Ozone Therapy Ulceration
Ozone Autohemotherapy in Lower Limb Ulcerations
Van der Zee1 and A. De Monte2 , 1 AZR, Erasmus University, Rotterdam, Netherlands. 2 P.A.S.S. Udine, Italy.
We report in this paper on the beneficial effects of Ozone Autohemotherapy (OHT) in two patients that were afflicted with painful, intractable leg ulcers. One had diabetes mellitus type II, the other probably had a vasculitis, but this could not be established with certainty. Both patients had seen many specialists; a dermatologist, an internist and vascular surgeon, but to know avail. Their clinical course went from bad to worse. The increasing pain became intolerable and finally they came to our pain clinic. Chemical lumbar sympathectomy and epidural blockade with bupivacaine and morphine were somewhat successful in managing their pain, but ineffective in treating the ulcers. Only after instituting extended Ozone Autohemotherapy did the ulcers heal.
Ozone therapy is recent in medicine and early reports on the efficacy of ozone therapy in certain pathological condition have gone practically unnoticed. The reason for this is that ozone was branded as a pollutant and health hazard, particularly to the upper airways. Absence of sound data on physiological and biochemical activity presented a hindrance to further clinical experimentation. In recent years the picture has changed rapidly in this respect. Moreover therapeutic ranges in the dosage of ozone has been identified (1); however exceeding this level, ozone may be highly toxic.
This semi-standardization in the clinical application of ozone has helped to further the status of ozone as a very effective therapeutic agent in many pathological conditions, and in some cases the agent of choice. It has become evident that even low (therapeutic) concentrations of ozone pose a strong oxidant stress in the body by the formation of reactive oxygen species (ROS)(2). Ozone is rapidly converted to oxygen, limiting the duration of oxidant stress. The oxidant stress elicits a pronounced and lasting upregulation of the enzymatic anti-oxidant system. The oxidant stress of ozone involves a plethora of cells and systems in the body, which will be briefly reviewed.
In addition there are other physiological effects of ozone, not necessarily related to oxidant antioxidant activity. We will refer to the latter as metabolic and rheological aspects of ozone therapy. We will briefly review and summarise in table format the spectrum of known bioactivity of ozone.
Early in the history of human ozone therapy, studies appeared of patients with peripheral occlusive artherosclorotic disease, whose symptoms of intermittent claudication improved significantly (3,4). The development of chronic ulcers is often on the basis of impaired microcirculation and microangiopathy, irrespective of their aetiology. The combination of biochemical, rheological and metabolic effects of OHT forms the rationale for its use inMore