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INFORMATION FOR DOCTORS

IOzone is able to stimulate the anti oxidant enzymes in the cells.

Ozone works as a powerful germicidal agent: Lower life forms like bacteria, virus, fungi, parasites lack anti oxidant enzymes. Therefore, they just cannot survive in presence of powerful oxidant like Ozone, however much they try and mutate!! Ozone is one of the most powerful germicidal agent.

This property of Ozone is used to treat infections.

How Does Ozone Therapy Work? (Mechanism of action)
[See Below for Disease-wise Mechanism of Action]

Ozone Therapy - Inactivation of bacteria, viruses, fungi, yeast and protozoa:
Ozone Therapy disrupts the integrity of the bacterial cell envelope through oxidation of the phospholipids and lipoproteins. In fungi, ozone inhibits cell growth at certain stages. With viruses, the ozone damages the viral capsid and upsets the reproductive cycle by disrupting the virus-to-cell contact with peroxidation. The weak enzyme coatings on cells which make them vulnerable to invasion by viruses make them susceptible to oxidation and elimination from the body, which then replaces them with healthy cells.

Ozone Therapy - Enhancement of circulation:
In circulatory disease, a clumping of red blood cells hinders blood flow through the small capillaries and decreases oxygen absorption due to reduced surface area. Ozone reduces or eliminates clumping and red cell flexibility is restored, along with oxygen carrying ability. Oxygenation (Oxygen Therapy) of the tissues increases as the arterial partial pressure increases and viscosity decreases. Ozone Therapy also oxidizes the plaque in arteries, allowing the removal of the breakdown products, unclogging the blood vessels.

Ozone Therapy - Stimulation of oxygen metabolism:
Ozone Therapy causes an increase in the red blood cell glycolysis rate. This leads to the stimulation of 2,3-diphosphoglycerate (2,3-DPG) which leads to an increase in the amount of oxygen released to the tissues. Ozone activates the Krebs cycle by enhancing oxidative carboxylation of pyruvate, stimulating production of ATP. Ozone Therapy also causes a significant reduction in NADH and helps to oxidize cytochrome C. There is a stimulation of the production of the enzymes which act as free radical scavengers and cell wall protectors: glutathione peroxidase, catalase, and superoxide dismutase. Production of prostacyline, a vasodilator, is also induced by ozoneFormation of peroxides: Ozone reacts with the unsaturated fatty acids of the lipid layer in cellular membranes, forming hydro peroxides. There is a synergistic effect with cellular-formed H2O2. Lipid peroxidation products include alkoxyl and peroxyl radicals, singlet oxygen, ozonides, carbonides, carbonyls, alkanes and alkenes.

Ozone Therapy - Dissolution of malignant tumors:
Ozone Therapy inhibits tumor metabolism. In addition, ozone oxidizes the outer lipid layer of malignant cells and destroys them through cell lysis (breakdown). Phagocytes produce H2O2 and hydroxyl to kill bacteria and viruses. The generation of hydroxyl by killer cells is critical to their cytotoxic capability. Ozone stimulates conversion of arginine to citrulline, nitrite and nitrate by phagocytes, promoting their action on tumors.

Ozone Therapy - Activation of the immune system:
Ozone Therapy administered at a concentration of between 30 and 55 ug/cc causes the greatest increase in the production of interferon and the greatest output of tumor necrosis factor (TNF) and interleukin-2. The production of interleukin-2 launches an entire cascade of subsequent immunological reactions.

Disease-wise Mechanism of Action

Ozone Therapy in Cancer Care:

Ozone helps in following ways in cancer.
1. Cancer cells are anaerobic. Ozone floods these cells with Oxygen in many ways.
a. It makes the RBCs release more Oxygen at tissue level.
b. It improves general circulation.
c. It leads to new vessel formation inside the tumor.
d. Ozone, by making tumor environment normoxic, makes it very difficult for hypoxic cancer cells to survive.
2. Ozone induces lymphocytes or white blood cells to produce lymphokines. These activated lymphocytes home in various lymphoid organs and brings entire immune system to an alert state. Thus Ozone improves immunity and fight against cancer cells.
3. Few circulatory cancer cells are killed by Ozone and acts as an autovaccine. Thus producing antibodies against its tumor cells and help in killing them.
4. Ozone is a powerful oxidant. However, it stimulates anti oxidative enzymes in our normal cells. This primes cells to deal effectively with further oxidative stress, causing preconditioning effect. Oxidative stress in the form of free radicals, generated by radiation or chemotherapy, is more effectively dealt with these anti oxidative enzymes. Thus side effects of these therapies are largely prevented by Ozone.
5. Cancer cells are lacking in anti oxidant enzymes unlike normal, healthy cells. Ozone rapidly oxidizes lipids in their cell membrane, causing hole and rupture of the cancer cells.
6. Ozone is a powerful germicidal agent. It is effectively used to treat infections commonly occurring in cancer patients, due to decrease immunity.
7. Cancer cells have lost apoptosis. Ozone induces apoptosis in cancer cells causing their death.
8. Liver activation by Ozone therapy helps induce liver enzymes which have powerful detoxification action.
9. Neuroimmunoendocrine system is so closely related that activation of one leads to activation of others. Ozone releases endorphins. This leads to better pain relief and a generalized feeling of well being.
10. General improvement in metabolism following Ozone therapy leads to energetic feeling for the patients. It makes the life of a cancer patient tolerable.

Ozone therapy is given by rectal route, somewhat similar to enema. It is totally painless quick and easy procedure and extremely effective. Ozone can also be given in vagina or in ears. Intramascular Ozone injections are very good for pain relief in cancer patients. Funneling over the tumor, intravenous ozonated saline drip, major autohemotherapy are other ways of giving Ozone. Mostly, Ozone is given for 20 procedures on alternate days. After that maintenance dose is required for at least for 6 months.

Ozone Therapy for Back Pain: Ozone nucleosis

Low back pain is a very disturbing symptom that can affect about 80 % of the world’s population. It is probably experienced by nearly everyone at some point in his or her life. In 90% cases it resolves spontaneously within 4 weeks with or even without any treatment. In most cases, physical therapies such as exercises, manipulation therapy can solve the problem.
However, if a herniated disc, that is the protrusion of the nucleus pulposus through the annulus fibrosus, is present and causes considerable pain, it must be removed with the least invasive procedure. All forms of treatment aim at decompressing the disc, foramen and the nerve root.
These can be done by taking the disc out and decompressing the foramen by surgery. Surgery has the risk that sometimes patients loose partial or total working abilities, deteriorating their quality of life. Though different treatments (conservative and surgical) exist for patients suffering from herniated disc, sometimes they failed.
Experimental models have demonstrated that the extruded nucleus pulposus can produce a chemical and immunological irritation of the radicular nerve, causing inflammation.

There are anatomic, mechanical compression, vascular, immune, inflammatory and neural factors responsible for disk-radicular conflict symptoms. Signs and symptoms of disk herniation are caused by compression of either nerve roots or the spinal cord. The specific signs and symptoms are based on which part is compressed and at which level the neural structures are compressed.
Mechanism of Ozone action
• Ozone’s action is due to the active oxygen atom (singlet oxygen) liberated from it.
• It attaches with the proteo-glycan bridges in the nucleus pulposus causing its degradation
• They are broken down and are no longer capable of holding water.
• This causes dehydration and resorption of the disk hernia.
• As a result disc shrinks and mummified and there is decompression of nerve roots.
• Ozone has analgesic and anti-inflammatory effects as it modifies mediators of inflammation and pain

Ozone Nucleolysis: the procedure
• Percutaneous injection of ozone-oxygen mixture is given with a 22 G spinal needle under fluoroscopy control.
• Conc. Of ozone is 29-30 microgram /ml.
• Ozone gas is injected immediately from an ozone generator.
• 3-10 ml of ozone is injected at the centre of the disc
• With/without intraforaminal injection.
• Procedure is performed under CT or C-Arm guidance.

Benefits of Ozone nucleolysis treatment
• It is a minimally invasive treatment with a negligible cost and rare side effects.
• A great advantage of this method is that practically it has no contraindications and it does not require hospitalization.
• An attenuation of the symptoms, and resumption of daily activities in over 80 % of patients.
• It produced an improvement of the clinical and biochemical parameters measured and also of the imaging.
• This technique in specialist hands is relatively easy.
• Some relapses could appear after two years of the treatment.
• Cervical hernia needed less ozone therapy sessions to eliminate the pain (between 2 - 4 sessions), compared to lumbar hernia which needed between 6 and 10 sessions to obtain the results.
• Not a single serious life-threatening complication was found in over 200,000 cases of Ozonucleolysis in different centers of European countries.

Careful selection of the patients is required. While selecting patients for Ozone therapy, following cases are excluded.
• Possible fracture
• Possible tumor or infection.
• Bladder or Bowel dysfunction.
• Severe or progressive neurologic dysfunction in the legs.
• Major motor weakness in quadriceps, plantar flexors, evertors, and dorsiflexors.

Ozone Nucleolysis is a Percutaneous procedure almost devoid of serious complications but a high success rate of nearly 90% and with a low recurrence rate.
Bombay hospital ozone disc nucleolysis cases conducted by the team of Dr.Sharad ghatge consultant interventional neuroradiologist and Dr.Dhaval modi head of neuroradiology

Total : 1455
Male- 740, female - 715
Results: Success rate 85 to 90%
Outcome measured by modified Mac nab method
• Excellent: disappearance of symptoms--------------42%
Complete recovery in working
And sport activity
• Good: occasional episodes of pain-------------24%
• Fair: partial improvement of symptoms ----------16%
Limitation of heavy activities
• Mediocre: insufficient improvement of symptoms------11%
Periodic administration of drugs
Limitation of physical activities
• No results: no improvement, sx required--------9%
• Bad: worsening of symptoms-----------0%

Ozone Therapy in OsteoArthritis:

Causes of osteoarthritis
• Mechanical forces leading to wear and tear
• Along with Mediators of pain in Chronic inflammatory reaction
• Edema and inflammation leading to ischemia
• Collagenase and proteoglycanases secreted by activated chondrocytes and monocytes leading to matrix degeneration, softening and destruction of knee joint

Mode of administration
Ozone therapy is given in the form of Injections under aseptic precautions around the knee (Peri articular Injections) and inside the knee joint (Intra articular)
Peri articular injections are given for 10 to 15 sittings or intra articular injections are done for 3-5 sittings

Mechanism of action of Ozone
• Proteolytic enzymes and endogenous ROS are inhibited
• Bradykinin and inflammatory PG release is inhibited
• Release of immunosuppressive cytokines TGF-beta and IL-10 may inhibit inflammation
• Disappearance of edema leads to improved circulation, washing away of lactic acid and relief in pain
• Ozone injections act as an analgesic
• Algic stimulation of skin can reduce pain through mechanism of Diffuse Noxious Inhibitory Control
• H2O2 may cause irreversible damage and death of nociceptors; consequently activation threshold
Simultaneous release of endorphins and blocked release of algic stimuli.

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Kindly get in touch with us for more information on how Ozone Therapy can help in your field of operation for your patients. Also please do browse through the Case Studies and Articles and Papers for information.

Ozone Forum of India