Low Ozone Concentrations Differentially Affect the Structural and Functional Features of Non-Activated and Activated Fibroblasts In Vitro.

Oxygen-ozone (O2-O3) therapy is increasingly applied as a complementary/adjuvant treatment for several diseases; however, the biological mechanisms accounting for the efficacy of low O3 concentrations need further investigations to understand the possibly multiple effects on the different cell types. In this work, we focused our attention on fibroblasts as ubiquitous connective cells playing roles in the body architecture, in the homeostasis of tissue-resident cells, and in many physiological and pathological processes. Using an established human fibroblast cell line as an in vitro model, we adopted a multimodal approach to explore a panel of cell structural and functional features, combining light and electron microscopy, Western blot analysis, real-time quantitative polymerase chain reaction, and multiplex assays for cytokines. The administration of O2-O3 gas mixtures induced multiple effects on fibroblasts, depending on their activation state: in non-activated fibroblasts, O3 stimulated proliferation, formation of cell surface protrusions, antioxidant response, and IL-6 and TGF-ß1 secretion, while in LPS-activated fibroblasts, O3 stimulated only antioxidant response and cytokines secretion. Therefore, the low O3 concentrations used in this study induced activation-like responses in non-activated fibroblasts, whereas in already activated fibroblasts, the cell protective capability was potentiated.

Photooxidation Responsive Elastin-Like Polypeptide Conjugates for Photodynamic Therapy Application.

Stimuli-responsive recombinant elastin-like polypeptides (ELPs) are artificial protein polymers derived from the hydrophobic domain of tropoelastin that have attracted significant interest for drug delivery and tissue engineering applications. In the present study, we have conjugated a photosensitizer (PS) to a hydrophobic methionine-containing ELP scaffold, which upon reaction with singlet oxygen (1O2) is transformed into a hydrophilic sulfoxide derivative facilitating the disassembly of photosensitizer-delivery particles during the photodynamic therapy (PDT) process. A peripherally substituted carboxy-Zn(II)-phthalocyanine derivative (TT1) bearing a carboxyl group directly linked to the Pc-ring, and presenting an absorption maximum around 680 nm, was selected as PS which simultaneously acted as a photooxidation catalyst. A TT1-ELP[M1V3-40] conjugate was prepared from ELP[M1V3-40] modified with an alkyne group at the N-terminal chain end, and from TT1-amide-C3-azide by copper(I)-catalyzed alkyne-azide cycloaddition (CuAAC) reaction. This innovative model photooxidation sensitive PS delivery technology offers promising attributes in terms of temperature-controlled particle formation and oxidation-triggered release, narrow molar mass distribution, reproducibility, scalability, non-immunogenicity, biocompatibility, and biodegradability for pharmaceutical applications in an effort to improve the clinical effectiveness of PDT treatments.

Insights on the mechanisms of action of ozone in the medical therapy against COVID-19.

An increasing amount of reports in the literature is showing that medical ozone (O3) is used, with encouraging results, in treating COVID-19 patients, optimizing pain and symptoms relief, respiratory parameters, inflammatory and coagulation markers and the overall health status, so reducing significantly how much time patients underwent hospitalization and intensive care. To date, aside from mechanisms taking into account the ability of O3 to activate a rapid oxidative stress response, by up-regulating antioxidant and scavenging enzymes, no sound hypothesis was addressed to attempt a synopsis of how O3 should act on COVID-19. The knowledge on how O3 works on inflammation and thrombosis mechanisms is of the utmost importance to make physicians endowed with new guns against SARS-CoV2 pandemic. This review tries to address this issue, so to expand the debate in the scientific community.

Synthesis of Xanthones, Thioxanthones and Acridones by a Metal-Free Photocatalytic Oxidation Using Visible Light and Molecular Oxygen.

9H-Xanthenes, 9H-thioxanthenes and 9,10-dihydroacridines can be easily oxidized to the corresponding xanthones, thioxanthones and acridones, respectively, by a simple photo-oxidation procedure carried out using molecular oxygen as oxidant under the irradiation of visible blue light and in the presence of riboflavin tetraacetate as a metal-free photocatalyst. The obtained yields are high or quantitative.

Combined therapies with exercise, ozone and mesenchymal stem cells improve the expression of HIF1 and SOX9 in the cartilage tissue of rats with knee osteoarthritis.

PURPOSE: Knee osteoarthritis (OA) is a common type of degenerative joint disease which decreases the quality of life. Sex-determining region Y box 9 (SOX9) and hypoxia-inducible factor-1 (HIF1) are considered as the key regulators of OA. We investigated the effect of combined therapies with mesenchymal stem cells (MSCs), ozone (O3) and exercise training on SOX9 and HIF1 expression in the cartilage of rats with knee OA. METHODS: Knee OA was induced by surgical method. OA rats were divided into model, MSCs, ozone, exercise, MSCs + ozone, MSCs + exercise, ozone + exercise and MSCs + ozone + exercise groups. Rats in the MSCs group received intraarticular injection of 1 × 106 cells/kg. Rats in the ozone group received O3 at the concentration of 20 µg/mL, once weekly for 3 weeks. Rats in the exercise group were trained on rodent treadmill three times per week. 48 hours after the programs, cartilage tissues were isolated and the expression of SOX9 and HIF1 was determined using Real-Time PCR. RESULTS: Significant differences were found in the expression of SOX9 and HIF1 between groups (P < 0.0001). Although combined therapies with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 in the cartilage tissue of rats with knee OA, combination of exercise with O3 was significantly more effective compared to the other combined therapies (P < 0.001). CONCLUSIONS: Combined therapy with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 genes in the cartilage of rats with knee OA; however, exercise + O3 was significantly more effective.

Molecular mechanisms in cognitive frailty: potential therapeutic targets for oxygen-ozone treatment.

In the last decade, cognitive frailty has gained great attention from the scientific community. It is characterized by high inflammation and oxidant state, endocrine and metabolic alterations, mitochondria dysfunctions and slowdown in regenerative processes and immune system, with a complex and multifactorial aetiology. Although several treatments are available, challenges regarding the efficacy and the costs persist. Here, we proposed an alternative non-pharmacological, non-side-effect, low cost therapy based on anti-inflammation, antioxidant, regenerative and anti-pathogens properties of ozone, through the activation of several molecular mechanisms (Nrf2-ARE, NF-κB, NFAT, AP-1, HIFα). We highlighted how these specific processes could be implicated in cognitive frailty to identify putative therapeutic targets for its treatment. The oxigen-ozone (O2-O3) therapy has never been tested for cognitive frailty. This work provides thus wide scientific background to build a consistent rationale for testing for the first time this therapy, that could modulate the immune, inflammatory, oxidant, metabolic, endocrine, microbiota and regenerative processes impaired in cognitive frailty. Although insights are needed, the O2-O3 therapy could represent a faster, easier, inexpensive monodomain intervention working in absence of side effects for cognitive frailty.

Clinical isolates of Trichophyton rubrum are completely inhibited by photochemical treatment with a γ-cyclodextrin formulation of curcuminoids.

INTRODUCTION: It was shown previously that dermatophytes can markedly be inhibited by a photochemical treatment with curcumin. This kind of photo-inactivation needs to be improved, however, because curcumin is poorly water-soluble. Therefore, a new water-soluble γ-cyclodextrin formulation of curcuminoids was tested for its photochemical inactivation of Trichophyton (T.) rubrum. MATERIALS AND METHODS: Conidia were harvested from 6 typical strains of T rubrum and used to inoculate wells of microtiter plates. These wells were also filled with a γ-cyclodextrin curcuminoid formulation with 0.1% DMSO and Sabouraud broth. The assays were then irradiated with visible light (wavelength 420 nm, 45 J/cm2 ). After 24 hours, curcuminoid was added once more, and irradiation was repeated. Fungal growth was monitored photometrically for 8 days and compared with controls. RESULTS: Growth of all 6 T rubrum strains was completely inhibited by the photochemical treatment with the γ-cyclodextrin formulation of curcuminoids. The same curcuminoid formulation applied without irradiation had only a minor inhibitory effect. DISCUSSION: Photo-inactivation of dermatophytes with a γ-cyclodextrin formulation of curcuminoids plus visible light is a very promising procedure with potential for a new treatment of patients with superficial tinea.

Ozone and pulsed electro-magnetic field therapies improve endometrial lining thickness in frozen embryo transfer cycles: Three case reports.

RATIONALE: In assisted reproductive technology, a persistently thin endometrial lining represents a huge challenge during frozen embryo transfer (FET) cycles. PATIENT CONCERNS: Three patients who had a persistently thin endometrial lining despite the use of several medical agents known to improve endometrial lining thickness. DIAGNOSES: Infertility undergoing FET cycles. INTERVENTIONS: A combination of transdermal and intravaginal ozone therapy along with Pulsed Electro-Magnetic Field (PEMF) therapy. OUTCOMES: Ozone with PEMF, both of which are known to have vasodilatatory, anti-inflammatory, and anti-oxidant actions, were successful in improving the thickness of the endometrial lining in all 3 patients. Two out of 3 patients became pregnant following single embryo transfer. LESSONS: Ozone with PEMF constitute a novel experimental approach for women with persistently thin endometrial lining undergoing FET. This novel approach needs validation by large well-designed studies.

Inactivation of Poliovirus by Ozone and the Impact of Ozone on the Viral Genome.

OBJECTIVE: To investigate the mechanisms underlying ozone-induced inactivation of poliovirus type 1 (PV1). METHODS: We used cell culture, long-overlapping RT-PCR, and spot hybridization assays to verify and accurately locate the sites of action of ozone that cause PV1 inactivation. We also employed recombinant viral genome RNA infection models to confirm our observations. RESULTS: Our results indicated that ozone inactivated PV1 primarily by disrupting the 5'-non-coding region (5'-NCR) of the PV1 genome. Further study revealed that ozone specifically damaged the 80-124 nucleotide (nt) region in the 5'-NCR. Recombinant viral genome RNA infection models confirmed that PV1 lacking this region was non-infectious. CONCLUSION: In this study, we not only elucidated the mechanisms by which ozone induces PV1 inactivation but also determined that the 80-124 nt region in the 5'-NCR is targeted by ozone to achieve this inactivation.

Untargeted GC-TOFMS-based cellular metabolism analysis to evaluate ozone degradation effect of deoxynivalenol.

Ozone plays an increasingly important role in food processing for its antimicrobial ability and degradation effects on mycotoxins. The mycotoxin deoxynivalenol (DON) was treated with saturated aqueous ozone for different amounts of time, and by-products were collected for compounds annotation and cytotoxicity evaluation. To investigate the cytotoxicity of ozone degradation by-products, untargeted GC-TOFMS-based metabolomics were utilized. Caco-2 cells were dosed with 0.1 µg/mL DON and saturated aqueous ozone-treated DON (treatment time: 1 min, 3 min, 5 min) for 24 h followed by cytotoxicity tests (cell viability assay, ROS assay, and apoptosis assay), and intracellular metabolic analysis. Cytotoxicity test results revealed that ozone treatment could degrade DON structure; however, its degradation products and cellular toxicity existed under different treatment time of ozone. Metabolomics analysis indicated that ozone-treated DON degradation products weakened DON-induced metabolic disorder, such as purines-related nucleotide metabolism; Krebs cycle-related fuel and energy metabolism; and lipid, alkaloid and amino acid metabolism. By contrast, the catecholamine pathway, which is related to latent inflammation and oxidative stress effects, was unaltered in the ozone-treated DON group, indicating that the potential cytotoxicity still existed. These findings provide a comprehensive safety evaluation for ozone-treated DON in vitro and propose a new strategy for studying the effects of ozone-treated food.

Efficacy of Ozone and Selenium Therapy for Alcoholic Liver Injury: An Experimental Model.

BACKGROUND/AIM: Alcoholic liver disease is an important health problem which is reversible during early stages of liver damage, but becomes permanent with time. Nowadays, many studies focus on various agents that prevent, reduce or slow the progression of the toxic effects of alcohol. In our study, we investigated the efficiency of ozone and selenium against oxidative damage in a model of alcohol-induced liver damage. MATERIALS AND METHODS: Forty-eight female Wistar Albino rats between 4 and 6 months of age and weighing 190-250 g were included in the study and were used as models of alcohol liver damage. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum and tissue total oxidant levels, serum and tissue total antioxidant levels, and the histopathological evaluation of the liver were performed in 8 groups. RESULTS: In the statistical analysis, it was observed that ozone and/or selenium therapies decreased the AST levels. Total oxidant and antioxidant serum levels were found to vary in serum and tissue. Ozone and/or selenium therapies decreased liver damage, according to histopathological findings. CONCLUSION: Through ozone and/or selenium therapies, less damage was observed histopathologically compared to the alcohol group. It is thought that the results of our study can be used in individual treatments following confirmation of liver damage in alcoholic patients.

Contrasting roles of oxidized lipids in modulating membrane microdomains.

Lipid rafts display a lateral heterogeneity forming membrane microdomains that hold a fundamental role on biological membranes and are indispensable to physiological functions of cells. Oxidative stress in cellular environments may cause lipid oxidation, changing membrane composition and organization, thus implying in effects in cell signaling and even loss of homeostasis. The individual contribution of oxidized lipid species to the formation or disruption of lipid rafts in membranes still remains unknown. Here, we investigate the role of different structures of oxidized phospholipids on rafts microdomains by carefully controlling the membrane composition. Our experimental approach based on fluorescence microscopy of giant unilamellar vesicles (GUV) enables the direct visualization of the impact of hydroperoxidized POPC lipid (referred to as POPCOOH) and shortened chain lipid PazePC (1-palmitoyl-2-azelaoyl-sn-glycero-3-phosphocholine) on phase separation. We found that the molecular structure of oxidized lipid is of paramount importance on lipid mixing and/or demixing. The hydrophobic mismatch promoted by POPCOOH coupled to its cylindrical molecular shape favor microdomains formation. In contrast, the conical shape of PazePC causes disarrangement of lipid 2D organized platforms. Our findings contribute to better unraveling how oxidized phospholipids can trigger formation or disruption of lipid rafts. As a consequence, phospholipid oxidation may indirectly affect association or dissociation of key biomolecules in the rafts thus altering cell signaling and homeostasis.

Survival of Listeria innocua on Fuji apples under commercial cold storage with or without low dose continuous ozone gaseous.

This study evaluated the fate of Listeria innocua, a non-pathogenic species closely related to Listeria monocytogenes, on Fuji apple fruit surfaces during commercial cold storage with and without continuous low doses of gaseous ozone. Unwaxed Fuji apples of commercially acceptable maturity were inoculated with 6.0-7.0 Log10 CFU L. innocua/apple, and subjected to refrigerated air (RA, 33 °F), controlled atmosphere (CA, 33 °F, 2% O2, 1% CO2), or CA with low doses of ozone gas (50.0 -87.0 ppb ) storage in a commercial facility for 30 weeks. A set of uninoculated apples was simultaneously subjected to the above storage conditions for total plate count and yeasts and molds enumeration. L. innocua survival under RA and CA storage was similar, which led to 2.5-3.0 Log10 CFU/apple reduction during storage. Continuous gaseous ozone application decreased L. innocua population on Fuji apples to ∼1.0 Log10 CFU/apple after 30-week storage, and suppressed apple native flora. CA storage delayed apple fruit ripening through reduction of apple firmness and titratable acidity loss, and low dose gaseous ozone application had no negative influence on apple visual quality, including both external and internal disorders. In summary, L. innocua decreased on Fuji apple surfaces during commercial long-term RA and CA storage. Ozone gas has the potential to be used as a supplemental intervention method to control Listeria spp. and to ensure fresh apple safety.

Ozone therapy ameliorates inflammation and endometrial injury in rats with pelvic inflammatory disease.

As a common cause of infertility, pelvic inflammatory disease (PID) is characterized by chronic pain, ectopic pregnancy as well as inflammation and infection of the female upper genital tract. Ozone water, also known as O3, has been previously reported to be a distinctly effective agent in treating inflammation. During the present study, we asserted the hypothesis that O3 could be applied by pelvic inflammation and works to regulate the expression of inflammatory factors including interleukin-6 (IL-6), IL-2 and tumor necrosis factor-α (TNF-α). In an attempt to evaluate the effect of O3 on PID, an acute PID rat model was subsequently established. O3 at concentrations of 45 µg/mL and 60 µg/mL in addition to levofloxacin (LVLX) was injected respectively into the PID rats in a bid to alter the contents of inflammatory factors and immunologic markers. Hematoxylin-eosin (HE) staining was applied to analyze endometrial inflammation. Reductions to the contents of IL-6 and TNF-α were recorded, while that of IL-2, IgA, IgG, IgM, C3 and C4, and E rosette formation rate and transformation rate of T lymphocytes exhibited notably elevated levels after the PID rats had been injected with 45 µg/mL O3, 60 µg/mL O3 or LVLX. The pathological condition of the endometrium in rats with PID was alleviated among the PID rats after injected with the 45 µg/mL O3, 60 µg/mL O3 or LVLX. Taken together, the key findings of the current study present evidence demonstrating that the administration of O3 to the pelvic cavity ameliorated the PID conditions among rat models via inhibition of the necrosis of the endometrial epithelial cells as well as alleviated the inflammatory reactions, highlighting a potential novel PID treatment target.

Short-Term Exposure to Nitrogen Dioxide Provides Basal Pathogen Resistance.

Nitrogen dioxide (NO2) forms in plants under stress conditions, but little is known about its physiological functions. Here, we explored the physiological functions of NO2 in plant cells using short-term fumigation of Arabidopsis (Arabidopsis thaliana) for 1 h with 10 µL L-1 NO2. Although leaf symptoms were absent, the expression of genes related to pathogen resistance was induced. Fumigated plants developed basal disease resistance, or pattern-triggered immunity, against the necrotrophic fungus Botrytis cinerea and the hemibiotrophic bacterium Pseudomonas syringae Functional salicylic acid and jasmonic acid (JA) signaling pathways were both required for the full expression of NO2-induced resistance against B. cinerea An early peak of salicylic acid accumulation immediately after NO2 exposure was followed by a transient accumulation of oxophytodienoic acid. The simultaneous NO2-induced expression of genes involved in jasmonate biosynthesis and jasmonate catabolism resulted in the complete suppression of JA and JA-isoleucine (JA-Ile) accumulation, which was accompanied by a rise in the levels of their catabolic intermediates 12-OH-JA, 12-OH-JA-Ile, and 12-COOH-JA-Ile. NO2-treated plants emitted the volatile monoterpene α-pinene and the sesquiterpene longifolene (syn. junipene), which could function in signaling or direct defense against pathogens. NO2-triggered B. cinerea resistance was dependent on enhanced early callose deposition and CYTOCHROME P450 79B2 (CYP79B2), CYP79B3, and PHYTOALEXIN DEFICIENT3 gene functions but independent of camalexin, CYP81F2, and 4-OH-indol-3-ylmethylglucosinolate derivatives. In sum, exogenous NO2 triggers basal pathogen resistance, pointing to a possible role for endogenous NO2 in defense signaling. Additionally, this study revealed the involvement of jasmonate catabolism and volatiles in pathogen immunity.

Methyl jasmonate and ozone affect the antioxidant system and the quality of wine grape during postharvest partial dehydration.

Postharvest partial dehydration is a technique used in the production of important dry and sweet wines in Italy. An accurate management of the dehydration environmental parameters allows for the modulation of berry metabolism and the maintenance/improvement of the enochemical quality of grapes. As it is known that water loss induces oxidative processes in berries, our hypothesis was that methyl jasmonate (MeJA) and ozone (O3), as postharvest treatments before partial dehydration, might be beneficial for grape berry quality. Grape bunches were postharvest treated with 10 or 100 µM MeJA at 20 °C or with ozone gas at 10 °C, in 70% relative humidity (RH) and air flow, for 12 h; the control bunches were untreated and kept at 20 °C for 12 h. Subsequently, partial dehydration was performed at 10 °C until a 30% weight loss (w.l.) was reached. MeJA hastened grape berry water loss. Polyphenol and flavonoid contents at the end of the partial dehydration were lower in the MeJA-treated berries than in the control and ozone samples. Superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), and guaiacol peroxidase (GPX) activity rates increased in the treated samples. In contrast, lipoxygenase (LOX) and polyphenoloxidase (PPO) had lower activities in the MeJA-treated samples than in the controls. It would seem that MeJA accelerates grape water loss but at the same time activates the antioxidant system. Ozone does not accelerate grape water loss but induces the antioxidant system and increases polyphenol content.

The Value of Ozone in CT-Guided Drainage of Multiloculated Pyogenic Liver Abscesses: A Randomized Controlled Study.

Objective: This study was designed to compare the effects of catheter drainage alone and combined with ozone in the management of multiloculated pyogenic liver abscess (PLA). Methods: The prospective study included 60 patients diagnosed with multiloculated PLA. All patients were randomly divided into two groups: catheter drainage alone (group I) and catheter drainage combined with ozone (group II). Drainage was considered successful when (1) the abscess cavity was drained and (2) clinical symptoms were resolved. Kruskal-Wallis nonparametric test was used to compare the success rates, length of stay (LOS), and need for further surgery of the two groups. P < 0.05 indicates significant difference. Results: All patients' catheters were successfully placed under CT guidance. Group I was treated with catheters alone and group II was treated with catheters and ozone. The success rates of groups I and II were 86% and 96%, respectively (P < 0.05). And compared with group II, the duration of fever in group I was longer (P < 0.05), and the LOS was also longer (P < 0.05). Conclusion: Catheter drainage combined with ozone is an effective and safe treatment in multiloculated PLA. The Clinical Registration Number is ChiCTR1800014865.

In vitro study evaluating the instantaneous treatment of ozonised olive oil on human sperm.

OBJECTIVE: The aim of our study was to evaluate the effects of ozonised olive oil (OOO) on human sperm in vitro. METHODS: Human sperm was incubated with OOO for 20 s in vitro. The lowest concentration that completely immobilised all the sperm in 20 s without subsequent recovery of motility was recorded as the minimum effective concentration (MEC). The effects of OOO at MEC on human sperm viability, mitochondrial and acrosomal status, DNA integrity and transmission electron microscopy were observed. RESULTS: Our findings demonstrate that OOO dose-dependently inhibits sperm motility. The MEC of OOO for 100% sperm immobilisation in 20 s was 6 µg/ml. Further experiments showed that sperm ultrastructure, function and DNA integrity were significantly affected after treatment with 6 µg/ml OOO in vitro. CONCLUSIONS: OOO has spermicidal potential and may be explored as a promising vaginal contraceptive agent.

Maternal exposure to NO2 enhances airway sensitivity to allergens in BALB/c mice through the JAK-STAT6 pathway.

Previous studies have indicated that nitrogen dioxide (NO2) exposure could increase airway sensitivity to allergens for children. Recently, fetal stress was proposed as a crucial factor for allergic airway response occurring in offspring. Considering that there is inadequate evidence linking maternal NO2 exposure to offspring airway sensitivity to allergens, pregnant Balb/c mice were exposed daily to 2.5 ppm NO2 throughout the gestation period; then, the offspring were challenged to an allergen (ovalbumin, OVA) to evaluate airway sensitivity. For air + saline group and air + OVA group, offspring mice were maternally exposed to clean air followed by treatment with saline and OVA, respectively, in adulthood. For NO2 + saline group and NO2 + OVA group, offspring mice were maternally exposed to NO2 followed by treatment with saline and OVA, respectively, in adulthood. The results showed that maternal NO2 exposure increased the level of OVA-immunoglobulin (Ig) E in serum and caused airway hyper-responsiveness and pathological changes in offspring. Furthermore, maternal NO2 exposure altered the expression of pro-inflammatory factors and impaired the T helper (Th) 1/Th2 balance. In addition, janus kinase)-signal transducer and activator of transcription 6 pathway participated in OVA-induced airway sensitivity of offspring. Our study showed that the potential risk of airway sensitivity to allergens in offspring is enhanced by maternal NO2 exposure and proposed a possible mechanism for preventing, alleviating, and evaluating the outcomes in polluted environments.

The efficacy of ozone therapy in neonatal rats with hypoxic ischemic brain injury.

OBJECTIVES: This study is aimed to determine the effect of ozone therapy in neonatal rats with experimentally induced hypoxic ischemic brain injury (HIBI). METHODS: The study included 7-d-old male Wistar rats that were randomized to the sham, control, ozone 1, and ozone 2 groups. All rats except those in the sham group were kept in a hypoxia chamber, and then the rats in the control group were given 0.5 mL of saline. Those in the ozone 1 group were given ozone 1 mg kg-1 intraperitoneally, and those in the ozone 2 group were given ozone 2 mg kg-1 intraperitoneally. RESULTS: There were significantly fewer apoptotic neurons in the right hemispheres of the rats in the ozone 1 and ozone 2 groups than in the control group (p < 0.001 and p < 0.001, respectively). There were significantly fewer apoptotic neurons in the right hemispheres of the rats in the ozone 2 group than in the ozone 1 group (p < 0.001). Morris Water Maze (MWM) test results were similar in the ozone 2 and sham groups. CONCLUSIONS: The present study's findings show that ozone therapy reduced neuronal apoptosis and improved cognitive function in neonatal rats with experimentally induced HIBI (Tab. 2, Ref. 30).