Evaluation of the Efficacy of Ozone Therapy on Liver Tissue in the Treatment of Sepsis in Rats with Cecal Perforation

Abstract

Background and Objectives: Sepsis and its related complications are associated with high morbidity and mortality, often leading to liver damage. Ozone, a molecule with anti-inflammatory and antioxidant properties, may offer protective effects. This study aimed to evaluate the therapeutic and protective impact of ozone on liver injury in a rat model of sepsis induced by cecal ligation and perforation (CLP). Material and Methods: A total of 36 rats were randomly divided into five groups: control (Group C), ozone (Group O), cecal ligation and perforation (Group CLP), ozone + cecal ligation and perforation (Group O+CLP), and cecal ligation and perforation + ozone (Group CLP+O). In the ozone groups, 4 mL of ozone (20 µ/mL) was injected intraperitoneally. Biochemical and histopathological parameters were evaluated in liver tissue samples obtained at the end of 24 h. Results: Polymorphonuclear leukocyte and monocyte infiltration and the total injury score were significantly reduced in the ozone-treated groups compared to the CLP group (p < 0.001). Tumor necrosis factor and interleukin 10 levels in the rat liver tissue were significantly reduced in the O+CLP and CLP+O groups compared to the CLP group, with the O+CLP group showing a more substantial decrease than the CLP+O group (p < 0.001). Thiobarbituric acid reactive substances and glutathione s-transferase levels were significantly lower in the ozone-treated groups compared to the CLP group (p < 0.001). Catalase activity was significantly elevated in the O+CLP group compared to the CLP group (p < 0.001). Serum aspartate transaminase, alanine transaminase, gamma-glutamyl transferase, and total bilirubin were significantly increased in the CLP group and decreased in the ozone-treated groups (p < 0.001, p < 0.001, p = 0.01, p < 0.001 respectively). Conclusions: Administering ozone to rats one hour before the CLP significantly mitigated liver damage, showing a more pronounced effect compared to administering ozone one hour after CLP. The results indicate that ozone could serve a protective function in managing sepsis-induced liver damage.

Keywords: inflammation; oxidative stress; ozone; sepsis.

Figure 1

Micrographs representing the H&E-stained sections of specimens from the control (A,B), ozone (C,D), and CLP (E–H) groups. Black arrow, necrosis; black arrowhead, varying levels of vacuolization in hepatocytes; wavy black arrow, congestion; curved black arrow, interstitial edema. Magnifications are 200× for micrographs (A,C,E,G) and 400× for (B,D,F,H). Stain: H&E.

Figure 2

Micrographs representing the H&E-stained sections of specimens from the CLP (A–D), O+CLP (E,F), and CLP+O (G,H) groups. Black arrow, necrosis; white arrowhead, polymorphonuclear leukocyte and monocyte infiltration; curved black arrow, interstitial edema. Magnifications are 200× for micrographs (A,C,E,G) and 400× for micrographs (B,D,F,H). Stain: H&E.

Figure 3

Micrographs (A,C,E,G,I) represent the IL10 immunostaining intensity of specimens from the control (A), ozone (C), and CLP (E), O+CLP (G), and CLP+O (I) groups. Micrographs (B,D,F,H,J) represent the TNF-α immunostaining intensity of specimens from the control (B), ozone (D), and CLP (F), O+CLP (H), and CLP+O (J) groups. Magnification is 200× for all micrographs.