Ozone (O3) therapy has been studied for more than a century and has been well established as an effective method to disinfect surfaces and liquids treat disease (Juchniewicz and Lubkowska, 2020). O3 therapy, sometimes referred to as oxygen-ozone therapy involves the administration of a mixture of oxygen and ozone (Alberto-Hernández et al, 2020). While ozone is a molecule consisting of three oxygen atoms, two of these three make up a stable pair (O2), which is accompanied by a third unstable atom, which gives the therapy its beneficial effects (Alberto-Hernández et al, 2020).
Why the ambivalence?
Despite O3 therapy having been around for more than 150 years, more than a century of study and evidence of its benefits, opinions are still divided over its use (Juchniewicz and Lubkowska, 2020). The reason for this may well be the potential toxicity of O3 (Juchniewicz and Lubkowska, 2020) and controversial study findings regarding its safety and efficacy (Di Mauro et al, 2019).
There is considerable variability among individual sensitivity to O3 exposure, so it is difficult to establish its precise toxicity level (Swanson and Chapman, 2020). For example, factors such as age, body mass index, fitness, health and respiratory conditions can all play a role in how much of an irritant O3 can be to a person (Juchniewicz and Lubkowska, 2020). When pollutants and nitrous oxides break apart producing O3, it is an irritant to the eyes and lungs, and repeated exposure to low doses of O3 is dangerous and can increase cardiovascular and respiratory mortality (Bell et al, 2004). However, O3 therapy is based on high doses in order to stimulate the immune system (Juchniewicz and Lubkowska, 2020).
As is importantly pointed out by Elvis and Ekta (2011), ozone toxicity does not apply to the controlled and proper administration of medical ozone. The level at which ozone occurs at the earth's surface is safe for humans, as is O3 therapy, the effects of which are consistent and without side effects (Juchniewicz and Lubkowska, 2020).
Potential benefits
In 1929, a book entitled Ozone and its therapeutic actions was published, detailing more than 100 diseases that could be treated by O3 therapy (Juchniewicz and Lubkowska, 2020), and our knowledge of its uses in healthcare has been gradually increasing ever since. Diseases or conditions that may benefit from treatment with ozone therapy are infected wounds, circulatory disorders, geriatric conditions, macular degeneration, viral diseases, rheumatism/arthritis, cancer, severe acute respiratory syndrome and AIDS (Elvis and Ekta, 2011).
Medical use of ozone initially started with the treatment of wounds and infections, and it has been shown to be effective in treating bacterial infections of the skin (Juchniewicz and Lubkowska, 2020). However, in vitro, animal and clinical trials have shown various other benefits and potential benefits. The O3 compound has haemodynamic and anti-inflammatory properties and has the ability to decrease cholesterol, improve glycaemic index and stimulate antioxidant defence (Juchniewicz and Lubkowska, 2020). It has also been proposed to result in benefits related to both health and quality of life for people with hypoxic syndromes, diabetes mellitus and peripheral arterial disease, particularly older people and those who are not eligible for standard revascularisation (Juchniewicz and Lubkowska, 2020).
Physical and chemical factors in zero-gravity environments affect human bodies, medications as well as the interactions between the two
For hypoxic and ischaemic syndromes, the success of medical ozone therapy has been attributed to its ability to modulate tissue oxygenation, and it may also be involved in recovering metabolism altered by chronic disease (Di Mauro et al, 2019). Furthermore, it stimulates arterial blood flow, especially in older people (Clavo et al, 2004) and can result in the recovery of motor function in people with acute cerebral infarction (Wu et al, 2013).
Interestingly, several researchers have even identified O3 therapy as adjuvant for COVID-19 (Marini et al, 2020) and in the treatment of COVID-19-associated pneumonia (Alberto-Hernández et al, 2020).