Methotrexate+Medical Ozone combined therapy in Rheumatoid Arthritis. From experimental models to clinical trials [abstract]

Resumo

INTRODUCTION: The aim of this work has been to investigate the medical ozone effects on 2 experimental models: PG/PS induced RA and synovitis followed for a clinical trial of efficacy. METHODS: mRNA levels of TNF-alpha and IL-1 beta, injury and protective biomarker of oxidative stress, morphology studies, A1 adenosine receptor role, Anti-Cyclic Citrullinated (Anti-CCP) levels and clinical variables were determined. RESULTS: Medical ozone ameliorated the expression of proinflammatory cytoquines, reduced oxidative damage while participation of A1 adenosine receptor in the antiinflammatory effects was demonstrated. In RA patients (n=60) MTX + ozone reduced the activity of the disease while MTX merely showed a tendency to decrease it. MTX + ozone reduced Anti-CCP levels as well as increased antioxidant system, and decreased oxidative damage whereas MTX did not change. CONCLUSIONS: Medical ozone was effective in the reduction of inflammatory response in 2 experimental studies. MTX + ozone increased the MTX clinical efficacy in RA patients. These results suggest that ozone can increase the efficacy of MTX probably because both share common therapeutic targets.