Uğuz S et al, 2016: Medical ozone therapy reduces shock wave therapy-induced renal injury.
Uğuz S, Demirer Z, Uysal B, Alp BF, Malkoc E, Guragac A, Turker T, Ateş F, Karademir K, Ozcan A, Yildirim I, Korkmaz A, Guven A.
Department of Urology, Gulhane Military Medical Faculty , Etlik , Ankara , Turkey.
Department of Physiology, Gulhane Military Medical Faculty , Etlik , Ankara , Turkey.
Department of Epidemiology, Gulhane Military Medical Faculty , Etlik , Ankara , Turkey.
Department of Pathology, Gulhane Military Medical Faculty , Etlik , Ankara , Turkey.
Department of Pediatric Surgery, Gulhane Military Medical Faculty , Etlik , Ankara , Turkey.
OBJECTIVES: Extracorporeal shock wave (ESW) lithotripsy is the preferred treatment modality for uncomplicated kidney stones. More recently free oxygen radical production following ESW application has been considered to be crucial in shock wave-induced renal damage. It has been shown that ozone therapy (OT) has ameliorative and preventive effects against various pathological conditions due to increased nitro-oxidative stress. In current study, we aimed to evaluate the efficacy of OT against ESW-induced renal injury.
METHODS: Twenty-four male Sprague-Dawley rats were divided into three groups: sham-operated, ESW, and ESW + OT groups. All groups except sham-operated group were subjected to ESW procedure. ESW + OT group received 1 mg/kg/day of oxygen/ozone mixture intraperitoneally at 2 h before ESW, and OT was continued once a day for consecutive three days. The animals were killed at the 4th day, and kidney tissue and blood samples were harvested for biochemical and histopathologic analysis.
RESULTS: Serum ALT and AST levels, serum neopterin, tissue nitrite/nitrate levels, and tissue oxidative stress parameters were increased in the ESW group and almost came close to control values in the treatment group (p < 0.05, ESW vs. ESW + OT). Histopathological injury scores were significantly lower in treatment group than the ESW group (p < 0.05, ESW vs. ESW + OT). Immunohistochemical iNOS staining scores in ESW group were higher than those of sham-operated group (p < 0.05, ESW vs. sham-operated), iNOS staining scores in OT group were significantly lower than the ESW group (p < 0.05, ESW + OT vs. ESW).
CONCLUSION: OT ameliorates nitro-oxidative stress and reduces the severity of pathological changes in the experimental ESW-induced renal injury of rat model.
Ren Fail. 2016 Jul;38(6):974-81. doi: 10.3109/0886022X.2016.1172941. Epub 2016 Apr 20.
In an interesting experimental study on rats, the biochemical and histological-pathological effects of ozone therapy (OT) in association with SWL were recorded.
It is of note that SWL and administration of ozone resulted in significant biochemical differences compared with that in only SWL-treated animals:
AST and ALP were lower
MDA, SOD and GSHPx were lower
Nitrogen oxide was lower
All these effects were commensurate with reduced nitro-oxidative stress. The histological-pathological changes as a consequence of SWL were less severe when ozone had been administered and that is an important effect.
It is of course neither easy nor straightforward to translate this kind of therapy to clinical routine, but if tissues can be better protected by a treatment like this, it is possible that also the principles for shockwave administration in the future can be modified and improved with the aim of achieving better and more rapid stone disintegration.