Repetitive Pneumoperitoneum with Ozonized Oxygen as a Preventive in Lethal Polymicrobial Sepsis in Rats

Abstract

The aim of this study was to test whether repetitive pretreatments of rats with ozonized oxygen at relatively low gas volumes into the abdomen (20 ml per rat per day) have any beneficial or detrimental effects on the course of a polymicrobial-induced lethal peritonitis. Peritonitis was induced in a surgical or a nonsurgical model by usage of fecal material from the cecum. As the biological read out we used the mortality analysis. To include possible mechanisms by which ozone might influence the septic outcome, we characterized the gene expression of the pro-inflammatory cytokines IL-1β, IL-2, and TNF-α mRNA in lymphoid organs. In both models, we found a significant beneficial influence of a dose-dependent O₂/O₃pneumoperitoneum on the survival rate when compared to control animals or to room air. The ozone-enhanced survival seems to be independent from altered cytokine expression because there were no differences noticed in the levels of bacterial-induced gene expression of IL-1β and TNF-α in septic animals pretreated with ozonized oxygen when compared to control animals.

Pre-treatment with ozonized oxygen (O3) aggravates inflammation in septic rats

“…There are a few reports, both in animals and in humans, which demonstrate beneficial effects of ozone in peritonitis [9,15,16]. Our results disagree with these observations, since we found that ozone pre-treatment caused a trend to a reduced survival from 50 % to 35 %, which may be due to an exaggerated pro-inflammatory cytokine release, disturbing the delicate pro-and anti-inflammatory cytokine balance after infection [17].…”

“…Our senses model differs from others [9], since we administer an antibiotic prophylaxis in an equivalent human dosage. Others performed trials without antibiotic prophylaxis [18] or with a clinically unusual applications (e. g. intramuscular) [19].…”

“…Whether ozone pre-treatment is beneficial in peritonitis is unclear, since there are contradictory reports of its immunological effects [9]. For modelling these complex clinical interactions, clinic modelling randomized trials (CMRTs) [10,11] are applicable.…”

Analysis of the bactericidal effect of ozone pneumoperitoneum

“…Schulz et al 14 found promising results on proving the efficacy of repetitive pre-treatment using intra-abdominal ozonized oxygen in reducing mortality in animals submitted to lethal polymicrobial peritonitis.…”

<i>In Vitro</i> Evaluation of Ozone Activity on Recent Clinically Isolated Bacterial Strains

“…The treatment of Bacillus subtilis spores with various oxidizing agents (including ozone) damages the inner membrane, making the spores more sensitive to subsequent thermal and osmotic stresses, with the increased rapid penetration of methylamine within the core [20]. The literature also confirms the synergic action of ozone with antibiotic therapy in vivo [21][22][23][24][25][26].…”