Ozonised Autohaemotherapy, Blood Viscosity and Red Cell Flexibility in Peripheral Arterial Disease (2001)

Background

In peripheral occlusive arterial disease the arteries supplying the legs are narrowed, so the muscles and skin are short of oxygen. The problem is made worse by the blood itself: in these patients it tends to be thicker, and the red cells stiffer, than normal. A red blood cell is wider than the smallest capillaries and has to fold to pass through them, so stiff red cells and thick blood mean even less oxygen reaches the tissue.

Ozonised autohaemotherapy - in which a quantity of the patient's own blood is exposed to an oxygen-ozone mixture and returned through a drip - had been used for circulation disorders in Italy for some years. Dr R. Giunta and colleagues in Naples set out to measure what it does to the flow properties of blood, a field known as haemorheology.

Study design

Twenty-seven people with peripheral occlusive arterial disease at Fontaine stage II to III (pain on walking, through to pain at rest) took part, together with 20 matched healthy volunteers who provided normal comparison values.

Each patient received one major ozonised autohaemotransfusion: 100 ml of their own blood was exposed to an oxygen-ozone mixture for 10 minutes and slowly reinfused. Measurements were taken beforehand and 30 minutes afterwards: whole blood viscosity, erythrocyte filterability, haematocrit (the proportion of blood made up of red cells), fibrinogen (a clotting protein that thickens blood), p50 (the standard measure of how readily haemoglobin gives up oxygen), 2,3-DPG, and plasma malonyl dialdehyde (MDA), a marker of lipid peroxidation.

As a control, the same patients also underwent the identical procedure with blood that had not been exposed to ozone.

Findings

At the start, the patients had significantly thicker blood, higher MDA and p50 values, and significantly poorer red cell filterability than the healthy volunteers.

Thirty minutes after ozonised blood, whole blood viscosity had fallen significantly, as had fibrinogen, with no change in haematocrit - so the blood was not simply diluted. Red cell filterability rose significantly, meaning the cells passed through fine pores more easily. The p50 value rose, indicating that haemoglobin was releasing oxygen more readily. Plasma MDA also rose, confirming that a brief, measurable oxidative event had taken place.

2,3-DPG did not change significantly. This compound is often given as the reason haemoglobin releases more oxygen after ozone; in this study the oxygen-release measure improved within 30 minutes without it.

After non-ozonised blood, none of the measures changed significantly.

What the authors concluded

The authors conclude that ozonised autohaemotransfusion may be useful for improving both the poor flow properties of the blood and the delivery of oxygen to the tissues in people with peripheral occlusive arterial disease.

Limitations of this study

The study measured blood in the laboratory 30 minutes after a single session. It did not follow patients to see whether walking distance, pain or ulcer healing improved, or how long the changes lasted.

Using each patient as their own control is a strength - it shows the effect came from the ozone, not from drawing and returning blood - but the abstract does not say whether the two procedures were given in random order or whether patients were unaware which they were receiving. With laboratory outcomes this matters less than it would with symptoms.

Twenty-seven patients is a small sample, from one centre.

The procedure studied was autohaemotherapy carried out in a clinic. The study does not show that other routes of giving ozone produce the same changes in blood flow. We have worked from the published abstract; the full paper is behind a paywall.

Peripheral arterial disease needs medical care. Ozone therapy is a complementary approach and should be discussed with your doctor.

Related reading

Oxygen-Ozone Therapy in Peripheral Arterial Disease: A Review Study

Ozone Acting on Human Blood: The Hormetic Dose-Response Relationship

How Ozone Therapy Works: The Science in Plain Words

Giunta R, Coppola A, Luongo C, Sammartino A, Guastafierro S, Grassia A, Giunta L, Mascolo L, Tirelli A, Coppola L. Ozonized autohemotransfusion improves hemorheological parameters and oxygen delivery to tissues in patients with peripheral occlusive arterial disease. Annals of Hematology. 2001;80(12):745-748. doi:10.1007/s002770100377