Ozone therapy: A clinical review

Background: revisiting ozone as a therapeutic gas

Ozone is an unstable molecule of three oxygen atoms, best known as an atmospheric gas and one of the most powerful oxidants available. Beyond its role in disinfection and water treatment, clinicians have long been interested in whether a carefully controlled dose might be turned to therapeutic use. This review gathers the scattered laboratory, animal and clinical evidence on how measured amounts of ozone appear to act in the body and where the gas had been trialled in practice.

Study design: a narrative review of ozone's chemistry and clinical uses

This is a narrative review rather than a systematic one. The authors draw together in vitro experiments, animal studies and clinical reports to describe ozone's chemistry, the ways it is generated and administered - including autohaemotherapy, insufflation and topical application - and its proposed biological mechanisms. There is no pooled analysis, no formal search strategy and no quality appraisal of the studies cited; the aim is to survey the field rather than to weigh the strength of individual trials.

Findings: from oxidative stress to immune modulation

The review reports that diabetic complications are linked to oxidative stress, and that ozone was found to activate the body's antioxidant system and influence blood-glucose levels. It describes ozone normalising organic peroxide levels by activating superoxide dismutase, an enzyme central to antioxidant defence.

In laboratory work, ozone was reported to inactivate HIV in vitro in a dose-dependent way, at concentrations described as non-cytotoxic; the effect was attributed to a reduction in the virus's p24 core protein. Ozone was also observed to raise cytokine production, a marker of immune activity. As a disinfectant, it markedly reduced concentrations of Acinetobacter baumannii, Clostridium difficile and methicillin-resistant Staphylococcus aureus in both dry and wet samples. In animal experiments, an oxygen and ozone mixture delayed the onset of arrhythmia chemically induced in rats.

What the authors concluded

The authors concluded that, given in controlled low doses, ozone may work through a form of measured oxidative stress that upregulates the body's own antioxidant and immune defences. On the strength of the evidence surveyed, they saw potential across disinfection, dentistry, wound care and the management of certain infections, while stressing that standardised dosing and more rigorous clinical trials would be needed before firm therapeutic claims could be made.

Limitations of this review

As a narrative review, this article carries no systematic literature search, no assessment of study quality and no pooled data, so it cannot establish how effective ozone is or how the cited studies compare. Much of the evidence it draws on is from in vitro or animal work, or from small, uncontrolled clinical reports, and the protocols vary widely. Ozone is also toxic to the respiratory tract, and its therapeutic window is narrow, which is why medical use depends on careful dosing and route of administration. The review describes possibilities rather than proven treatments, and its findings should be read as a starting point for further research rather than as clinical guidance.