Possible Mechanisms
of Viral Inactivation by Ozone

by Gérard V. Sunnen, M.D.

This is an addendum to a February/March 1994
article on Ozone in Medicine.


The inactivation of viral particles by ozone may take place by a variety of mechanisms which range from direct physico-chemical effects to more indirect immunological pathways. Virions coated by a lipid glycoprotein envelope such as rectoviruses, hepatitis B and C, Herpes 1 and 2, and Epstein-Barr among others, are vulnerable to the influence of ozone by its intense oxidizing properties,

In retroviruses for example, which possess a glycolipid encapsulation, ozone confronts the double bond sites in its matrix thus destroying its architecture. Without its envelope, the virus perishes.(60) In virions which lack a lipid envelope but whose nucleic acids are surrounded by a protein capsid such as those of the minovirus family, ozone may diffuse through the protein coating and deform or cleave the genome core. Viruses, unlike cells, lack enzymes designed to repair injured DNA or RNA, and are incapacitated by this process.

In major autohemotherapy, relatively large amounts of blood are treated with ozone, then reinfused into the patient. The dosage and concentration of ozone administered is carefully calibrated so that maximal antiviral action is mobilized while at the same time sparing the integrity and viability of the cellular elements. Viruses are small, denuded of complex defenses,(63) and vulnerable to the oxidative challenge of ozone. Cells, in contrast, are large and incorporate a multiplicity of homeostatic mechanisms. There are developing technologies which are designed to treat whole blood in a manner similar to the dialysis process.

In the case of retroviral infection, it is extracellular viral particles which are presumably most affected by ozone oxidation. Intracellular virions or provirions on the other hand, were thought to be relatively spared of destruction by ozone by the barrier of cellular membranes, the buffer of cytoplasmic constituents, and by the refuge provided by their incorporation into the genome of the host cell. However, it has been demonstrated that ozone possesses the capacity to inactivate intracellular virions as well.(64)

Major autohemotherapy, repeatedly administered, could thus exert a culling action on circulating virions, especially during phases of the viral life cycle associated with viral seeding in the general circulation, the so-called viremic episodes. Studies attempting to measure the efficacy of this treatment modality should take into account the patient's clinical status as it relates to the cycle phase of viral activity at the time of the therapeutic intervention.

Immunological mechanisms may be invoked through several pathways. In minor autohemotherapy, a small amount of blood is ozone-treated in such a manner as to fragment most virions without regard to preserving cellular elements. This treated blood, injected intramuscularly, carries fragments of viral envelope and nucleic acids which find their way into the general circulation and to the immune network. The latter, if still relatively operational, begins to manufacture appropriate antibodies which in turn, serve to counter the evolution of the infection.

The interesting feature of this technique is that antibodies thus manufactured are individualized to the particular patient receiving the treatment, since they are derived from their own viral stock, In view of the high mutability of retroviruses, each patient carries a unique viral strain. Minor autohemotherapy can thus be conceptualized as a method of autovaccination providing a high degree of antibody specificity.

A non-invasive and increasingly popular method of oxygen/ozone administration, the so-called "Sauna bag" method, does not involve heat, but consists of enclosing the patient up to the shoulders with a comfortable ozone-resistant plastic cover. An oxygen/ozone mixture is introduced in the bag, and' the patient allows it to interface with the entire skin surface for a few minutes. Surprisingly, the mixture is able to penetrate far enough into the capillary networks to raise blood oxygen pressure. Presumably then, ozone is able to exert its biochemical influence. The added advantage in this technique is that superficial skin conditions amenable to antiseptic influence are addressed. As with all ozone therapies, gas mixture concentration and duration of exposure need to be clinically adjusted and monitored.

In recent years, it has been discovered that nitric oxide, a gas under atmospheric conditions traditionally associated with toxicity, actually exerts essential biological functions. It has a free radical structure, is short-lived, and is an eager electron contributor. Aside from its activity as a neurotransmitter and as an antihypertensive agent, nitric oxide appears to be an essential component of the mechanisms by which macrophages become activated to destroy tumor cells, bacteria and viruses. Macrophages, scavenger components of the immune network, become activated by creating minuscule amounts of nitric oxide using arginine as a substrate and the enzyme nitric oxide synthase. Without nitrid oxide, macrophages remain idle. It has also been shown that nitric oxide is directly toxic to tumor cells.(62)

It may be theorized that ozone with the mobilization of its own free radical structure could facilitate the elaboration of nitric oxide in macrophages, thus promoting their scavenging mission.

In January 1994, the first Phase 1 (human) clinical trial of ozone therapy will be conducted at 5 major University centers in Italy. It will involve 300 volunteers, will be conducted according to FDA-approved protocols, and will test the effectiveness of major auto-hemotherapy in AIDS and Hepatitis B. The scientific community is eagerly awaiting the data generated by this breakthrough study.

Ozone's interactions with biological systems and its activities in pathogen inactivation are varied, complex, and to a large extent still largely unknown. The recent discoveries that nitne oxide and carBon monoxide(61)(62) assume crucial functions in regulating metabolic and physiological health, may give new reasearch impetus to the investigation of the therapeutic properties of ozone.

Gérard V. Sunnen, M.D, 200 East 33rd St. #26J New York, NY 10016 212-679-0679

Editor's Comment: The original article "Ozone in Medicine" (Feb/Mar 1994 TLfD) was previously published in the Journal o Advancement in Medicine (1988).


    60. Wells K, Latino J, Gavalchin J, Poiesz B: Inactivation of Human lmmunodeficiency Virus Type 1 by Ozone in vitro. Blood. Oct. 1, 1991;78(7):1882-1890.

    61. Verma A, Hirsch D, Glatt C, Ronnett G, Snyder S: Carbon Monoxide: A Putative Neural Messenger. Science. 15 Jan 1993:259(5093):381-384.

    62. Snyder S. Bredt D: Biological Role of Nitric Oxide. Scientific American. May 1992;266(5):68-77.

    63. Evans E. ed: Viral Infections of Humans. 1991. 3rd Edition. Plenum Medical book Company. New York and London.

    64.Baggs A: Are Worry-free Transfusions Just a Whiff of Ozone Away? Can Med Assoc J. 1993:148(7):1156-1160

    65.Carpendale M, Griffiss J: Is There a Role for Medical Ozone in the Treatment of HIV and Associated Infections? Proceedings, Eleventh Ozone World Congress, San Francisco, 1993.


Gérard V. Sunnen M.D.
200 East 33rd St.
New York, NY 10016
212/679-0679 (voice)
212-679-8008 (fax)