Increased Growth Factors Play a Role in Wound Healing Promoted by Noninvasive Oxygen-Ozone Therapy in Diabetic Patients with Foot Ulcers

Abstract

Management of diabetic foot ulcers (DFUs) is a great challenge for clinicians. Although the oxygen-ozone treatment improves the diabetic outcome, there are few clinical trials to verify the efficacy and illuminate the underlying mechanisms of oxygen-ozone treatment on DFUs. In the present study, a total of 50 type 2 diabetic patients complicated with DFUs, Wagner stage 2~4, were randomized into control group treated by standard therapy only and ozone group treated by standard therapy plus oxygen-ozone treatment. The therapeutic effects were graded into 4 levels from grade 0 (no change) to grade 3 (wound healing). The wound sizes were measured at baseline and day 20, respectively. Tissue biopsies were performed at baseline and day 11. The expressions of vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet-derived growth factor (PDGF) proteins in the pathologic specimens were determined by immunohistochemical examinations. The effective rate of ozone group was significantly higher than that of control group (92% versus 64%, P < 0.05). The wound size reduction was significantly more in ozone group than in control group (P < 0.001). After treatment, the expressions of VEGF, TGF-β, and PDGF proteins at day 11 were significantly higher in ozone group than in control group. Ozone therapy promotes the wound healing of DFUs via potential induction of VEGF, TGF-β, and PDGF at early stage of the treatment. (Clinical trial registry number is ChiCTR-TRC-14004415).

Tratamiento de úlceras en el pie diabético. Revisión

“…Con respecto a la ozonoterapia, los dos artí-culos revisados encontraron como beneficiosa esta terapia, ya que se promueve la cicatrización de la herida y la liberación endógena de VEGF, TGF-β y PDGF 9,10 . No obstante, según Zhang, J. et al la aplicación local de factores de crecimiento ha demostrado una leve eficacia, por lo que puede ser más importante estimular la expresión de factores de crecimiento endógenos en el sitio local de la herida como se demuestra en su estudio 10 .…”

“…No obstante, según Zhang, J. et al la aplicación local de factores de crecimiento ha demostrado una leve eficacia, por lo que puede ser más importante estimular la expresión de factores de crecimiento endógenos en el sitio local de la herida como se demuestra en su estudio 10 . Por el contrario, el metaanálisis de Zhao, X.H.…”

The Effect of Ozone Gel on Bone Matrix Production by Human Osteosarcoma Cell Line Saos-2

“…Unfortunately, this study did not investigate the mechanism underlying the upregulation of these early bone matrix markers. Previous reports have identified that oxygen ozone therapy promotes the production of growth factors such as VEGF 27) . In addition, ozone gas is known to promote the production of FGF and other related cytokines 28) .…”

Use of ozone in medicine and veterinary practice

“…Badania na dużej grupie pacjentów potwierdziły korzystny wpływ okładów z ozonowanej oliwy na gojenie przewlekłych ran w porównaniu z grupą kontrolną (12,47).…”