Clinical Uses and Molecular Aspects of Ozone Therapy:

Background

Ozone has been used industrially for well over a century, in areas such as water disinfection, but interest in its therapeutic applications has grown steadily in more recent decades. Despite this growing interest, evidence for its clinical use has remained scattered across many small studies covering different conditions, doses and delivery routes. This review set out to bring that evidence together, examining both the safety profile of ozone therapy and the molecular mechanisms that might explain its effects, across uses ranging from wound care to pain management and infection control.

Study design

This is a narrative literature review rather than a new clinical trial. The authors synthesised findings from a range of previously published randomised clinical trials, systematic reviews and laboratory (in vitro and animal) studies looking at ozone's effects on immune cells, oxidative stress pathways and antimicrobial activity, as well as its clinical use in wound healing, pain, postoperative recovery and infectious disease.

Findings

Drawing on this body of evidence, the authors describe three main mechanisms through which ozone appears to act: modulation of the immune system, direct antimicrobial activity against bacteria, fungi and viruses, and regulation of the balance between oxidants and antioxidants in the body. These effects were consistently described as dose-dependent. Lower concentrations, in the range of roughly 10 to 50 micrograms per millilitre, were associated with anti-inflammatory and wound-healing effects, while higher concentrations were linked to inflammatory and potentially toxic responses. The review also noted ozone's role in supporting the healing of chronic and infected wounds by helping to modulate immune cell activity at the wound site.

What the authors concluded

The authors concluded that ozone therapy shows promise as a complementary option for treating wounds, chronic inflammatory conditions and infectious diseases, provided it is dosed carefully and delivered through an appropriate route, such as topical application, parenteral injection or intravenous administration. They framed its therapeutic potential as closely tied to this dose-response relationship, with benefit and harm sitting on the same curve depending on concentration.

Limitations of this study

As a narrative review rather than a systematic review or new trial, this paper synthesises and interprets existing studies rather than generating new safety or efficacy data itself, so its conclusions are only as strong as the underlying studies it draws on. The authors themselves point to a lack of standardisation in dosing protocols across the studies reviewed, which makes direct comparisons between studies difficult. They also note that limited formal medical recognition of ozone therapy in many countries has restricted the development of consistent clinical guidelines, meaning practice can vary considerably between practitioners and settings.