Effects of medical ozone upon healthy equine joints: Clinical and laboratorial aspects

Ozone therapy by rectal insufflation in dogs: safety and oxidative stress - a randomized cross-over study

Ozone therapy acts in the body inducing controlled oxidative stress, thereby improving the antioxidant, immune and circulatory responses. However, very little is known about how this therapy affects oxidative stress indicators in dogs. We aimed to assess the clinical, hematological, biochemical and oxidative stress parameters of healthy dogs subjected to ozone therapy and oxygen therapy by rectal insufflation. Ten healthy dogs were allocated into three experimental groups in a cross-over design: control, without intervention; ozone, which received 100 µg of O3/kg through rectal insufflation; and oxygen, which received an ozone-equivalent volume of medicinal O2 through rectal insufflation. Dogs received four applications weekly and were followed up until the seventh week. Ozone therapy significantly increased the weight, mean corpuscular volume and mean platelet volume and decreased total cholesterol of treated dogs. Regarding oxidative stress, ozone therapy reduced total antioxidant capacity by ferric reduction (TAC-FRAP) in D7 compared with baseline and the control, significantly increased total antioxidant capacity by cupric reduction (TAC-CUPRAC) in D42 and D49 compared with the control group, caused an increase in uric acid compared with the oxygen group and decreased lipid peroxidation on D21 compared with the control group. In conclusion, ozone therapy through rectal insufflation causes transient oxidative stress followed by an antioxidant response and discreetly interferes with a few clinical, hematological and biochemical variables in healthy dogs, although variables still remained within the reference ranges for the species, thus proving the safety of the therapy. Furthermore, oxygen therapy causes oxidative stress without inducing a subsequent antioxidant response.

Arthroscopic evaluation of the synovial membrane and its relationship with histological changes and biomarkers in equine joint disease

The synovial membrane (SM) presents itself with distinctive characteristics during arthroscopic procedures in cases of osteoarthritis (OA) as well as osteochondritis dissecans (OCD) in horses. Most of the arthroscopic findings of the SM are limited to a description of a nonspecific inflammation state. In the present study, the macroscopic and histological aspects of the SM in OA and OCD horses were compared to those of healthy horses. The expression of interleukin (IL) in SM was also investigated. Besides, the concentrations of ILs and keratan sulfate (KS) in the synovial fluid (SF), and the molecular weights of the SF hyaluronic acid (HA) were also determined and correlated to the macroscopic and histological aspects of SM. This study included 10 healthy horses (control group), 12 horses with OA, and 12 with OCD. Macroscopic scores of the SM were higher in the OA group in comparison to the control and OCD groups. However, histological scores between OA and OCD were not different, and both were higher than the control group. Only in the OA group, there was a correlation between macroscopic and histological aspects of the SM, especially between volume and quantity of villi with perivascular inflammatory cells and synovial proliferation. The OA group has shown decreased expression of IL-10 in the SM, lower IL-10 and KS, and higher IL-1β and IL-6 in the SF in comparison to the control and OCD groups. There was a significant negative correlation between the macroscopic aspect of the SM and the molecular weights AH in the OA group. There was no correlation between the macroscopic aspect of the SM and all dosages in the OA and OCD group. In the OA joints, the evaluation of the shape of the SM during arthroscopy promotes a better indicator for joint inflammatory or tissue repair processes, while in the osteochondritic joints, investigation of the histological aspects are recommended to rule out an incipient OA development process. Both are helpful and should be considered to guide the postoperative treatment.

Ozone and its derivatives in veterinary medicine: A careful appraisal

•

In the Vet field, there are lot of scientific publications with missing or incomplete data, poor case reports and papers without a control group or unrepresentative sample.

•

Differences between animal and human blood composition, anatomy and physiology must be taken into consideration, especially in therapies not yet fully approved.

•

Some practitioners produce their own ozonated solution or autohemotherapy, in the absence of information regarding the compatibility of the material used.

•

Other than the properties of the commercial preparations, the standardization of both treatment methods and times influence the results obtained with ozone therapy.

The therapeutic use of ozone and its derivatives in the veterinary medicine it is still in an emergent stage. Gaseous ozone chemical instability makes necessary its extemporaneous preparation and the accordance about ozone treatments with the highest quality standards in publications is of paramount importance. Moreover, the numerous method of administration in different animal species, the prevalence of case reports, the deficiency of consistent evaluation of the outcomes, as well as the lack of standardization of the treatment operating procedures represents an open question for its spreading and official approval. The keywords “ozone”, “ozonated”, “ozonation” “ozonized”, “ozonization”, “oxygen-ozone therapy”, “veterinary”, “pets”, “animal” were used to perform a literature review using PubMed, Cochrane, Google Scholar, Zotero databases with the temporal restriction for published manuscripts starting from 2010. All the researches were critically evaluated, regardless of the impact factor, if any, of the journals in which they were presented. The deepening of the mechanisms of action of this bio-oxidative therapy can open new horizons on its use. The distinctive condition to achieve such a scenario is an improved knowledge of the qualitative/quantitative characteristics of ozone and its derivatives. All with the aim of taking nothing away to the cited original research papers, but of improving the promising therapeutic implications of ozone therapy in veterinary medicine as a standardization stimulus about this therapeutic resource with multiple application specificities.

The main uses of ozone therapy in diseases of large animals: A review

Ozone (O₃) is a molecule composed of three oxygen atoms, highly unstable, capable of reacting with various substances of the human and animal organism, giving rise to by-products that will participate in biochemical reactions. Thus, O₃ has a wide mechanism of action and can be used in different diseases of large animals. In those animals, the therapy is used mainly in reproductive diseases and wound healing.

Macrophage Activation in the Synovium of Healthy and Osteoarthritic Equine Joints

Synovitis is a major component of osteoarthritis and is driven primarily by macrophages. Synovial macrophages are crucial for joint homeostasis (M2-like phenotype), but induce inflammation (M1-like) when regulatory functions become overwhelmed. Macrophage phenotypes in synovium from osteoarthritic and healthy joints are poorly characterized; however, comparative knowledge of their phenotypes during health and disease is paramount for developing targeted treatments. This study compared patterns of macrophage activation in healthy and osteoarthritic equine synovium and correlated histology with cytokine/chemokine profiles in synovial fluid. Synovial histology and immunohistochemistry for M1-like (CD86), M2-like (CD206, IL-10), and pan macrophage (CD14) markers were performed on biopsies from 29 healthy and 26 osteoarthritic equine joints. Synovial fluid cytokines (MCP-1, IL-10, PGE2, IL-1β, IL-6, TNF-α, IL-1ra) and growth factors (GM-CSF, SDF-1α+β, IGF-1, and FGF-2) were quantified. Macrophage phenotypes were not as clearly defined in vivo as they are in vitro. All macrophage markers were expressed with minimal differences between OA and normal joints. Expression for all markers increased proportionate to synovial inflammation, especially CD86. Synovial fluid MCP-1 was higher in osteoarthritic joints while SDF-1 and IL-10 were lower, and PGE2 concentrations did not differ between groups. Increased CD14/CD86/CD206/IL-10 expression was associated with synovial hyperplasia, consistent with macrophage recruitment and activation in response to injury. Lower synovial fluid IL-10 could suggest that homeostatic mechanisms from synovial macrophages became overwhelmed preventing inflammation resolution, resulting in chronic inflammation and OA. Further investigations into mechanisms of arthritis resolution are warranted. Developing pro-resolving therapies may provide superior results in the treatment of OA.

The effect of medical ozone treatment on cartilage chondrocyte autophagy in a rat model of osteoarthritis

Many studies have shown that ozone (O₃) can inhibit inflammation in osteoarthritis (OA) and regulate the metabolic balance of articular cartilage, but the mechanisms of this process are not well understood. Our study investigated the therapeutic mechanism of O₃ in OA. OA models were established, and the MWT and PWL were measured. HE staining and safranin O-fast green staining were used to observe cartilage degeneration. The levels of MMP-13, collagen-2, LC3II and P62 were measured by immunohistochemistry, and the levels of TNF-α and IL-6 were measured by ELISA. The results showed that intra-articular injection of O₃ can effectively alleviate pain and inhibit cartilage degeneration in OA rats. O₃ can also reduce the concentrations of TNF-α and IL-6, inhibit the expression of MMP-13 and the degradation of collagen-2, upregulate the autophagy-related protein LC3II and inhibit P62. This effect is associated with the upregulation of chondrocyte autophagy in OA.

Ozone therapy in veterinary medicine: A review

Ozone (O₃) is a triatomic form of oxygen. As O₃ rapidly dissociates into water and releases a reactive form of oxygen that may oxidize cells, the gas mixture of O₃/O₂ is used in medicine. ATP is widely available for cellular activity. O₃ can be administered via the systemic and local routes. Although O₃ is known as one of the most powerful oxidants, it also promotes antioxidant enzymes. Additionally, it stimulates some of the cells of the immune system and inactivates pathogens, including bacteria, fungi, yeasts, protozoa, and viruses. Owing to these activities, O₃ is used to improve several diseases, both in human and in veterinary medicine. Considering the wide scope of O₃ application, the aim of this review was to reiterate the mechanisms of action of O₃ and its utilization in different mammalian species (bovine, ovine-caprine, equine, canine, porcine).

Effects of transrectal medicinal ozone in horses - clinical and laboratory aspects

ABSTRACT Ozone (O3) therapy has been used for medical procedures for centuries; however, there are no extensive studies on its utilization in horses. This study aimed to evaluate the application of transrectal O3 on horses by physical and laboratorial evaluation, and production of reactive oxygen species (ROS). Sixteen healthy horses were separated in two groups: a control group (CG) and a group treated with O3 (TG). The TG animals received 1L of an oxygen and O3 mixture transrectally. The initial dose was 10µg/ml for the first two applications, 15μg/ml for the following two applications, and 20μg/ml for the next six applications. The CG animals received 1L of oxygen transrectally. In TG animals no variations in the physical examination were detected; furthermore, TG animals did not exhibit changes in biochemical evaluation results, fibrinogen concentrations, or ROS production. TG animals had increased red blood cell counts, hemoglobin concentrations, and packet cell volume values in comparison to the baseline and CG values. We could infer that O3 affected the red blood cell counts and improved rhetological properties of the blood. The transrectal application of O3 in horses is safe and can indirectly improve the oxygenation and metabolism of tissues.