Ozone Therapy Effects on Biomarkers and Lung Function in Asthma

Background

Asthma is a chronic inflammatory disease of the airways in which allergic (atopic) mechanisms and oxidative stress both play a part. In atopic asthma, raised immunoglobulin E (IgE) and heightened immune-cell activity drive airway inflammation, while an imbalance between oxidants and the body's antioxidant defences can worsen tissue damage and narrow the airways. Researchers in Cuba set out to test whether medical ozone, given systemically, could influence these immune and antioxidant markers and, in turn, lung function in people with atopic asthma.

Study design

The study enrolled 113 people with atopic asthma, aged 15 to 50. There was no control or placebo group and patients were not randomised; instead they were divided into three groups according to the ozone protocol they received. One group received major autohaemotherapy (a small volume of the patient's own blood mixed with an ozone-oxygen mixture and reinfused) at a 4 mg dose, a second received major autohaemotherapy at 8 mg, and a third received rectal insufflation of ozone gas at 10 mg. Treatment was delivered in repeated cycles of daily sessions (five per week), spaced across roughly a year. The team measured serum IgE, HLA-DR expression on immune cells, a panel of glutathione-related antioxidant enzymes, and lung function by spirometry (including FEV1).

Findings

The changes differed markedly between protocols. The major autohaemotherapy 8 mg group showed the strongest response, with statistically significant falls in IgE and in HLA-DR expression, large rises across the glutathione antioxidant enzymes, and a significant improvement in FEV1. Rectal insufflation at 10 mg produced smaller but still significant reductions in IgE and HLA-DR, while the lower 4 mg autohaemotherapy dose produced the least change, with several measures not reaching statistical significance. In the higher-dose groups the authors also reported clinical improvement in symptoms such as breathlessness and wheezing.

What the authors concluded

The authors concluded that systemic ozone therapy reduced IgE and inflammatory markers while boosting antioxidant defences, and that the effect appeared dose-related, with the 8 mg autohaemotherapy protocol the most effective. They suggested ozone therapy could be considered as a possible therapeutic or adjuvant approach for atopic asthma, while calling for further research.

Limitations of this study

This was a non-randomised study with no control or placebo group, so the improvements cannot be confidently separated from the natural course of the disease, seasonal variation, concurrent medication or a placebo effect. Group sizes were modest and treatment was not blinded. The authors themselves noted that the mechanism behind the immune changes is not fully proven and that direct evidence of the cytokines involved was still needed. The results should therefore be read as preliminary and hypothesis-generating rather than as proof of effectiveness.