Ozone MOAs

Question 1

Antioxidant capacity

Answer 1

Ozone therapy initiates an endogenous cascade and releases biologically active substrates in response to the transient, moderate oxidative stress that ozone induces. By reacting with polyunsaturated fatty acids (PUFA) and water, ozone creates hydrogen peroxide (H2O2), a reactive oxygen species (ROS), and a mixture of lipid ozonation products (LOP). The moderate oxidative stress caused by ozone increases activation of the transcriptional factor mediating nuclear factor-erythroid 2-related factor 2 (Nrf2), responsible for activating the transcription of antioxidant response elements (ARE). Upon induction of ARE transcription, an assortment of antioxidant enzymes gains increased concentration levels.
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Reduction of disc volume The primary mechanism of action of the oxygen/ozone mixture is reduction in size of the herniated disc due to a redox reaction between the O3 and the glycosamino-glycans in the nucleus pulposis. This reduces the osmotic gradient across the end plates resulting in disc dehydration and volume reduction.

Question 2

Stimulation of oxygen metabolism

Answer 2

Ozone therapy can lead to an increase in the red blood cell glycolysis rate, which stimulates 2,3-diphosphoglycerate and increases the amount of oxygen released to the tissues. It can also activate the Krebs cycle by enhancing oxidative carboxylation of pyruvate and stimulating ATP production. Additionally, ozone stimulates the production of enzymes that act as free radical scavengers and cell-wall protectors, such as glutathione peroxidase, catalase, and superoxide dismutase, and induces the production of prostacyline, a vasodilator.

Question 3

Analgesic and anti-inflammatory effects

Answer 3

Ozone inhibits the synthesis and release of prostaglandins, bradykinin, and various algogenic molecules, and increases the release of antagonists of pro-inflammatory cytokines. Animal studies confirm the effect of ozone on cytokine production.

Question 4

Activation of the immune system

Answer 4

Ozone administered at a concentration of between 30 and 55 μg/cc can cause an increase in the production of interferon and tumor necrosis factor.

Question 5

Reduction of disc volume

Answer 5

The primary mechanism of action of the oxygen/ozone mixture is reduction in size of the herniated disc due to a redox reaction between the O3 and the glycosamino-glycans in the nucleus pulposis. This reduces the osmotic gradient across the end plates resulting in disc dehydration and volume reduction.

Question 6

Improved microcirculation and oxygen saturation

Answer 6

Ozone decreases vascular stasis by improving microcirculation and oxygen saturation, and reduces pain through alleviating hypoxic related pain.