title: Medical ozone increases methotrexate clinical response and improves cellular redox balance in patients with rheumatoid arthritis.
abstract: Medical ozone reduced inflammation, IL-1β, TNF-α mRNA levels and oxidative stress in PG/PS-induced arthritis in rats. The aim of this study was to investigate the medical ozone effects in patients with rheumatoid arthritis treated with methotrexate and methotrexate+ozone, and to compare between them. A randomized clinical study with 60 patients was performed, who were divided into two groups: one (n=30) treated with methotrexate (MTX), folic acid and Ibuprophen (MTX group) and the second group (n=30) received the same as the MTX group+medical ozone by rectal insufflation of the gas (MTX+ozone group). The clinical response of the patients was evaluated by comparing Disease Activity Score 28 (DAS28), Health Assessment Questionnaire Disability Index (HAQ-DI), Anti-Cyclic Citrullinated (Anti-CCP) levels, reactants of acute phase and biochemical markers of oxidative stress before and after 20 days of treatment. MTX+ozone reduced the activity of the disease while MTX merely showed a tendency to decrease the variables. Reactants of acute phase displayed a similar picture. MTX+ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. Glutathione correlated with all clinical variables just after MTX+ozone. MTX+ozone increased the MTX clinical response in patients with rheumatoid arthritis. No side effects were observed. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets. Medical ozone treatment is capable of being a complementary therapy in the treatment of rheumatoid arthritis.
authors.affiliation: Pharmacy and Food Institute, University of Havana, Calle 222 # 2317 e/23 y 31, Coronela, Lisa, Habana, Havana 10 400, Cuba. Electronic address: olga@infomed.sld.cu.
authors.forename: Olga Sonia
authors.initials: OS
authors.lastname: León Fernández
authors.affiliation: Medical Society for the Use of Ozone in Prevention and Therapy, Iffezheim/Baden-Baden d-76473, Germany.
authors.forename: Renate
authors.initials: R
authors.lastname: Viebahn-Haensler
authors.affiliation: National Institute of Rheumatology, Ministry of Public Health, 10 de Octubre e/Agua Dulce y Cruz del Padre, Municipio Cerro, La Habana, Cuba.
authors.forename: Gilberto López
authors.initials: GL
authors.lastname: Cabreja
authors.affiliation: National Institute of Rheumatology, Ministry of Public Health, 10 de Octubre e/Agua Dulce y Cruz del Padre, Municipio Cerro, La Habana, Cuba.
authors.forename: Irainis Serrano
authors.initials: IS
authors.lastname: Espinosa
authors.affiliation: Pharmacy and Food Institute, University of Havana, Calle 222 # 2317 e/23 y 31, Coronela, Lisa, Habana, Havana 10 400, Cuba.
authors.forename: Yanet Hernández
authors.initials: YH
authors.lastname: Matos
authors.affiliation: Department of Pharmacology, CEBIMAR, Havana 10 400, Cuba.
authors.forename: Liván Delgado
authors.initials: LD
authors.lastname: Roche
authors.affiliation: Pharmacy and Food Institute, University of Havana, Calle 222 # 2317 e/23 y 31, Coronela, Lisa, Habana, Havana 10 400, Cuba.
authors.forename: Beatriz Tamargo
authors.initials: BT
authors.lastname: Santos
authors.affiliation: Pharmacy and Food Institute, University of Havana, Calle 222 # 2317 e/23 y 31, Coronela, Lisa, Habana, Havana 10 400, Cuba.
authors.forename: Gabriel Takon
authors.initials: GT
authors.lastname: Oru
authors.affiliation: Pharmacy and Food Institute, University of Havana, Calle 222 # 2317 e/23 y 31, Coronela, Lisa, Habana, Havana 10 400, Cuba.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Polo Vega
mesh_terms: D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use*; D008875:Middle Aged; D010084:Oxidation-Reduction / Q000187:drug effects; D010126:Ozone / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D015415:Biomarkers; D010126:Ozone; D008727:Methotrexate
keywords: Medical ozone; Methotrexate; Rheumatoid arthritis