Ozone therapy — method of improving body state at tissue level. Application in medicine and b combination with sanatorium treatment in Crimea (review)

In medicine, the current method of treatment of various pathologies — ozone therapy is gaining popularity. On the basis of modern literary data, the advantage of the use of ozone therapy in the complex treatment of certain diseases has been shown, as well as the main contraindications have been identified. The main task of ozone therapy is to improve tissue circulation, as well as to promote better supply of oxygen to cells, which has a positive effect and accelerates tissue regeneration. It has been found that ozone therapy is widespread in more than ten sanatoriums of the Republic of Crimea. Data on the use of ozone therapy in some sanatoriums of Crimea, such as “Sanatorium Kirov”, “Poltava Crimea”, “Tavria”, in sanatorium named after N. I. Pyrogov, “Slavutich”, “Mishor”, “Ai-Petri” and hotel complex “Yalta-Inturist” are presented. The review describes possible methods of ozone therapy, as well as some peculiarities of ozone use in sanatorium treatment.

Mechanical Circulatory Assist Devices

Mechanical circulatory assist devices (MCADs) are used in patients with decompensated heart failure refractory to medical therapy. The devices are used as a bridge to transplant, as a bridge to recovery for reversible conditions, as a bridge to decision while a patient’s eligibility for transplant is determined, and as destination therapy to support left-sided heart function when a patient is not eligible for transplant. MCADs restore tissue circulation by increasing blood flow and, thereby, improving organ function.

Pathophysiologic Aspects of Soft Tissue Microcirculation in the Zone of Long Bones Pseudarthrosis

Thirty four patients with delayed consolidating fractures and long bones pseudarthrosis and 30 healthy individuals (control group) were examined using laser Doppler flowmetry and computed thermography. It was shown that during the osteogenesis process no isolated changes in bone circulation took place but the potentialities of blood flow in the extremity segment as a whole were mobilized. Important role of bone surrounding soft tissue circulation for provision of adequate osteogenesis was confirmed. In case of pseudarthrosis formation microcirculation system, especially its nutrient part, responded «keenly» to the changes in regional metabolism and bone regeneration. That stipulated diagnostic and prognostic importance of soft tissue microhemocirculation study in the zone of pseudarthrosis. Preoperative functional examination of soft tissue circulation enabled to determine risk group for nonconsolidation ordelayed consolidation of fractures. For better result special treatment tactics can be used (osteogenesis stimulators, free vascularized autografts, etc.).

ATP Release from Red Blood Cells Is Regulated by a Negative Feedback Pathway where ADP Acts on P2Y13 Receptors.

Background: Red blood cells regulate tissue circulation and O2 delivery by releasing the vasodilator adenosine triphosphate (ATP) in response to hypoxia. When released extracellularly, ATP is rapidly degraded to adenosine diphosphate (ADP) in the circulation by ectonucleotidases. ATP and ADP activate subtypes of the large P2 receptor family (15 subtypes). Here we show that ADP acting on P2Y13 receptors on red blood cells serves as a negative feedback pathway for the inhibition of ATP release. Methods: mRNA was quantified with real-time PCR. Western blot was used to detect P2 receptors with available antibodies. cAMP levels were determined with an enzyme immunoassay. ATP release was measured in incubated red blood cells using microdialysis and a luciferase assay. In a pig model, catheters were inserted through the carotid artery to place a catheter in the left coronary artery, and through the jugular vein to place a microdialysis probe in the coronary vein. 2-MeSADP was injected in the artery and ATP levels were measured in the coronary vein. Results: mRNA of the ADP receptor P2Y13 was highly expressed in human red blood cells and reticulocytes, whilst other ADP receptors were not (Fig.1). Figure Figure The stable ADP analogue 2-MeSADP decreased ATP release from red blood cells by inhibition of cAMP. The P2Y12 and P2Y13 receptor antagonist AR-C67085 (30 mM), but not the P2Y1 blocker MRS2179, inhibited the effects of 2-MeSADP. At doses where AR-C67085 only blocks P2Y12 (100 nM), it had no effect. AR-C67085 and the nucleotidase apyrase increased cAMP per se, indicating a constant cAMP inhibitory effect of endogenous extracellular ADP. 2-MeSADP reduced plasma ATP concentrations in an in vivo pig model. Furthermore, a missense polymorphism in the coding region of P2Y13 has been found that is in total disequilibrium with 5 polymorphisms in P2Y12 (the important ADP receptor in platelets) forming a haplotype that could contribute to vascular disease. Conclusion: Our results show that P2Y13 is selectively expressed in human red blood cells. The ATP degradation product ADP inhibited ATP release by acting on this receptor. This negative feedback system could be important in the control of plasma ATP levels and tissue circulation. Because blood consists of approximately 40% red blood cells, containing a 1000-fold higher ATP concentration than plasma (mM vs. uM), even a minor release of ATP from the high intracellular concentrations could have major circulatory effects. A negative system may therefore be of great physiological importance to mitigate ATP release. In addition, this finding could be of interest for efforts to preserve intracellular ATP in red blood cells during storage.