Major ozone autohemotherapy (MAH) is a popular clinical
practice
for treating a variety of pathological conditions due to the mild
and controlled oxidative stress produced by the reaction of ozone
gas with other biological components. Previous studies have shown
that blood ozonation leads to structural changes in hemoglobin (Hb);
therefore, in the present study, the molecular effects of ozonation
on Hb of a healthy individual were assessed by ozonating whole blood
samples with single doses of ozone at 40, 60, and 80 μg/mL or
double doses of ozone at 20 + 20, 30 + 30, and 40 + 40 μg/mL
ozone to investigate whether ozonating once versus twice (but with
the same final ozone concentration) would have varying effects on
Hb. Additionally, our study aimed to verify whether using a very high
ozone concentration (80 + 80 μg/mL), despite mixing it with
blood in two steps, would result in Hb autoxidation. The pH, oxygen
partial pressure, and saturation percentage of the whole blood samples
were measured through a venous blood gas test, and the purified Hb
samples were analyzed using several techniques including intrinsic
fluorescence, circular dichroism and UV–vis absorption spectroscopies,
SDS-polyacrylamide gel electrophoresis, dynamic light scattering,
and a zeta potential analyzer. Structural and sequence analyses were
also used to study the Hb heme pocket autoxidation sites and the residues
involved. The results showed that the oligomerization and instability
of Hb can be reduced if the ozone concentration to be used in MAH
is divided into two doses. Indeed, our study demonstrated that two-step
ozonation with 20, 30, and 40 μg/mL of ozone instead of single-dose
ozonation with 40, 60, and 80 μg/mL of ozone reduced the potential
adverse effects of ozone on Hb including protein instability and oligomerization.
Moreover, it was found that for certain residues, their orientation
or displacement leads to the entry of excess water molecules into
the heme moiety, which can contribute to Hb autoxidation. Additionally,
the autoxidation rate was found to be higher in alpha globins compared
to beta globins.