Так как на форуме приводился лишь abstract статьи «The influence of ozonated autohemotherapy on oxidative stress in hemodialyzed patients with atherosclerotic ischemia of lower limbs» - возникали вопросы в толковании выводов.
Привожу её полностью. Хочу обратить внимание на фразу из статьи: «The precise control of applied ozone dosage seems to play a critical role». Положение, которое неоднократно подчеркивал в разговоре с уважаемым Евгений Евгеньевичем. Озонотерапия – дозозависимая терапия. И обсуждать терапевтические или побочные эффекты озона без жесткой привязки к дозам, концентрациям, методам введения - совершенно бессмысленное занятие. Например, в наших установках стоимость метрологии (сертифицированной) занимает 75% от общей стоимости оборудования.
Хочу также отметить, что польские исследователи использовали более высокие дозировки (по немецким рекомендациям), чем прописаны у нас. Но имеется тенденция в сторону сближения рекомендуемых доз к Российским (!), т.е. в сторону их снижения.
The International Journal of Artificial Organs / Vol. 26 / no. 4, 2003 / pp. 297-303
The influence of ozonated autohemotherapy on oxidative stress in hemodialyzed patients with atherosclerotic ischemia of lower limbs
L. TYLICKI 1, T. NIEWEGLOWSKI 1, B. BIEDUNKIEWICZ 1, A. CHAMIENIA 1, A. DEBSKA-SLIZIEN 1,
E. ALEKSANDROWICZ 2, W. LYSIAK-SZYDLOWSKA 2, B. RUTKOWSKI 1
1 Department of Nephrology, Transplantology and Internal Medicine
2 Department of Clinical Nutrition and Diagnostic Laboratory, Medical University of Gdansk, Gdansk - Poland
ABSTRACT: Ozonated autohemotherapy is used as a complementary medical approach in the treatment of vascular disorders. One of the greatest problems concerning an application of ozone in medicine is its induction of oxidative stress. The standards of ozonotherapy were elaborated recently making this treatment useful and probably non toxic. The aim of the present study was to investigate the influence of ozonated autohemotherapy on the oxidative stress extent in hemodialyzed patients, known to be particularly exposed to generation and deleterious effects of free radicals. Twelve continuously hemodialyzed subjects with atherosclerotic ischemia of the lower limbs were examined in a prospective, controlled, single blind study. Autohemotherapy with blood exposure to oxygen served as a control. The protein and lipid peroxidation products, the reduced glutathione level in red blood cells and free hemoglobin plasma concentration were measured. The study showed that ozonated autohemotherapy with ozone concentration 50 µg/ml per gram of blood induced a significant decrease in glutathione level after 9 sessions of this procedure. Therapy did not cause either the enhancement of protein and lipid peroxidation, or erythrocytes damage. It seems likely that the antioxidant defense system, part of which is glutathione, neutralizes oxidative properties of ozone in this concentration and protects against oxidative cell damage. (Int J Artif Organs 2003; 26: 297- 303)
KEY WORDS: Ozone, Autohemotherapy, Atherosclerosis, Hemodialysis, Renal failure, Oxidative stress, Free radicals, Hemolysis
INTRODUCTION
Ozonotherapy as a complementary medical approach has been known for more than 50 years. There are some areas where this kind of treatment may be useful nowadays, e.g. resistant infectious diseases, immune deficiency syndromes, degenerative diseases of the central nervous system, orthopedic pathologies and vascular disorders. Over the last decade standards of ozone use in medicine were elaborated making this therapy useful and probably safe. The precise control of applied ozone dosage seems to play a critical role. The route of ozone administration defined as ozonated autohemotherapy (O3-AHT) is most commonly used and consists of the ex vivo sterile exposure of a known blood volume to an equivalent volume of oxygen-ozone mixture with strictly established ozone concentration (1). Patients with end-stage renal disease (ESRD) on maintenance renal replacement therapy are particularly exposed to the development of atherosclerosis (2). Many of them manifest coronary heart disease or atherosclerotic ischemia of lower limbs (AILL). Several reports have indicated that treatment with ozone was useful in the therapy of AILL (3, 4). The mechanisms involved in the beneficial activity of this therapy, lead to the improvement of blood flow in hypoxic areas and the attenuation of ischemic symptoms (4). One of the greatest problems concerning ozonotherapy is its potential toxicity. Ozone is known as a highly reactive oxidant that in inhalatory form may be hazardous to the respiratory system (5). Oxidative injury has been considered as one of the possible side effects of O3-AHT since the role of oxidative stress has been proven in the pathogenesis of many disorders (6, 7). It is obvious that ozone in contact with blood can induce the generation of reactive oxygen species (ROS) (8). However, this effect is detrimental only when high a concentration of ozone is used or in a case of a severely impaired antioxidant defense system (1). The safe range of ozone concentrations in O3-AHT is currently known (1). ROS generation during O3-AHT, applied in dosages from this range, is believed to be almost completely quenched by multifactorial antioxidant systems present in plasma and blood cells (1, 8). The recommendations concerning ozone dosage are based on the studies and therapeutic experience derived from the treatment of subjects with preserved renal function. This problem has not yet been studied in hemodialyzed (HD) patients, who have an impaired antioxidant system and therefore are particularly threatened by deleterious effects of free radicals (9). In this context the safety of O3-AHT, a therapeutic intervention with a potential to generate ROS is of particular importance. We performed a prospective, controlled, single blind study to find whether O3-AHT causes oxidative stress in patients with ESRD treated chronically with HD. Effects of O3-AHT, applied in the therapeutic dose of ozone - 50µg/ml on the level of lipid and protein peroxidation, the extent of red blood cell hemolysis and the reduced glutathione (GSH) concentration in red blood cells were determined.