LT animals showed signs of CR, just a mild acute rejection was observed in 1 animal. A significant decrease of Hspb27, Prdx, Epas1, Gpx3, Vegfa, Sftpa1, Sftpb, Plvap, Klf2, Cldn5, Thbd, Dsip, and Fmo2 gene expression in the O3-LT group was observed CONCLUSIONS: O3 therapy significantly delayed the onset of CR regulating the expression of genes involved in its pathogenesis. No known immunosuppressive therapy has been capable of achieving similar results. From a translational point of view, O3 therapy could become a new adjuvant treatment for CR in patients undergoing LT.
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Affiliation(s)
- Norberto Santana-Rodríguez
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York; Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, ULPGC, Spain.
| | - Pedro Llontop
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, ULPGC, Spain; Experimental Surgery, Research Unit, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Bernardino Clavo
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, ULPGC, Spain; Experimental Surgery, Research Unit, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - María D Fiuza-Pérez
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, ULPGC, Spain; Experimental Surgery, Research Unit, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Keila Zerecero
- Experimental Surgery, Research Unit, Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | - Adil Ayub
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | - Khalid Alshehri
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | - Nagib A Yordi
- Department of Orthopedic Surgery and Upper Extremity Unit, Healthpoint Hospital, Abu Dhabi, United Arab Emirates
| | - Lamberto Re
- Department of Clinical Pharmacology and Toxicology, Medinat SAS, Ancona, Italy
| | - Wissam Raad
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | - Leandro Fernández-Pérez
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias (IUIBS)-BioPharm Group, ULPGC, Spain
| | - Ricardo García-Herrera
- Academic Division of Agricultural Sciences, Universidad Juárez Autónoma, Tabasco, México
| | - Chyun-Yin J Huang
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
| | - Faiz Y Bhora
- Department of Thoracic Surgery, Mount Sinai Health System, New York, New York
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