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To the Editor-in-Chief of International Journal of Impotence Research

International Journal of Impotence Research volume 33, pages 568–569 (2021)Cite this article

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I read with care the recent article from Colakerol et al. entitled “Effects of ozone treatment on penile erection capacity and nitric oxide synthase levels in diabetic rats” [1]. This interesting paper shows the effects of intraperitoneal ozone treatment on functional and biochemical changes in corpus cavernosum of streptozotocin-induced diabetic rats. I would like to comment on some aspects related to ozone treatment. In fact, the Authors report “a 60 μL/mL (97% O2–3% O3) gas mixture was administered intraperitoneally with a 25G injector everyday for 2 weeks”. At a non-superficial reading, the lack of the overall volume administered and the unusual indication of the concentration of ozone immediately catches the eye. These aspects are very important if we consider the particular nature of ozone as a biologically active substance. For clarity’s sake, ozone does not act through traditional drug–receptor interactions. When it is administered in the gaseous form, ozone cannot directly transmit chemical signals able to induce physiological or biochemical changes because of its extreme reactivity. Moreover, ozone cannot be considered a pro-drug in the common sense of the term. In fact, pro-drugs are biologically inactive molecules that, once introduced into the body, require chemical transformations, generally of enzymatic nature, for activation. So, ozone can be classified as an effector molecule generator. Depending on method of administration, administration site, appropriateness of dosage as well as derivative formulations, as a rule, small molecules both hydrophilic (mainly hydrogen peroxide) and lipophilic (mainly alkenals) will be produced. Such small molecules selectively interact with host biological activity, modulating enzyme activity, gene expression and/or cellular signals, including the production of NO [2, 3].

The possibility of dealing with ozone in the gaseous state mixed with another gas (namely, medical oxygen) leads to clarify some aspects of expression modalities of concentrations units [4].

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References

  1. Colakerol A, Temiz MZ, Tavukcu HH, Aikan S, Ozsoy S, Sahan A, et al. Effects of ozone treatment on penile erection capacity and nitric oxide synthase levels in diabetic rats. Int J Impot Res. 2020. https://doi.org/10.1038/s41443-020-0301-1.

  2. Zanardi I, Borrelli E, Valacchi G, Travagli V, Bocci V. Ozone: a multifaceted molecule with unexpected therapeutic activity. Curr Med Chem. 2016;23:304–14.

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  5. Rakness K, Gordon G, Langlais B, Masschelein W, Matsumoto N, Richard Y, et al. Guideline for measurement of ozone concentration in the process gas from an ozone generator. Ozone Sci Eng. 1996;18:209–29.

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  1. Department of Biotechnology, Chemistry and Pharmacy – Department of National Excellence 2018-2022, Viale Aldo Moro 2, 53100, Siena, Italy

    Valter Travagli

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Correspondence to Valter Travagli.

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Travagli, V. To the Editor-in-Chief of International Journal of Impotence Research. Int J Impot Res 33, 568–569 (2021). https://doi.org/10.1038/s41443-020-0334-5

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