Major Ozonated Autohemotherapy Preconditioning Ameliorates Kidney Ischemia-Reperfusion Injury

Medical ozone has therapeutic properties as an antimicrobial, anti-inflammatory, modulator of antioxidant defense system. Major ozonated autohemotherapy (MOA) is a new therapeutic approach that is widely used in the treatment of many diseases. The objective of the present study was to determine whether preischemic application of MOAwould attenuate renal ischemia-reperfusion injury (IRI) in rabbits. Twenty-four male New Zealand white rabbits were divided into four groups, each including six animals: (1) Sham-operated group, (2) Ozone group (the MOA group without IRI), (3) IR group (60 min ischemia followed by 24 h reperfusion),and(4)IR+MOAgroup(MOAgroup).TheeffectsofMOAwereexaminedbyuseofhematologic and biochemical parameters consisting of neutrophil to lymphocyte ratio (NLR), interleukin-6 (IL-6), tumor necrosisfactor-α(TNF-α),ischemia-modifiedalbumin(IMA),totalantioxidantstatus(TAS),totaloxidantstatus (TOS), and oxidative stress index (OSI). In addition, the histopathological changes including the tubular brush border loss (TBBL), tubular cast (TC), tubular necrosis (TN), intertubular hemorrhage and congestion (IHC), dilatationofbowmanspace(DBS),andinterstitialinflammatorycellsinfiltration(IECI)wereevaluated.IntheIR group, compared to the Sham group, biochemical parameters indicating oxidative stress, NLR, IL-6, TNF-α, IMA, TOS, and OSI have increased. MOA reduced inflammation and oxidative stress parameters. Although TASvalueshavedecreasedintheIRgroupandincreasedintheMOA-pretreatedgroup,nosignificantchangesin TAS values were detected between the IR and MOA groups. The total score was obtained by summing all the scores from morphological kidney damage markers. The total score has increased with IR damage when compared with the Sham group (13.83 ± 4.30 vs 1.51 ± 1.71; p=0.002). But, the total score has decreased significantly after application of MOA (5.01 ± 1.49; p=0.002; compared with the IR group). MOA precondi- tioningiseffectiveinreducingtissuedamageinducedinkidneyischemia-reperfusioninjury.Theprotectiveeffect of MOA is mediated via reducing inflammatory response and regulating of reactive oxygen species (ROS). Renal histology also showed convincing evidence regarding MOA's protective nature against kidney injury induced renal ischemia-reperfusion. Consequently, MOA might be helpful in protecting the kidneys from IR- induced damage in humans, probably through the anti-inflammatory effect and reducing the total oxidant status.