Changes of the cytokine profile in patients with traumatic synovitis on the background of ozone therapy

Objectives – the cytokine profile research in patients with posttraumatic synovitis during intravenous and intra-articular ozone therapy.

Material and methods. The research involved 69 patients with traumatic knee joint damage complicated by posttraumatic synovitis.

Patients in Group I (35 people) received a traditional treatment. Patients in Group II (34 people) along with the traditional therapy had intravenous injection of 200 ml of ozonated solution of sodium chloride in ozone concentration 2 mg/l once daily for 10 days, and intra-articular injection of 20 ml ozone-oxygen mixture in ozone concentration of 15 mg/l once every second day, in an amount of 5 injections.

During arthroscopy, the lavage of the joint cavity was performed with ozonated saline solution at a concentration of 2.0 mg/l.

The cytokine profile was evaluated by the content of pro-inflammatory cytokines (TNF-á, IL-1â, IL-6, IL-17), regulatory (IL-2), IL-1 receptor antagonist, and anti-inflammatory (IL-4, IL-10) cytokines by solid-phase enzyme immunoassay with peroxidase as an indicator. Statistical analysis of the results was carried out using the Student t-test.

Results. The use of intravenous and intra-articular ozone therapy contributed to synchronous decrease of the levels of pro-inflammatory cytokines with simultaneous reduction of anti-inflammatory mediators of inflammation. TNF-á content decreased by 24.6% (p₂<0.001), IL-17 – by 17.3% (p₂<0.01), IL-6 – by 20.1% (p₂<0.001), IL-1â – by 19.1% (p₂<0.001), IL-2 – by 25.7% (p₂<0.001), IL-1RА – by 24.4% (p₂<0.001), IL-10 – by 21.3%(p₂<0.001), IL-4 – by 25.7% (p₂<0.001) in comparison to traditional treatment.

Conclusion. The complex ozone therapy led to the decrease of inflammation, which was reflected in the depression dynamics of the studied cytokines. These results allow us to evaluate it as an effective treatment method for post-traumatic synovitis which effectively reduces the secondary posttraumatic alteration of tissue structures.