Consideraciones sobre el uso de la Ozonoterapia (O3) en el tratamiento de la Endometriosis

Autores/as

DOI:

https://doi.org/10.33448/rsd-v9i9.7616

Palabras clave:

Ozono; Ozonoterapia; Endometriosis.

Resumen

La endometriosis se define como la presencia de una glándula endometrial y/o estroma endometrial fuera del útero. Los pacientes con endometriosis presentan un cuadro clínico con mucha variabilidad, con prevalencia de dismenorrea sintomática, dispareunia, dolor pélvico crónico, disuria, disquecia e infertilidad. Actualmente, está ampliamente aceptado que la endometriosis es una enfermedad asociada a una respuesta inflamatoria general en la cavidad peritoneal y que se ha propuesto el estrés oxidativo como un factor potencial involucrado en la fisiopatología de la enfermedad. En este contexto, es importante buscar alternativas terapéuticas innovadoras y de bajo costo, capaces de prevenir y / o disminuir la progresión del daño tisular y mitigar los impactos inherentes a la enfermedad. Por lo tanto, este estudio busca, a través de una revisión narrativa, proporcionar una comprensión de la evidencia actual disponible sobre la importancia de la ozonoterapia y su posible aplicabilidad en el tratamiento de la endometriosis. La evidencia muestra que el ozono tiene la capacidad de mejorar la oxigenación corporal, modular el proceso inflamatorio, aumentar el sistema inmunológico y antioxidante, ayudar a aliviar enfermedades causadas por daño oxidativo similares a las complicaciones de la endometriosis. Así, la evidencia encontrada en este estudio indica que la ozonoterapia podría proponerse como una intervención terapéutica eficaz y segura en el tratamiento de la endometriosis, dentro de las prácticas integradoras. Sin embargo, no existen ensayos clínicos controlados y aleatorizados que hayan evaluado el efecto de la aplicación de la ozonoterapia en la prevención, control y tratamiento de la endometriosis.

Citas

Alexandre, A., Corò, L., Paradiso, R., Dall'aglio, R., Alexandre, A. M., Fraschini, F., & Spaggiari, P. G. (2011). Treatment of symptomatic lumbar spinal degenerative pathologies by means of combined conservative biochemical treatments. Acta neurochirurgica. Supplement, 108, 127–135. https://doi.org/10.1007/978-3-211-99370-5_20

Alpay, Z., Saed, G. M., & Diamond, M. P. (2006). Female infertility and free radicals: potential role in adhesions and endometriosis. Journal of the Society for Gynecologic Investigation, 13(6), 390–398. https://doi.org/10.1016/j.jsgi.2006.05.002

Atallah, N. A, Castro, A. A. Revisão sistemática da literatura e metanálise: a melhor forma de evidência para tomada de decisão em saúde e a maneira mais rápida de atualização terapêutica. Disponível em: http://www.epm.br/Cochrane

Anzolin, Ana Paula, & Bertol, Charise Dallazem. (2018). Ozonioterapia como terapêutica integrativa no tratamento da osteoartrose: uma revisão sistemática. BrJP, 1(2), 171-175. https://dx.doi.org/10.5935/2595-0118.20180033

Augoulea, A., Mastorakos, G., Lambrinoudaki, I., Christodoulakos, G., & Creatsas, G. (2009). The role of the oxidative-stress in the endometriosis-related infertility. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 25(2), 75–81. https://doi.org/10.1080/09513590802485012

Barbosa, Kiriaque Barra Ferreira, Costa, Neuza Maria Brunoro, Alfenas, Rita de Cássia Gonçalves, De Paula, Sérgio Oliveira, Minim, Valéria Paula Rodrigues, & Bressan, Josefina. (2010). Estresse oxidativo: conceito, implicações e fatores modulatórios. Revista de Nutrição, 23(4), 629-643. https://doi.org/10.1590/S1415-52732010000400013

Bazot, M., Malzy, P., Cortez, A., Roseau, G., Amouyal, P., & Daraï, E. (2007). Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 30(7), 994–1001. https://doi.org/10.1002/uog.4070

Bellelis, P., Dias, J. A., Jr, Podgaec, S., Gonzales, M., Baracat, E. C., & Abrão, M. S. (2010). Epidemiological and clinical aspects of pelvic endometriosis–a case series. Revista da Associacao Medica Brasileira (1992), 56(4), 467–471. https://doi.org/10.1590/s0104-42302010000400022

Bocci V. (1999). Biological and clinical effects of ozone. Has ozone therapy a future in medicine?. British journal of biomedical science, 56(4), 270–279.

Bocci V. (2006). Is it true that ozone is always toxic? The end of a dogma. Toxicology and applied pharmacology, 216(3), 493–504. https://doi.org/10.1016/j.taap.2006.06.009

Bocci, V., Zanardi, I., & Travagli, V. (2011). Oxygen/ozone as a medical gas mixture. A critical evaluation of the various methods clarifies positive and negative aspects. Medical gas research, 1(1), 6. https://doi.org/10.1186/2045-9912-1-6

Bocci, V. A., Zanardi, I., & Travagli, V. (2011). Ozone acting on human blood yields a hormetic dose-response relationship. Journal of translational medicine, 9, 66. https://doi.org/10.1186/1479-5876-9-66

Binda, M. M., Molinas, C. R., & Koninckx, P. R. (2003). Reactive oxygen species and adhesion formation: clinical implications in adhesion prevention. Human reproduction (Oxford, England), 18(12), 2503–2507. https://doi.org/10.1093/humrep/deg481

Braidy, N., Izadi, M., Sureda, A., Jonaidi-Jafari, N., Banki, A., Nabavi, S. F., & Nabavi, S. M. (2018). Therapeutic relevance of ozone therapy in degenerative diseases: Focus on diabetes and spinal pain. Journal of cellular physiology, 233(4), 2705–2714. https://doi.org/10.1002/jcp.26044

Bulun S. E. (2009). Endometriosis. The New England journal of medicine, 360(3), 268–279. https://doi.org/10.1056/NEJMra0804690

Da Broi, M. G., & Navarro, P. A. (2016). Oxidative stress and oocyte quality: ethiopathogenic mechanisms of minimal/mild endometriosis-related infertility. Cell and tissue research, 364(1), 1–7. https://doi.org/10.1007/s00441-015-2339-9

Davis, Colin J.a; McMillan, Lindsayb Pain in endometriosis: effectiveness of medical and surgical management, Current Opinion in Obstetrics and Gynecology: December 2003 - Volume 15 - Issue 6 - p 507-512

Di Paolo, N., Bocci, V., & Gaggiotti, E. (2004). Ozone therapy. The International journal of artificial organs, 27(3), 168–175. https://doi.org/10.1177/039139880402700303

Đuričić, D., Valpotić, H., & Samardžija, M. (2015). Prophylaxis and therapeutic potential of ozone in buiatrics: Current knowledge. Animal reproduction science, 159, 1–7. https://doi.org/10.1016/j.anireprosci.2015.05.017

Đuričić, D., Valpotić, H., Žura Žaja, I., & Samardžija, M. (2016). Comparison of Intrauterine Antibiotics versus Ozone Medical Use in Sheep with Retained Placenta and Following Obstetric Assistance. Reproduction in domestic animals = Zuchthygiene, 51(4), 538–540. https://doi.org/10.1111/rda.12715

Fauconnier, A., Fritel, X., & Chapron, C. (2009). Relations entre endométriose et algie pelvienne chronique: quel est le niveau de preuve? [Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications]. Gynecologie, obstetrique & fertilite, 37(1), 57–69. https://doi.org/10.1016/j.gyobfe.2008.08.016

Francisco, Viviane Vieira, D'Ippolito, Giuseppe, Silva, Gláucia Palácio de Andrade e, Bezerra, Alexandre Sérgio de Araújo, & Szejnfeld, Jacob. (2005). Prevalência de artefatos em exames de ressonância magnética do abdome utilizando a seqüência GRASE: comparável com as melhores seqüências rápidas?. Radiologia Brasileira, 38(5), 323-328. https://doi.org/10.1590/S0100-39842005000500003

Guerra XV, Limonta YN, Contreras IH, Freyre RL, Ramírez AMP. Resultados de los costos en ozonoterapia. Rev Cubana Enfermer 1999;15(2):104-108.

Gupta, S., Goldberg, J. M., Aziz, N., Goldberg, E., Krajcir, N., & Agarwal, A. (2008). Pathogenic mechanisms in endometriosis-associated infertility. Fertility and sterility, 90(2), 247–257. https://doi.org/10.1016/j.fertnstert.2008.02.093

Hahn, G., Oliveira, J., & Bock, P. (2017). O papel do fator nuclear eritróide 2 relacionado ao fator 2 (Nrf2) no diabetes mellitus. Clinical & Biomedical Research, 37(3). Retrieved from https://seer.ufrgs.br/hcpa/article/view/73

Hernández OD, González RC. Ozonoterapia en úlceras flebostáticas. Rev Cubana Cir 2001;40(2):123-129.

Hsu, A. L., Khachikyan, I., & Stratton, P. (2010). Invasive and noninvasive methods for the diagnosis of endometriosis. Clinical obstetrics and gynecology, 53(2), 413–419. https://doi.org/10.1097/GRF.0b013e3181db7ce8

Joseph, J., Ametepe, E. S., Haribabu, N., Agbayani, G., Krishnan, L., Blais, A., & Sad, S. (2016). Inhibition of ROS and upregulation of inflammatory cytokines by FoxO3a promotes survival against Salmonella typhimurium. Nature communications, 7, 12748. https://doi.org/10.1038/ncomms12748

Kaspar, J. W., Niture, S. K., & Jaiswal, A. K. (2009). Nrf2:INrf2 (Keap1) signaling in oxidative stress. Free radical biology & medicine, 47(9), 1304–1309. https://doi.org/10.1016/j.freeradbiomed.2009.07.035

Kennedy, S., Bergqvist, A., Chapron, C., D'Hooghe, T., Dunselman, G., Greb, R., Hummelshoj, L., Prentice, A., Saridogan, E., & ESHRE Special Interest Group for Endometriosis and Endometrium Guideline Development Group (2005). ESHRE guideline for the diagnosis and treatment of endometriosis. Human reproduction (Oxford, England), 20(10), 2698–2704. https://doi.org/10.1093/humrep/dei135

Kobayashi, E. H., Suzuki, T., Funayama, R., Nagashima, T., Hayashi, M., Sekine, H., Tanaka, N., Moriguchi, T., Motohashi, H., Nakayama, K., & Yamamoto, M. (2016). Nrf2 suppresses macrophage inflammatory response by blocking proinflammatory cytokine transcription. Nature communications, 7, 11624. https://doi.org/10.1038/ncomms11624

Lemos, N. A., Arbo, E., Scalco, R., Weiler, E., Rosa, V., & Cunha-Filho, J. S. (2008). Decreased anti-Müllerian hormone and altered ovarian follicular cohort in infertile patients with mild/minimal endometriosis. Fertility and sterility, 89(5), 1064–1068. https://doi.org/10.1016/j.fertnstert.2007.04.048

Lousse, J. C., Van Langendonckt, A., Defrere, S., Ramos, R. G., Colette, S., & Donnez, J. (2012). Peritoneal endometriosis is an inflammatory disease. Frontiers in bioscience (Elite edition), 4, 23–40. https://doi.org/10.2741/358

Maul, L. V., Morrision, J. E., Schollmeyer, T., Alkatout, I., & Mettler, L. (2014). Surgical therapy of ovarian endometrioma: recurrence and pregnancy rates. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 18(3), e2014.00223. https://doi.org/10.4293/JSLS.2014.00223

Melo, V. L., Sá, S. P. C., Passos, M. B. P., Ferreira, J. B. dos S., Alóchio, K. V., Sardinha, M. T. M. U., & Christóvam, B. P. (2020). Ozonioterapia realizada pelo Enfermeiro na imunomodulação em paciente com “Craurose vulvar”: relato de experiência. Research, Society and Development, 9(8). https://doi.org/10.33448/rsd-v9i8.6153

Menendez-Cepero S. General protocols based on evidences. Proceedings of the 5Th WFOT Meeting; 2016 Nov 18-20; Mumbai, India. J Ozone Ther. 2018;2(2). doi: 10.7203/ jo3t.2.2.2018.11125

Mengarda, C. V., Passos, E. P., Picon, P., Costa, A. F., & Picon, P. D. (2008). Validação de versão para o português de questionário sobre qualidade de vida para mulher com endometriose (Endometriosis Health Profile Questionnaire--EHP-30) [Validation of Brazilian Portuguese version of quality of life questionnaire for women with endometriosis (Endometriosis Health Profile Questionnaire--EHP-30)]. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia, 30(8), 384–392. https://doi.org/10.1590/s0100-72032008000800003

Murphy, A. A., Santanam, N., Morales, A. J., & Parthasarathy, S. (1998). Lysophosphatidyl choline, a chemotactic factor for monocytes/T-lymphocytes is elevated in endometriosis. The Journal of clinical endocrinology and metabolism, 83(6), 2110–2113. https://doi.org/10.1210/jcem.83.6.4823

Pacheco, José Fernando, Dias, Rogério, Silva, Márcia Guimarães da, Tristão, Andréa da Rocha, & De Luca, Laurival Antônio. (2003). Prevenção de aderências pélvicas: estudo experimental em ratas com diferentes modalidades terapêuticas. Revista Brasileira de Ginecologia e Obstetrícia, 25(5), 359-364. https://doi.org/10.1590/S0100-72032003000500009

Pereira A.S. et al. (2018). Metodologia da pesquisa científica. Santa Maria, RS : UFSM, NTE, 2018. Disponível em: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1. Acesso em: 17 de agosto de 2020.

Pecorelli, A., Bocci, V., Acquaviva, A., Belmonte, G., Gardi, C., Virgili, F., Ciccoli, L., & Valacchi, G. (2013). NRF2 activation is involved in ozonated human serum upregulation of HO-1 in endothelial cells. Toxicology and applied pharmacology, 267(1), 30–40. https://doi.org/10.1016/j.taap.2012.12.001

Re, L., Martínez-Sánchez, G., Bordicchia, M., Malcangi, G., Pocognoli, A., Morales-Segura, M. A., Rothchild, J., & Rojas, A. (2014). Is ozone pre-conditioning effect linked to Nrf2/EpRE activation pathway in vivo? A preliminary result. European journal of pharmacology, 742, 158–162. https://doi.org/10.1016/j.ejphar.2014.08.029

Recio del Pino, Eulalia, Arias Serrano, Maritza, Rodríguez del Río, Magalys, & Garrido, María de los Angeles. (1999). Aspectos de la ozonoterapia en pacientes con neuropatía periférica epidémica. Revista Cubana de Enfermería, 15(2), 114-118. Recuperado en 07 de agosto de 2020, de http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03191999000200010&lng=es&tlng=es.

Revised American Society for Reproductive Medicine classification of endometriosis: 1996. (1997). Fertility and sterility, 67(5), 817–821. https://doi.org/10.1016/s0015-0282(97)81391-x

Ruder, E. H., Hartman, T. J., Blumberg, J., & Goldman, M. B. (2008). Oxidative stress and antioxidants: exposure and impact on female fertility. Human reproduction update, 14(4), 345–357. https://doi.org/10.1093/humupd/dmn011

Rushworth, S. A., Zaitseva, L., Murray, M. Y., Shah, N. M., Bowles, K. M., & MacEwan, D. J. (2012). The high Nrf2 expression in human acute myeloid leukemia is driven by NF-κB and underlies its chemo-resistance. Blood, 120(26), 5188–5198. https://doi.org/10.1182/blood-2012-04-422121

Schug, T. T., Xu, Q., Gao, H., Peres-da-Silva, A., Draper, D. W., Fessler, M. B., Purushotham, A., & Li, X. (2010). Myeloid deletion of SIRT1 induces inflammatory signaling in response to environmental stress. Molecular and cellular biology, 30(19), 4712–4721. https://doi.org/10.1128/MCB.00657-10

Thimmulappa, R. K., Lee, H., Rangasamy, T., Reddy, S. P., Yamamoto, M., Kensler, T. W., & Biswal, S. (2006). Nrf2 is a critical regulator of the innate immune response and survival during experimental sepsis. The Journal of clinical investigation, 116(4), 984–995. https://doi.org/10.1172/JCI25790

Travagli, V., Zanardi, I., Bernini, P., Nepi, S., Tenori, L., & Bocci, V. (2010). Effects of ozone blood treatment on the metabolite profile of human blood. International journal of toxicology, 29(2), 165–174. https://doi.org/10.1177/1091581809360069

Viebahn-Hänsler R, León-Fernández OS, Fahmy Z. Systemic ozone applications, Major autohemotherapy and Rectal Insufflation, evaluated according to the International classification of Evidence-Based Medicine. A new basis for reimbursement of medical expenses by private and social insurances [abstract]. Proceedings of The World Conference on Ozone Therapy in Medicine, Dentistry and Veterinary. Ancona (Italy). September 22nd – 23rd - 24th , 2017. J Ozone Ther. 2019;3(4):78. doi: 10.7203/jo3t.3.4.2019.15550

Wang, G., Tokushige, N., Markham, R., & Fraser, I. S. (2009). Rich innervation of deep infiltrating endometriosis. Human reproduction (Oxford, England), 24(4), 827–834. https://doi.org/10.1093/humrep/den464

Wykes, C. B., Clark, T. J., & Khan, K. S. (2004). Accuracy of laparoscopy in the diagnosis of endometriosis: a systematic quantitative review. BJOG : an international journal of obstetrics and gynaecology, 111(11), 1204–1212. https://doi.org/10.1111/j.1471-0528.2004.00433.x

Yu, G., Liu, X., Chen, Z., Chen, H., Wang, L., Wang, Z., Qiu, T., & Weng, X. (2016). Ozone therapy could attenuate tubulointerstitial injury in adenine-induced CKD rats by mediating Nrf2 and NF-κB. Iranian journal of basic medical sciences, 19(10), 1136–1143.

Merhi, Z., Garg, B., Moseley-LaRue, R., Moseley, A. R., Smith, A. H., & Zhang, J. (2019). Ozone therapy: a potential therapeutic adjunct for improving female reproductive health. Medical gas research, 9(2), 101–105. https://doi.org/10.4103/2045-9912.260652

Zobel R, Martinec R, Ivanović D, Rošić N, Stančić Z, et al. (2014) Intrauterine ozone administration for Intrauterine ozone administration for improving fertility rate in Simmental cattle improving fertility rate in Simmental cattle. Veterinarski Arhiv 84(1): 1-8.

Publicado

23/08/2020

Cómo citar

MORAIS, J. P.; TIM, C. R. .; ASSIS, L. . Consideraciones sobre el uso de la Ozonoterapia (O3) en el tratamiento de la Endometriosis. Research, Society and Development, [S. l.], v. 9, n. 9, p. e403997616, 2020. DOI: 10.33448/rsd-v9i9.7616. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/7616. Acesso em: 22 nov. 2024.

Número

Sección

Ingenierías